Transurethral resection of the prostate (
TURP) is the gold standard of surgical treatment of the BPH. Alternative surgical techniques have been developed for patients with
blood coagulation disorders secondary to
anticoagulants or antiplatelet intake. The photoselective vaporization of the prostate (PVP) by Green
Laser is a technique used with the aim of obtaining tissue ablation with instantaneous hemostasis. In our experience we sensed the feeling of some differences between the two technologies. For each patient, we calculated the difference (delta) between Qmax, Qmed, PMR to 6 months after surgery compared with preoperative measurements (deltaQmax, deltaQmed, deltaPMR). In the comparison between PVP and
TURP the differences between the results, in terms of deltaQmax (11.04 vs. 8.9 ml/sec), deltaQmed (5.87 vs. 3.64 ml/sec), deltaPMR, are not statistically significant, therefore it is clear that if we consider the average of the results, significant differences do not come out between the two techniques. Instead, the real differences emerge from consideration of standard deviations: the higher standard deviations of Qmax and Qmed of PVP compared to
TURP (8.29 vs 5.01; 5,51 vs 1.64) indicate that the final result of an intervention being performed by
TURP is nearest to the expected preoperatively result; on the contrary the final result of an operation being performed by PVP shows a significantly higher variability. As regards for our clinical decision it follows that the proposal of a
surgical procedure which shows the "risk" of a higher variability of the final result is justified only in cases of high cardiovascular or blood coagulation "risk".