Transurethral electrovaporization of the prostate (TUVP) is effective, safe and durable.

Transurethral electrovaporization of the prostate (TUVP) is one of the alternative, minimally invasive procedures to treat BPH with promising initial results. We reviewed the available English literature to evaluate the long-term safety, efficacy and durability of TUVP using various vaporizing electrodes. We performed a MEDLINE keyword search and assessed all prospective randomized studies, which compared TUVP to standard transurethral resection of the prostate (TURP) that reached 1 y follow-up. Data were analysed for improvement of IPSS and Q(max), operation time, hospital stay, perioperative bleeding, postoperative irritative symptoms, long-term side effects and reoperation rate. We reviewed a total of 244 TUVP compared to 259 TURP patients in six prospective randomized studies that reached 1 y follow-up. Less perioperative bleeding, shorter catheterization time (mean of TUVP: 30 h vs TURP: 61 h) and shorter hospital stay (mean of 1.4 days vs TURP: 3.4 days) were reported in the TUVP patients. The improvement in IPSS (71%) and mean Q(max) (20 ml/s) was similar in both groups. The reoperation rate was 2% per year in both vaporization and resection patients. In conclusion, analysis of the prospective randomized trials that reached 1 year follow-up revealed that TUVP is as effective as standard TURP in the treatment of BPH. Long-term side effects and reoperation rates are comparable and the initial improvement was maintained over 1 year for the majority of patients.

A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy.

OBJECTIVE: To compare the safety, efficacy and durability of transurethral electrovaporization of the prostate (TUVP) with standard transurethral resection of the prostate (TURP). PATIENTS AND METHODS: In all, 104 patients admitted from the waiting list for surgery for BPH were randomized to either TUVP (52 patients, mean age 67.5 years) or TURP (52 patients, mean age 70.2 years); 51, 47 and 40 patients in each arm completed 1, 2 and 3 years of follow-up, respectively. Patients were assessed at baseline and during the follow-up using the International Prostate Symptom Score (IPSS), the associated quality-of-life score (QoL), postvoid residual volume (PVR) and maximum urinary flow rate (Qmax). RESULTS: Both groups had comparable mean IPSS, QoL, Qmax and PVR at baseline. The mean (SD) values for TUVP and TURP, respectively, at 3 years showed a significant and maintained improvement in IPSS, at 4.1 (3.3) and 7.1 (6.2) (P = 0.01), in QoL, at 1.0 (0.9) and 1.6 (1.4) (P = 0.04), and in Qmax, at 22.2 (8.5) and 18 (7.1) mL/s (P = 0.02), with decreases in PVR of 30 (38) and 21.9 (26.2) mL (P = 0.27). The re-operation rate in each group was 4% during the first year, 4% during the second year and 5% during the third year. After surgery and at 1, 2 and 3 years of follow-up, impotence was reported in 17% of the TUVP group and 11% of the TURP group (P = 0.49), and retrograde ejaculation in 72% of the TUVP group and 89% of the TURP group (P = 0.47). CONCLUSION: The 3-year follow-up results confirm that TUVP is as effective as standard TURP in the treatment of moderate-sized BPH. The long-term side-effects and complications were comparable and the initial improvement was maintained over 3 years in most patients in both groups.

Two-year follow-up of a prospective randomised trial of electrovaporization versus resection of prostate.

OBJECTIVES: Transurethral electrovaporization of the prostate (TUVP) has become a popular, minimally invasive procedure to treat BPH with promising initial results. This study was conducted to compare the efficacy, safety and durability of TUVP with standard TURP. We report the 2-year follow-up. METHODS: 104 consecutive men with BPH admitted for surgery were randomised to TUVP (52 patients, mean age: 67.5 years) or TURP (52 patients, mean age: 70.2 years). 47 patients in each arm completed 2-year follow-up. RESULTS: Follow-up data at 2 years show a comparable, significant and maintained improvement in mean IPSS (TUVP: 4.3 vs. TURP: 6.3), quality of life score (TUVP: 1. 1 vs. TURP: 1.7), and maximum flow rate (TUVP: 22.4 vs. TURP: 21.2 ml/s) with fall in mean post-void residual volume (TUVP: 18.8 vs. TURP: 22.8 ml). Postoperative impotence reported in TUVP: 17% vs. TURP: 11% (p = 0.49) and retrograde ejaculation TUVP: 72% vs. TURP: 89% (p = 0.47). Two patients in each arm (4%) had urethral stricture and 2 patients (4%) in the resected group had bladder neck stricture. Four patients in each group required re-operation for residual adenoma during the 2 years (4% in each arm each year). CONCLUSIONS: Our 2 years' follow-up results suggest that TUVP is as effective as standard TURP in the treatment of moderate-sized BPH with comparable durability.

Transurethral electrovaporization of the prostate--a possible alternative to transurethral resection: a one-year follow-up of a prospective randomized trial.

OBJECTIVE: To compare the efficacy, safety and durability of transurethral electrovaporization of the prostate (TUVP) with standard transurethral resection (TURP) in a prospective randomized trial. PATIENTS AND METHODS: The study included 104 consecutive men with symptomatic benign prostatic hyperplasia (BPH) admitted for surgery who were randomized to TUVP or TURP. The variables evaluated included the duration of surgery, catheterization and hospital stay, the International Prostate Symptom Score (IPSS), a quality-of-life assessment (QOL), the maximum urinary flow rate (Qmax) and the postvoid residual urine volume (PVR). RESULTS: Both groups showed a comparable significant and maintained decline in the mean IPSS, from 26.5 to 4.4 (TUVP) and from 26.6 to 5.9 (TURP), and increase in mean Qmax, from 8.6 to 20.8 mL/s [corrected] (TUVP) and 8.6 to 22.8 mL/s (TURP) after 1 year. However, there were significant differences in the mean duration of catheterization (TUVP 20.9 h, TURP 46.6 h, P<0.001), hospital stay (TUVP 2.2 day, TURP 3.1 days, P<0.001), and the duration and volume of post-operative irrigation (TUVP none, TURP 18.1 h with 17.5 L of saline). Two patients in each group developed urethral strictures (4%) and two patients in each group required re-operation for residual adenoma (4%); two patients undergoing TURP had a bladder neck stricture (4%). CONCLUSION: The results suggest that TUVP is as effective as standard TURP in the treatment of moderate-sized BPH. TUVP offers the advantage of using established instruments, has excellent peri-operative haemostasis and requires a shorter hospital stay.

Renal cell carcinoma containing fat mimicking angiomyolipoma: demonstration with CT scan and histopathology.

We report a case of a large renal tumour containing small amounts of fat and some calcification that proved to be a renal cell carcinoma. The CT appearance of the tumour was suggestive of an angiomyolipoma. Although the overwhelming majority of renal masses containing fat are angiomyolipomas, in the presence of calcification the diagnosis of renal cell carcinoma should be entertained.

Urethral caruncle: an unusual presentation of ovarian tumour.

Secondary female urethral cancer presenting as urethral caruncle is extremely rare. We report a primary ovarian adenocarcinoma in a 78-year-old female patient presented initially as a urethral caruncle. This case represents the first reported case in the world literature. The clinical features, investigations and pertinent literature are reviewed.

Antenatally diagnosed seminal vesicular cyst.

Congenital seminal vesicular cysts represent a rare embryological malformation usually associated with ipsilateral renal dysplasia. We report a case which was diagnosed antenatally as a ureterocele and found postnatally to be a seminal vesicular cyst.

Xanthogranulomatous pyelonephritis in childhood: pre-operative diagnosis is possible.

OBJECTIVE: To diagnose xanthogranulomatous pyelonephritis (XGP) in childhood pre-operatively. PATIENTS AND METHODS: Eleven cases of XGP presenting to Birmingham Children's Hospital over a 10-year-period are reported. Nine (82%) were diagnosed preoperatively on the clinical and radiological findings. RESULTS: The characteristic clinical findings were urinary tract infection (9 cases), palpable renal mass (8 cases) and anaemia (8 cases). The most common radiological findings were enlarged kidney (9 cases), renal calculi (7 cases) and non-functioning kidney (6 cases). Renal ultrasound typically demonstrated a central echoic area (6 cases) and multiple hypoechoic areas in the parenchyma (7 cases). A computed tomography (CT) scan was performed in three cases. This showed characteristic multiple, low attenuation, unenhanced areas within the parenchyma with extension of the inflammatory process into peri-nephric fat (two cases). Ten cases (91%) were of the diffuse type. There was extension into the peri-nephric fat in eight cases (73%). Three cases (27%) were associated with congenital urological abnormalities. Nephrectomy was performed in 10 cases and a partial nephrectomy in one. CONCLUSION: XGP is uncommon in childhood but should always be considered in the differential diagnosis of renal masses, especially in the presence of anaemia. Nephrectomy usually results in a permanent cure.