NEW YORK (Reuters Health) – Photoselective vaporization of the prostate (PVP) offers similar efficacy with better quality of life, compared with transurethral resection of the prostate (TURP), in men with benign prostatic hyperplasia (BPH), researchers from Italy report.
“The most impressive result is the full satisfaction, in terms of symptoms, sexual function, and most importantly, return to normal life, for patients undergoing PVP,” Dr. Giorgio I. Russo from University of Catania, in Italy, told Reuters Health by email.
The previously published GOLIATH trial showed that PVP yielded a better International Prostate Symptoms Score (IPSS) and peak flow, as well as fewer complications, compared with TURP, after 2 years of follow-up in men with benign prostatic obstruction.
In the current study, Dr. Russo and colleagues compared PVP with TURP using the BPH6 tool in 55 propensity score-matched pairs of men with BPH. The BPH6 accounts for relief of lower urinary tract symptoms (LUTS), recovery experience, erectile function, ejaculatory function, continence, and safety.
Postoperative catheterization time was more than 3 days shorter after PVP than after TURP (mean, 1.25 vs. 4.67 days), whereas the two groups did not differ significantly in IPSS, Sexual Health Inventory for Men, or peak-flow improvements.
At 1 year, significantly more men in the PVP group (45.6%) than in the TURP group (18.2%) satisfied all six BPH6 improvement criteria, according to the August 17 International Journal of Impotence Research online report.
Among the BPH6 individual components, PVP significantly outperformed TURP with regard to recovery, ejaculatory function, and safety.
In multivariate analysis, PVP was independently associated with significantly greater odds of achieving all six BPH6 endpoints.
“Both procedures are similarly effective when accounting for LUTS parameters, such as IPSS and peak-flow improvement, but when taking into account other quality-of-life issues, PVP seems to be superior,” Dr. Russo concluded. “In particular, PVP is associated with less pain after surgery, better ejaculation, and return to normal life.”
Dr. Russo added that, in his view, PVP should become the standard of care for men with BPH-related LUTS.
SOURCE: http://go.nature.com/2gDXuhb
Int J Impotence Res 2017.
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