Information for researchers
A randomised controlled trial to determine the clinical and cost effectiveness of thulium laser transurethral vaporesection of the prostate (ThuVARP) versus transurethral resection of the prostate (TURP) in the National Health Service (NHS).
TURP has been the standard operation for benign prostate obstruction (BPO) for 40 years, with ~25,000 procedures performed per year, and has remained largely unchanged. It is generally a very successful operation, but has well documented risks for the patient. Various laser techniques have become available but none are widely used in the NHS because of lengthy training required for surgeons or inferior performance on clinical outcomes.
The thulium laser technique (ThuVARP) vaporises and resects the prostate using a surgical technique similar to TURP, facilitating a shorter training period for surgeons. The small amount of study data currently available suggests that ThuVARP may have certain advantages over TURP. These include reduced blood loss and shorter hospital stay, earlier return to normal activities, and shorter duration of catheterization.
The key aim of this study is to determine whether ThuVARP is equivalent to TURP as treatment for men with lower urinary tract symptoms, or urinary retention, secondary to BPO. Comparative clinical effectiveness will be measured by the International Prostate Symptom Score (IPSS) and maximum urine flow rate (Qmax). Secondary outcomes include surgical complications, length of hospital stay and cost-effectiveness.