Transurethral vaporization-resection of the prostate versus standard transurethral prostatectomy: Comparative changes in histopathological features of the resected specimens

Objectives: Transurethral vaporization resection of the prostate (TUVRP) is a recent modification of the standard transurethral resection of the prostate (TURP). TUVRP uses a band electrode coupled to a high electrocuting energy to achieve simultaneous resection, vaporization and coagulation of the prostate. We evaluated the histopathological resection specimens of patients treated with TUVRP to see whether the higher energy used will result in thermal artifacts that will interfere with the pathological evaluation of the prostate, and compared the results to TURF specimens. Material and Methods: The histopathological specimens of 50 patients that underwent TUVRP or TURF were reviewed. Artifactual pathological patterns that were identified in the specimens included: abnormal cellular orientation and spindling, artifactual cellular detachment from the underlying basement membrane, atypical cytological changes or areas of stromal coagulative necrosis. Each identified pattern was awarded 1 point. The severity of cautery artifact was graded into mild, moderate or severe according to the sum of points in each specimen. Results: Mild cautery artifact changes were noted in 1 patient who underwent TURF. Moderate changes were noted in 21 patients in each TURF and TUVRP groups while severe changes were noted in 4 and 3 patients undergoing TUVRP and TURF respectively. There were no statistically significant differences between the groups with regard to the severity of the cauterization-induced changes. Conclusions: The quality of histopathological specimens produced by TUVRP is similar to the standard TURF. It seems that the higher energy use in electrovaporization technique does not result in greater thermal injury to the tissues possibly because of the cooling effect of the irrigation fluids used intraoperatively. Copyright (C) 2000 S. Karger AG, Basel.