1991 TWO-YEAR PROSPECTIVE, RANDOMIZED COMPARISON BETWEEN THE BIPOLAR PLASMA ENUCLEATION OF THE PROSTATE AND OPEN PROSTATECTOMY IN BPH CASES OVER 80 ML

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology (II)1 Apr 20131991 TWO-YEAR PROSPECTIVE, RANDOMIZED COMPARISON BETWEEN THE BIPOLAR PLASMA ENUCLEATION OF THE PROSTATE AND OPEN PROSTATECTOMY IN BPH CASES OVER 80 ML Bogdan Geavlete, Florin Stanescu, Catalin Iacoboaie, and Petrisor Geavlete Bogdan GeavleteBogdan Geavlete Bucharest, Romania More articles by this author , Florin StanescuFlorin Stanescu Bucharest, Romania More articles by this author , Catalin IacoboaieCatalin Iacoboaie Bucharest, Romania More articles by this author , and Petrisor GeavletePetrisor Geavlete Bucharest, Romania More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2410AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This long term, prospective, randomized trial aimed to evaluate the viability of the bipolar plasma enucleation of the prostate (BPEP) by comparison to open transvesical prostatectomy (OP) in cases of large prostates concerning surgical efficacy, perioperative morbidity and follow-up parameters. METHODS A total of 140 benign prostatic hyperplasia (BPH) patients with prostate volume over 80 mL, maximum flow rate (Qmax) below 10 mL/s and International Prostate Symptom Score (IPSS) over 19 were randomized in the 2 study arms (70 cases each). All patients were assessed preoperatively and every 6 months after surgery for a period of 2 years by IPSS, Qmax, quality of life score (QoL), post-voiding residual urinary volume (PVR), postoperative prostate volume and PSA level. RESULTS The two series were characterized by similar preoperative parameters, including the prostate volume (132.6 versus 129.7 mL). The BPEP and OP techniques emphasized similar mean operating times (91.4 versus 87.5 minutes) and resected tissue weights (108.3 versus 115.4 grams). The postoperative hematuria rate (2.9% versus 12.9%) as well as the mean hemoglobin drop (1.7 versus 3.1 g/dL), catheterization period (1.5 versus 5.8 days) and hospital stay (2.1 versus 6.9 days) were significantly improved for BPEP. The re-catheterization for acute urinary retention was more frequent in the OP group (8.6% versus 1.4%), while the rates of early irritative symptoms were similar for BPEP and OP (11.4% versus 7.1%). During the 2 year' follow-up period, no statistically significant difference was determined in terms of IPSS, Qmax, QoL, PVR, PSA level and postoperative prostate volume between the two series. Consequently, the calculated prostate volume decrease (83.0-84.7% versus 82.1-83.9%) and PSA level reduction (90.6-92.5% versus 90.1- 92.6%) by comparison to the preoperative measurements were statistically equivalent for the BPEP and OP groups. CONCLUSIONS BPEP represents a promising endoscopic approach in large BPH cases, characterized by good surgical efficiency and similar BPH tissue removal capabilities when compared to standard open prostatectomy. Plasma enucleation patients benefited from significantly reduced complications, shorter convalescence period and satisfactory long term follow-up symptom scores and voiding parameters. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e817 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bogdan Geavlete Bucharest, Romania More articles by this author Florin Stanescu Bucharest, Romania More articles by this author Catalin Iacoboaie Bucharest, Romania More articles by this author Petrisor Geavlete Bucharest, Romania More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...