Medium term outcome of bipolar plasma vaporization in prostate cancer patients – A palliative modality of preserving spontaneous voiding

Objectives:This retrospective analysis evaluated the efficiency, safety, and medium term postoperative results of bipolar plasma vaporization (BPV) in prostate cancer (PCa) cases associating complete urinary retention. Materials and Methods: A series of 40 patients diagnosed with locally advanced or metastatic PCa and complete urinary retention requiring a Foley catheter indwelling underwent BPV aiming to restore spontaneous voiding. A total of 35 patients completed the one year evaluation protocol consisting of International Prostate Symptom Score (IPSS), quality of life score (QoL), maximum flow rate (Qmax) and post-voiding residual urinary volume (PVR), measured at 1, 3, 6 and 12 months after surgery. Results: BPV was successfully performed in all cases with satisfactory efficiency, as confirmed by the mean operation time (42.8 minutes) and hemoglobin drop (0.7 g/dl). A fast and safe postoperative recovery period was described in this series (hematuria rate – 7.5%; mean catheterization period – 36 hours; mean hospital stay – 2.5 days; early-irritative symptoms’ rate – 15%). At 1, 3, 6 and 12 months, satisfactory values were determined in terms of IPSS, Qmax, QoL and PVR. These parameters emphasized a stable evolution throughout the entire follow-up, as 88.6% of the patients maintained spontaneous voiding. Conclusions: The present trial confirmed the plasma-button vaporization as a promising therapeutic approach in PCa cases associating complete urinary retention. The technique displayed good efficacy, low perioperative morbidity, short convalescence, and satisfactory urodynamics and symptom score parameters during the one-year follow-up period. Abbreviations: BPV – bipolar plasma vaporization; PCa – prostate cancer; TURP – transurethral resection of the prostate; BPH – benign prostatic hyperplasia; BOO – bladder outlet obstruction; LUTS – lower urinary tract symptoms; IPSS – International Prostate Symptom Score; QoL – quality of life score; Qmax – maximum flow rate; RV – post-voiding residual urinary volume