Comparative Study of the Effectiveness and Safety of Transurethral Bipolar Plasmakinetic Enucleation of the Prostate and Transurethral Bipolar Plasmakinetic Resection of the Prostate for Massive Benign Prostate Hyperplasia (>80 ml)

Background The aim of this study was to compare the clinical safety and effectiveness of transurethral bipolar plasmakinetic enucleation of the prostate (PKEP) vs. transurethral bipolar plasmakinetic resection of the prostate (PKRP) in the treatment of benign prostate hyperplasia (BPH) more than 80 ml. Material/Methods From June 2015 to February 2019, 179 BPH patients with prostate volume greater than 80 ml were enrolled and separated into a PKEP (n=81) group and a PKRP group (n=98). The patients in the 2 groups were followed up for 6 months. We collected and analyzed data from the international Prostate Symptom Score (IPSS), residual urine volume (RUV), quality of life (QOL), maximum urine flow rate (Qmax), and international erectile function index (ILEF-5). The clinical data collected during and after the operation and surgical complications were compared between the 2 groups. Results The PKEP group had significantly shorter operation time, bladder flushing time, indwelling catheter time, and hospitalization time, and has less intraoperative blood loss, intraoperative blood transfusion, postoperative secondary hemorrhage, bladder neck contracture, capsule perforation, and retrograde ejaculation (P<0.05). Compared with the PKRP group, the postoperative IPSS and QOL scores were significantly lower in the PKEP group (P<0.05), while the excision glandular tissue weight and Qmax were significantly improved (P<0.05). There were no significant differences in ILEF-5 scores, RUV, urethral stricture, urinary incontinence, or erectile dysfunction between the 2 groups (p>0.05). Conclusions PKEP treatment of BPH with a large volume (>80 ml) has the advantages of complete gland resection, good surgical effect, improved surgical safety, and reduced intraoperative and postoperative complications.

[1]  P. Rai,et al.  Comparison of bipolar plasmakinetic transurethral enucleation and resection of prostate gland in patients receiving anticoagulants and/or platelet aggregation inhibitors. , 2019, Minerva urologica e nefrologica = The Italian journal of urology and nephrology.

[2]  Xukun Liu,et al.  Effects of Calcium Oxalate on Expression of Clusterin and Lower Urinary Tract Symptoms in Prostatitis and Benign Prostatic Hyperplasia Patients with Calculi , 2018, Medical science monitor : international medical journal of experimental and clinical research.

[3]  A. El-Assmy,et al.  Erectile and ejaculatory functions changes following bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study , 2018, International Urology and Nephrology.

[4]  Jiasheng Chen,et al.  Dual-centre randomized-controlled trial comparing transurethral endoscopic enucleation of the prostate using diode laser vs. bipolar plasmakinetic for the treatment of LUTS secondary of benign prostate obstruction: 1-year follow-up results , 2018, World Journal of Urology.

[5]  C. Stief,et al.  “Finding the needle in a haystack”: oncologic evaluation of patients treated for LUTS with holmium laser enucleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP) , 2017, World Journal of Urology.

[6]  T. Gharib,et al.  Bipolar Plasmakinetic Enucleoresection of the Prostate: Our Experience with 245 Patients for 3 Years of Follow-Up. , 2017, Journal of endourology.

[7]  Chenhui Shen,et al.  Technical aspects of transurethral plasmakinetic enucleation and resection of the prostate for benign prostatic hyperplasia , 2017, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[8]  Xinghuan Wang,et al.  The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function , 2016, Medicine.

[9]  Denglong Wu,et al.  A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up , 2016, Lasers in Medical Science.

[10]  Xuecheng Dong,et al.  Five-Year Follow-Up Study of Transurethral Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia. , 2016, Journal of endourology.

[11]  Y. Wen,et al.  Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials , 2016, World journal of urology.

[12]  K. Loughlin,et al.  Benign prostatic hyperplasia: epidemiology, economics and evaluation. , 2015, The Canadian journal of urology.

[13]  Hui Zhang,et al.  Plasmakinetic Vapor Enucleation of the Prostate with Button Electrode versus Plasmakinetic Resection of the Prostate for Benign Prostatic Enlargement >90 ml: Perioperative and 3-Month Follow-Up Results of a Prospective, Randomized Clinical Trial , 2015, Urologia Internationalis.

[14]  R. Laing,et al.  Modified transurethral resection of the prostate (TURP) for men with moderate lower urinary tract symptoms (LUTS) before brachytherapy is safe and feasible , 2015, BJU international.

[15]  H. Woo,et al.  Ejaculatory dysfunction after treatment for lower urinary tract symptoms: retrograde ejaculation or retrograde thinking? , 2015, BJU international.

[16]  Á. Atallah,et al.  Surgery for stress urinary incontinence due to presumed sphincter deficiency after prostate surgery. , 2014, The Cochrane database of systematic reviews.

[17]  Jian-ming Tan,et al.  Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than 100 grams: a randomized noninferiority controlled trial with long-term results at 6 years. , 2014, European urology.

[18]  S. Maclennan,et al.  Systematic review and meta‐analysis of the clinical effectiveness of bipolar compared with monopolar transurethral resection of the prostate (TURP) , 2014, BJU international.

[19]  Jin-rui Yang,et al.  Plasmakinetic enucleation of the prostate versus transvesical open prostatectomy for benign prostatic hyperplasia >80 mL: 12-month follow-up results of a randomized clinical trial. , 2013, Urology.

[20]  Junhua Zheng,et al.  Improvement of erectile function in patients with benign prostatic hyperplasia undergoing transurethral plasmakinetic resection of the prostate , 2013, International journal of urology : official journal of the Japanese Urological Association.

[21]  Alexander Bachmann,et al.  EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. , 2013, European urology.

[22]  Sheng-qiang Xia,et al.  A comparative study of thulium laser resection of the prostate and bipolar transurethral plasmakinetic prostatectomy for treating benign prostatic hyperplasia , 2013, BJU international.

[23]  Naikai Liao,et al.  A study comparing plasmakinetic enucleation with bipolar plasmakinetic resection of the prostate for benign prostatic hyperplasia. , 2012, Journal of endourology.

[24]  Naikai Liao,et al.  Transurethral bipolar plasmakinetic resection combined with 2 μm continuous wave laser vaporization: a new method for the treatment of large volume benign prostatic hyperplasia. , 2012, Photomedicine and laser surgery.

[25]  H. Sim,et al.  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. , 2011, Singapore medical journal.

[26]  P. Tang,et al.  A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL. , 2010, Urology.

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