Korean J Urol.  2006 Jan;47(1):13-19. 10.4111/kju.2006.47.1.13.

Comparative Study on the Treatment Outcome and Safety of TURP, ILC, TUNA and TEAP for Patients with Benign Prostatic Hyperplasia

• Kim TS
• Choi S
• Rhew HY
• Ahn JH
• Jang JH
• Cho MH

• KMID: 2294209
• DOI: http://doi.org/10.4111/kju.2006.47.1.13

Abstract

PURPOSE: We wanted to compare the treatment outcome, safety, efficacy and complications of transurethral resection of the prostate (TURP), interstitial laser coagulation (ILC), transurethral needle ablation (TUNA) and transurethral ethanol ablation of the prostate (TEAP) for the treatment of benign prostatic hyperplasia (BPH).
MATERIALS AND METHODS
In this prospective, randomized study, a total of 403 patients with symptomatic BPH were treated by TURP, ILC, TUNA or TEAP from January 1998 to December 2002. ILC was performed using the Indigo 830e LaserOptic(TM) System with a specially designed interstitial thermotherapy light guide, TUNA was performed using the VidaMed TUNA System and TEAP was performed using the Prostaject(TM) device. The treatment outcomes were evaluated at 3 months, 6 months and 1 year with the International Prostate Symptom Score (IPSS), the prostate volume, the maximal urinary flow rate (Qmax), the post-void residual urine (PVR), and the quality of life (QoL) assessment score.
RESULTS
All the patients in the four groups showed significant improvement for all the parameters. After 1 year, the four groups showed significant improvement in the clinical and voiding parameters (IPSS, Qmax, PVR, prostate volume and QoL). Our results did not show significant differences in the IPSS, prostate volume and QoL among the four groups. However, the TURP group showed a higher Qmax, and the TEAP group showed a less reduced prostate volume than the other groups during the follow-up period (p<0.05). The period of hospital admission showed no significant difference between the ILC, TUNA and TEAP groups, but the TURP group showed a longer hospital admission period compared to the other groups. The TURP group was markedly associated with more complications than the other groups.
CONCLUSIONS
These early results indicate that ILC, TUNA and TEAP are safe, effective and useful alternative therapies to TURP for the patients with symptomatic BPH.

Keyword

Treatment outcome; Safety; Benign prostatic hyperplasia

MeSH Terms

Complementary Therapies
Ethanol
Follow-Up Studies
Humans
Hyperthermia, Induced
Indigo Carmine
Laser Coagulation
Needles
Prospective Studies
Prostate
Prostatic Hyperplasia*
Quality of Life
Transurethral Resection of Prostate*
Treatment Outcome*
Tuna*
Ethanol
Indigo Carmine

Figure

• 

  Fig. 1 Changes of the International Prostate Symptom Score (IPSS). IPSS significantly improves following all the procedures (*: p<0.05, significance compared to baseline). TURP: transurethral resection of prostate, ILC: interstitial laser coagulation, TUNA: transurethral needle ablation, TEAP: transurethral ethanol ablation of prostate.

• 

  Fig. 2 Changes of the maximal flow rates following the operative procedures. The maximal flow rates improve significantly following all the procedures (*: p<0.05, significance compared to baseline).

• 

  Fig. 3 Changes of the post-void residual urine volume following the operative procedures. The post-void residual urine volume is significantly reduced following all the procedures (*: p<0.05, significance compared to baseline).

• 

  Fig. 4 Changes of prostate volume (ml) following the operative procedures. The prostate volume was significantly reduced following all the procedures (*: p<0.05, significance compared to baseline).

• 

  Fig. 5 Changes of the quality of life score following the operative procedures. The QoL score is significantly reduced following all the procedures (*: p<0.05, significance compared to baseline).

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