\ \ He end of the thulium fibre which may interfere with the view of the surgical plane. • the thulium laser cuts and chars tissue, rather than pushing the lobes bluntly from the capsule. viagra price on prescription This makes it difficult to remain in the correct plane. viagra price on prescription Pvp versus holep - a review of the evidence randomised trials pvp there is only a single published randomised trial for pvp, comparing pvp to turp (9). viagra generic This paper is difficult to interpret as the trial had not concluded at the time of its publication, and only 44 of one hundred twenty patients had been evaluated at 12 months. The definitive results are awaited with interest. Holep there are 8 published randomised trials comparing holep to: turp (10-14), transurethral vapour resection (tuvrp) (14), bipolar enucleation (15), open prostatectomy (16,17) and holmium bladder neck incision (hobni) (18). The 4 holep versus turp trials report significantly less blood loss, catheter time, need for irrigation, nursing contact, and shorter hospital stay for holep. viagra coupon The holep operating times are consistently longer than for turp but more tissue is removed with holep. buy viagra cheap No tur syndrome has ever been reported with holep. Subjective and objective measures of success are at least equivalent to turp. discounted generic viagra Holep is the first transurethral procedure to show improved urodynamic outcomes compared to turp: tan et al reported significantly greater urodynamic relief of bladder outlet with holep at 6 months (10), although this was not reported in another trial (19). In the randomised trial comparing holep to tuvrp, holep resulted in significantly less blood loss, less need for irrigation, less nursing time and shorter hospital stay (14). viagra online without prescription-canada Neill et al reported that enucleation was feasible using a gyrus bipolar radiofrequency device but that it resulted in significantly longer operating time, need for irrigation and recovery room time than holep (15). viagra price on prescription Outcomes at 1,3,6 and 12 months were equivalent. order viagra online There are two randomised trials comparing holep to open prostatectomy for large prostates (16,17). Both report significantly longer operating time for holep, but significantly less blood loss, shorter catheter and hospital times, and equivalent improvements in symptom and quality of life scores, maximal flow rates and post void residual volumes at 18 month (16) and 2 year (17) follow up. where is a safe place to buy viagra online Aho et al reported that holep and hobni were feasible as day stay procedures for patients with glands less than 40 grams, and that holep resulted in superior relief of bladder outlet obstruction particularly in those with prostates larger than 30 grams (18). Perioperative management as bot. viagra no prescription \ \ \

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