Benign Prostatic Obstruction Plasma Vaporisation of the Prostate: Initial Clinical Results Oliver Reich a, *, Boris Schlenker a , Christian Gratzke a , Derya Tilki a , Malte Riecken b , Christian Stief a , Michael Seitz a , Alexander Bachmann b a Department of Urology, University Hospital Munich Grosshadern, Ludwig Maximilians University, D 81377 Munich, Germany b Department of Urology, University Hospital Basel, Basel, Switzerland EUROPEAN UROLOGY 57 (2010) 693–698 available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted May 12, 2009 Published online ahead of print on May 26, 2009 Keywords: Prostate Lower urinary tract symptoms Benign prostatic hyperplasia Plasma vaporisation Endourology Abstract Background: Laser vaporisation of the prostate has had a considerable impact in recent years. In an attempt to achieve tissue vaporisation with bipolar high- frequency generators, plasma vaporisation was recently introduced. Objective: To provide the first clinical information on bipolar plasma vaporisation of the prostate for patients with lower urinary tract symptoms (LUTS) due to bladder outlet obstruction (BOO). Design, setting, and participants: Thirty patients were included in this prospective bicentre study. Intervention: All patients underwent bipolar plasma vaporisation with a novel electrode (Olympus Winter & Ibe GmbH, Hamburg, Germany). Measurements: International Prostate Symptom Score (IPSS), bother score, max- imum flow rate (Q max ), and postvoid residual were evaluated at baseline and at the time of discharge as well as at 1, 3, and 6 mo after the intervention. Results and limitations: Mean preoperative prostate volume was 59  32 ml (range: 30–170), and mean operating time was 61  26 min (range: 20–140). Besides one reoperation (conventional transurethral prostatectomy) due to persistent obstruction, no major complication occurred intra- or postoperatively and no blood transfusion was required. Catheterisation time averaged 41  35 h (range: 18–192). Transient mild to moderate dysuria was noted in four patients (13%). At 1, 3, and 6 mo, Q max increased from 6.6  2.7 ml/s preoperative to 17.3  4.7 ml/s ( p < 0.01), 18.5  4.6 ml/s ( p < 0.01), and 18.1  5.0 ml/s ( p < 0.01), respectively. The IPSS decreased from 20.8  3.6 to 10.4  3.5 ( p < 0.01), 8.2  2.9 ( p < 0.01), and 8.1  3.1 ( p < 0.01), respectively. These data represent a small nonrandomised study cohort with limited follow-up. Conclusions: Our initial experience indicates that bipolar plasma vaporisation might be a safe and effective treatment option for patients with LUTS due to BOO. To define the potential role of this novel technique, randomised trials with longer follow-up are mandatory. # 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved. * Corresponding author. Tel. +49 89 7095 3524; Fax: +49 89 7095 6533. E-mail address: oreich@med.uni-muenchen.de, OMReich@aol.com (O. Reich). 0302-2838/$ – see back matter # 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2009.05.031