Comparison of Bipolar Plasma Vaporization versus Standard Holmium Laser Enucleation of the Prostate: Surgical Procedures and Clinical Outcomes for Small Prostate Volumes

Abstract

Bipolar plasma vaporization of the prostate (BPVP) is an attractive alternative to resection. There are numerous studies comparing transurethral resection of prostate or photoselective vaporization of the prostate with BPVP; however, there is a lack of data comparing holmium laser enucleation of the prostate (HoLEP) with BPVP. We aimed to compare HoLEP and BPVP with a focus on functional outcomes, safety, and complications. Methods: From January 2017 to June 2018, patients who underwent HoLEP or BPVP for benign prostatic hypertrophy were enrolled in this study. Inclusion criteria were a prostate volume <40 mL measured by transrectal ultrasound, international prostate symptom score (IPSS) >7, maximum urinary flow rate (Qmax) <15 mL/s, and postvoiding residual volume (PVR) >100 mL. Perioperative and postoperative parameters including IPSS, Qmax, quality of life, PVR, and complications were compared between groups. Results: Sixty-three patients were enrolled in this study. There were small differences in perioperative parameters. Hospital stays and catheterization periods were significantly shorter in the BPVP group. The postoperative complications were comparable between groups. PVR was comparable in both groups except for 1 month postoperatively. The incontinence rate was higher in the HoLEP group, but without statistical significance. Conclusion: In terms of surgical safety and efficacy as well as patient comfort, BPVP is comparable with HoLEP for small prostate volumes. BPVP can be a viable alternative technique in small BPH surgical treatment.