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Introduction and objectives: Greenlight laser vaporization (LV) of the prostate is characterized by simultaneous
vaporization and coagulation of prostatic tissue resulting in tissue ablation together with excellent hemostasis during the
procedure. It has been reported that bipolar plasma vaporization (BPV) of the prostate might be an alternative for LV. So
far, it has not been shown that BPV is as effective as LV in terms of tissue ablation or hemostasis. We performed
transrectal three-dimensional ultrasound investigations to compare the efficiency of tissue ablation between LV and
BPV.
Methods: Between 11.2009 and 5.2011, 50 patients underwent pure BPV in our institution. These patients were matched
with regard to the pre-operative prostate volume to 50 LV patients from our existing 3D-volumetry-database. Transrectal
3D ultrasound and planimetric volumetry of the prostate were performed pre-operatively, after catheter removal, 6 weeks
and 6 months.
Results: Median pre-operative prostate volume was not significantly different between the two groups (45.3ml vs.
45.4ml; p=1.0). After catheter removal, median absolute volume reduction (BPV 12.4ml, LV 6.55ml) as well as relative
volume reduction (27.8% vs. 16.4%) were significantly higher in the BPV group (p<0.001). After six weeks (42.9% vs.
33.3%) and six months (47.2% vs. 39.7%), relative volume reduction remained significantly higher in the BPV group
(p<0.001). Absolute volume reduction was non-significantly higher in the BPV group after six weeks (18.4ml, 13.8ml;
p=0.051) and six months (20.8ml, 18ml; p=0.3). Clinical outcome parameters improved significantly in both groups
without relevant differences between the groups.
Conclusions: Both vaporization techniques result in efficient tissue ablation with initial prostatic swelling. BPV seems
to be superior due to a higher relative volume reduction. This difference had no clinical impact after a follow-up of 6M.
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