Login to Access Video or Poster Abstract: MP27-12
Sources of Funding: none

Introduction

As per Goliath trial, Greenlight laser (XPS) Photoselective Vaporization of the prostate (GL.PVP) is non-inferior to TURP in reduction of LUTs secondary to BPH with all advantages of laser. Plasma Kinetic vaporization of the prostate (PKVP) is a potential contender to the evolving Greenlight PVP._x000D_ _x000D_ In this study, non-inferiority of PKVP compared to GL.PVP, in reduction of LUTS secondary to BPH, was tested in a randomized trial._x000D_

Methods

Between November 2014 and October 2015, 120 patients with complicated BPH (size 30-80 cc) were randomized to GL.PVP and PKVP._x000D_ Patients were assessed postoperatively using I-PSS, QOL, Qmax and PVR (at 1, 4, and 12 months), IIEF-15 and PSA (at 4 and 12 months). _x000D_ Non-inferiority of I-PSS at 1 year was evaluated using a 1-sided test at 5% level of significance. The statistical significance of other comparators was assessed at the (2-sided) 5% level._x000D_

Results

At time of analysis 58 GL.PVP and 61 PKVP procedures were included._x000D_ Patients` demographics, prostate size , indications of intervention and perioperative parameters were comparable between both groups apart from more perioperative irrigant fluid use in GL.PVP (P =0.014)._x000D_ More postoperative dysuria was reported after PKVP, dysuria visual analogue scale 4(0-10) vs. 6(0-10), P=0.005 in GL.PVP and PKVP respectively. _x000D_ Urinary outcome measures revealed significant comparable improvement in both groups at different follow up points either in the net value or in the percentage improvement from baseline measure. At 1 year, median IPSS was 6 (1:25) vs 5 (1:18) P=0.7, median QoL was 1 (0:5) vs 1 (1:5) P=0.84, mean Q max was 22±9.4 vs 20±8.5 ml/sec P=0.42, median PVR was 20 (0:97) vs 25 (0:109) ml P=0.14, in GL.PVP and PKVP respectively. _x000D_ Median postoperative change in PSA was 63.5% (-54:95) following GL.PVP vs 31.6% (-66:30) after PKVP, P=0.027_x000D_ Both groups showed comparable perioperative and late postoperative complication and re-intervention rate during the first year._x000D_ Among sexually active men (25%), there was significant reduction of IIEF-15 score following PKVP in comparison to GL.PVP _x000D_

Conclusions

PKVP is a safe and effective modality in treating patients with LUTS secondary to small to moderate sized BPH. In terms of symptoms control, it was not inferior to GL.PVP at 1 year. Long-term durability of the outcome is critical considering the difference in postoperative PSA reduction. Impact on the sexual function should be considered for further evaluation in a larger cohort of sexually active men.

Funding

none