Bipolar plasmakinetic transurethral resection of the prostate vs. transurethral enucleation and resection of the prostate: pre- and postoperative comparisons of parameters used in assessing benign prostatic enlargement.

INTRODUCTION Transurethral enucleation and resection of the prostate (TUERP) may offer a better treatment for benign prostatic enlargement. We compared the perioperative parameters and outcome following bipolar plasmakinetic transurethral resection of the prostate (TURP) and TUERP. METHODS Data from two independent institutions were reviewed retrospectively. 50 and 45 consecutive patients were enrolled in the TURP and TUERP groups, respectively. Pre- and postoperative parameters, including prostatic specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPSS), quality of life (QOL) score, uroflowmetry and prostate volume (PV), were compared. RESULTS Age at surgery, preoperative PSA (5.8 +/- 4.0 versus 7.6 +/- 5.9 ng/ml) and PV (55.8 +/- 31.6 versus 53.2 +/- 26.8 g) showed no significant difference (p-value greater than 0.05). However, postoperative PSA (2.8 +/- 3.0 versus 0.8 +/- 0.4 ng/ml; p-value less than 0.05) and PV (15.2 +/- 7.7 versus 10.5 +/- 5.4 g; p-value less than 0.01) differed significantly between the TURP and TUERP groups, respectively. There were no significant differences in IPSS, QOL and Qmax between the two groups during follow-up (p-value is 0.62, 0.68 and 0.13, respectively). However, for the TUERP group, the postoperative post-void residual urine volume (PVR) was significantly better (13.8 +/- 19.5 versus 25.2 +/- 18.7 ml; p-value less than 0.01). CONCLUSION The TUERP technique achieved more complete resection than TURP, with a smaller post procedure PV and lower PSA and PVR after surgery. This may predict better long-term results for patients who had TUERP.

[1]  S. Ahyai,et al.  Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. , 2008, European urology.

[2]  Yuji Shimizu,et al.  Trial of Complete Detachment of the Whole Prostate Lobes in Benign Prostate Hyperplasia by Transurethral Enucleation of the Prostate , 2007, Urologia Internationalis.

[3]  C. Stief,et al.  Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. , 2007, The Journal of urology.

[4]  Rainer Hofmann,et al.  Complications of transurethral resection of the prostate (TURP)--incidence, management, and prevention. , 2006, European urology.

[5]  A. Westenberg,et al.  A randomised trial comparing holmium laser enucleation versus transurethral resection in the treatment of prostates larger than 40 grams: results at 2 years. , 2006, European urology.

[6]  R. Kuntz.  Current role of lasers in the treatment of benign prostatic hyperplasia (BPH). , 2006, European urology.

[7]  Chunxiao Liu,et al.  V1403: Real Endo-Enucleation of Prostate for Treatment of Benign Prostatic Hyperplasia , 2006 .

[8]  R. Paterson,et al.  Change in serum prostate specific antigen concentration after holmium laser enucleation of the prostate: a marker for completeness of adenoma resection? , 2005, Journal of endourology.

[9]  Yuji Shimizu,et al.  Measurement of Residual Adenoma after Transurethral Resection of the Prostate by Transurethral Enucleation Technique , 2005, Urologia Internationalis.

[10]  K. Lim,et al.  Transurethral resection of prostate (TURP) through the decades--a comparison of results over the last thirty years in a single institution in Asia. , 2004, Annals of the Academy of Medicine, Singapore.

[11]  U. Nseyo,et al.  Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia: 12-month results from the first United States multicenter prospective trial. , 2004, The Journal of urology.

[12]  C. Cheng,et al.  Effects of bladder volume on transabdominal ultrasound measurements of intravesical prostatic protrusion and volume , 2002, International journal of urology : official journal of the Japanese Urological Association.

[13]  S. Chen,et al.  The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia , 2000, BJU international.

[14]  R C Bruskewitz,et al.  Recent developments in the surgical management of benign prostatic hyperplasia. , 1998, Urology.

[15]  J. Hugosson,et al.  Reference range of prostate-specific antigen after transurethral resection of the prostate. , 1996, Urology.

[16]  C. Roehrborn.  The Agency for Health Care Policy and Research. Clinical guidelines for the diagnosis and treatment of benign prostatic hyperplasia. , 1995, The Urologic clinics of North America.

[17]  K McPherson,et al.  Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. , 1989, The New England journal of medicine.

[18]  M. Akimoto,et al.  Transurethral enucleation of benign prostatic hyperplasia. , 1986, The Journal of urology.

[19]  N. Roos,et al.  A population-based study of prostatectomy: outcomes associated with differing surgical approaches. , 1987, The Journal of urology.

[20]  Y. Hiraoka.  A new method of prostatectomy, transurethral detachment and resection of benign prostatic hyperplasia. , 1983, Nihon Ika Daigaku zasshi.

[21]  A. Dunphy.  TRANSURETHRAL RESECTION. , 1963, The Canadian nurse.