A preliminary study on transurethral electrovaporization of the prostate (TVP) using VaporTrode

(BACKGROUND): Surgical therapy for Benign Prostatic Hypertrophy (B.P.H.) has mainly depended upon Transurethral Resection of the Prostate (TUR-P) using a cutting loop electrode. Recently, a new technique TVP was reported using the VaporTrode apparatus. We assessed the safety and efficacy of the VaporTrode in a preliminary study. (METHODS): Histological changes of the muscle and liver of pigs were examined after vaporization using the VaporTrode and a cutting loop electrode. First, histological changes were investigated following vaporization after one stroke at a slow hand speed. Next, histological changes were assessed following vaporization at fixed stroke speed in an experimental model. (RESULTS): At an electrical output of less than 275 W, the depth of the vaporized layer increased as the stroke speed became slower (4.0 cm/s-2.5 cm/s). When the electrical output was 300 W, the depth of vaporized layer increased even at a faster stroke speed (2.5 cm/s-3.0 cm/s.) The depth of the desiccated layer increased as the stroke speed became slower at any electrical output. However, when the stroke speed was 4.0 cm/s, the depth of this layer was less than 2.0 mm. With the cutting loop electrode, the depth of the desiccated layer increased at a higher electrical power, but the change was very small. (CONCLUSION): To achieve deep enough vaporized and desiccated layers safely, the VaporTrode should be used at a stroke speed slower than 3.0 cm/s and a high electrical power of about 275 W.