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

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 (R) DrillCut (TM) or Lumenis (R) 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 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 was associated with significantly lower morcellation rate when compared with the VersaCut (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. The DrillCut was associated with significantly higher cost of disposables when compared with the VersaCut ($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. However, this difference may not be clinically significant. Although both morcellators were comparable in their safety, the DrillCut was associated with higher cost of disposables when compared with the VersaCut.