A prospective study of transurethral resection of prostate and transurethral enucleation of prostate for benign prostatic hyperplasia according to different weights of prostate

Abstract

Objective To compare the clinical effect of transurethral plasma kinetic enucleation of prostate (TPKEP) and transurethral resection of prostat (TURP) for benign prostatic hyperplasia (BPH) according to different weights of prostate.Methods 245 cases of BPH were divided into two groups randomly.122 cases underwent TURP and 123 cases underwent TPKEP.All cases were divided into three subgroups:67 cases in ＜40 g group,96 cases in 40-70 g group and 82 cases in ＞70 g group,according to different weights of prostate.Perioperative parameters and short-term outcomes between two groups were compared.Results In the ＜40 g subgroup there was no significant difference between two groups in perioperative factors and short-term outcomes (P＞0.05).In the 40-70 g subgroup,tissue resected by TPKEP was significantly more than that by TURP (30.2± 13.1 g versus 30.2± 13.1 g,P＜0.05).The intraoperative blood loss was less in TPKEP group than that in TURP group (70.1±10.4 ml versus 81.3±11.3 ml,P＜0.05).The decline of prostate specific antigen (PSA) was more dramatically in TPKEP group than that in TURP group after 3 months (2.6±0.3 μg/L versus 2.1±0.6 pg/L,P＜0.05).In the ＞70 g subgroup,the decline of PSA level was (3.4±0.3) μg/L after 3 months in TPKEP group,more than (2.3±0.7) μg/L in TURP group (P＜0.05).The increase of Qmax after 3 months in TPKEP group was (18.6±3.5) ml/s,more than (16.6±3.4) ml/s in TURP group (P＜0.05).There was no significant difference between the two groups in international prostate symptoms score and residual urine volume (P＞0.05).The transfusion rate for TPKEP (3 ca-ses) were lower than that for TURP (12 cases) (P＜0.05),but the incidence of false incontinence for TPKEP (17 cases) were higher than that for TURP (6 cases) (P＜0.05).Conclusions Compared with TURP,TPKEP resect the entire prostate with the advantages of less blood loss and more effective for a large prostate.TPKEP had no advantage for small prostate,and the medical results are equivalencies in prostate with medium size. Key words: Transurethral plasma kinetic enucleation of prostate; Transurethral resection of prostate; Prostatic hyperplasia; Prospective studies