Photoselective vaporisation of the prostate (PVP) and transurethral resection of the prostate (TURP) have similar operative times in experienced hands.

Abstract

Introduction: Photoselective vaporisation of the prostate (PVP) has been criticised for its long operative time compared to transurethral resection of prostate (TURP). Purpose(s): To demonstrate that with appropriate training, PVP and TURP have similar operative times. Prior to commencing the study, our surgeon was supervised and mentored for 30 cases by a recognised world expert in PVP. Furthermore, he had completed a Greenlight workshop at Cornell University, NYC. Material(s) and Method(s): A prospective database was collected. Between February 2011 and July 2011, 43 men underwent PVP. Surgery was carried out on a 120WLithium Triborate laser (LBO). 43 patients underwent PVP by a single surgeon at our institution. Total operative time and energy utilisation were evaluated. Result(s): Two cases were excluded from analysis. One, as PVP was used to control transfusion dependant haematuria following Holmium Laser Enucleation of the Prostate. One, as the procedure had to be abandoned due to excessive bleeding and it was felt unsafe to continue. The mean operative time was 64.34 minutes (range 19 - 140 minutes). Mean energy used was 222402.46 J (range 22240 - 598142J). Conclusion(s): The average operative time for PVP closely resembles average operative TURP time. As our surgeon's mean operative time is comparable to his mentor's recently published mean operative time of 67 minutes, we believe the learning curve to be short. Therefore, once competent with PVP, operative time should not be significantly longer than TURP. Furthermore, with the 180W LBO laser and Moxy fibre, operative time will decrease further.