A prospective study of transurethral bipolar plasmakinetic resection of the prostate vs. transurethral plasmakinetic enucleation of prostate for benign prostatic hyperplasia with different volumes (Report of 521 cases)
Wang Shixian1,Yang Shuifa1,Yang Enming1,Pan Dongshan1,Wang Fei1
1Department of Urology, Xiamen Second Hospital, Xiamen 361021, China
Abstract：Objective: To compare the clinical safety and efficiency of transurethral bipolar plasmakinetic resection of the prostate (PKRP) vs. transurethral plasmakinetic enucleation of prostate (TPKEP) for benign prostatic hyperplasia (BPH) according to different volumes of prostate. Methods: 521 patients with lower urinary tract symptoms complicated with BPH were prospectively studied from February 2010 to March 2016. They were divided into two groups randomly according to the volume of the prostate. One group with volume being less than 100 mL included 380 cases, and the other group with volume being more than 100 mL included 141 cases. In less than 100 mL group, 182 cases underwent PKRP and 192 cases underwent TPKEP. In more than 100 mL group, 78 cases were subjected to PKRP and 63 cases to TPKEP. All patients were preoperatively assessed and evaluated at 3rd month after surgery. The perioperative data and postoperative outcomes were compared. Postoperative complications were recorded. Results: No statistically significant differences in age, prostate volume, International Prostate Symptom Score (IPSS), quality of life (QOL), post void residual urine (PVRU) volume, and maximum flow rate (Qmax) were seen between the two groups preoperatively. In less than 100 mL group, more resected prostate tissues and less blood loss were seen by means of TPKEP than PKRP. Furthermore, IPSS, QOL, PVRU and Qmax were improved dramatically by means of TPKEP than the counterpart (P<0.05). However, the incidence of false incontinence of TPKEP was higher than that of PKRP (P＜0.05). In more than 100 mL group, more resected prostate tissues were also seen by means of TPKEP than PKRP. Furthermore, IPSS, QOL, PVRU and Qmax were also improved dramatically (P<0.05). However, more intraoperative blood loss was seen, as well as the incidence of postoperative delayed hemorrhage and false incontinence for TPKEP were higher than those for PKRP (P<0.05). Conclusions: TPKEP is a safe and effective method for the transurethral management of BPH. TPKEP resects the prostate more entirely than PKRP, which causes more fluent urination. However, false incontinence for TPKEP is higher than that for PKRP. And more intraoperative blood loss and postoperative delayed hemorrhage are seen for large BPH. TPKEP can't replace PKRP completely.
王世先,杨水法,杨恩明,潘东山,王飞. 不同前列腺体积采用经尿道双极等离子电切术与剜除术治疗的前瞻性对比研究(附521例报告)[J]. 微创泌尿外科杂志, 2016, 5(3): 145-149.
Wang Shixian,Yang Shuifa,Yang Enming,Pan Dongshan,Wang Fei. A prospective study of transurethral bipolar plasmakinetic resection of the prostate vs. transurethral plasmakinetic enucleation of prostate for benign prostatic hyperplasia with different volumes (Report of 521 cases). JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(3): 145-149.
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