DrillCutTM vs VersaCutTM prostate tissue morcellation devices after holmium laser enucleation: A prospective, randomized controlled trial

Ahmed Ibrahim; Mostafa M Elhilali; Mohammed A Elkoushy; Sero Andonian; Serge Carrier

doi:10.5489/cuaj.5626

DrillCut^TM vs VersaCut^TM prostate tissue morcellation devices after holmium laser enucleation: A prospective, randomized controlled trial

Can Urol Assoc J. 2019 Aug;13(8):266-270. doi: 10.5489/cuaj.5626.

Authors

Ahmed Ibrahim¹, Mostafa M Elhilali¹, Mohammed A Elkoushy^{1

2}, Sero Andonian¹, Serge Carrier¹

Affiliations

¹ Department of Urology, McGill University Health Center, Montreal, QC, Canada.
² Department of Urology, Suez Canal University, Egypt.

Abstract

Introduction: We aimed to compare efficacy, safety, and cost of disposables of the DrillCut^TM morcellator with the VersaCut^TM morcellator after holmium laser enucleation of the prostate (HoLEP).

Methods: After obtaining ethical approval, consecutive patients undergoing HoLEP for symptomatic benign prostatic hyperplasia were randomized to have their enucleated prostates morcellated by either Karl Storz^® DrillCut^TM or Lumenis^® VersaCut^TM morcellators. All procedures were performed by two experienced urologists. Patients' demographics and perioperative data were recorded. Both morcellators were compared for their safety, efficacy, and cost-effectiveness.

Results: Eighty-two patients were included in the study (41 per each arm). Both groups were comparable in terms of age, preoperative prostate size (114 vs. 112 mL; p>0.05), enucleation time (95.3 vs. 91.7 minutes; p>0.05), and morcellation time (22.6 vs. 17.3 minutes; p>0.05). The DrillCut^TM was associated with significantly lower morcellation rate when compared with the VersaCut^TM (3.6 vs. 4.9 g/min; p= 0.03). In terms of safety, there was no significant difference between both morcellators in complication rates (2.4% vs. 7.3 %; p=0.1). However, there was one case of bladder perforation requiring exploration with the VersaCut^TM. The DrillCut^TM was associated with significantly higher cost of disposables when compared with the VersaCut^TM ($247.5 vs. $160.9; p<0.01).

Conclusions: Despite the small sample size, the DrillCut™ was associated with lower morcellation rate when compared with the VersaCut^TM. However, this difference may not be clinically significant. Although both morcellators were comparable in their safety, the DrillCut^TM was associated with higher cost of disposables when compared with the VersaCut^TM.