A Study Comparing Plasmakinetic Enucleation with Bipolar Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia

Abstract

Plasmakinetic enucleation of the prostate (PKEP) has been reported to be a new method for the transurethral management of benign prostatic hyperplasia (BPH). Our objective was to compare the safety and efficiency of PKEP with that of bipolar plasmakinetic resection of the prostate (PKRP) in the management of BPH. A total of 303 patients with lower urinary tract symptoms associated with BPH were included in our study. Of these, 143 patients underwent PKRP and 160 underwent PKEP. All patients were preoperatively assessed and evaluated at 3 months after surgery. International Prostate Symptom Score (IPSS), quality of life (QoL), postvoid residual urine (PVRU) volume, and maximum flow rate (Qmax) were obtained at the follow-up. The perioperative data and postoperative outcomes were compared. Immediate and late complications were recorded. There were no significant differences between the two surgical groups preoperatively. The mean prostate volumes in the PKRP and PKEP groups were 75.6 cc and 77.3 cc, respectively. Both groups were similar with respect to operative time, resected tissue weight, catheterization time, and the total length of hospital stay. The blood loss observed in the PKEP group was significantly less than that of conventional PKRP (P<0.0001). PKEP was significantly superior to PKRP in terms of the transient incontinence in the postoperative period (P=0.03). Both groups resulted in a significant improvement from baseline in terms of IPSS, QoL, Qmax, and PVRU volume values. No significant difference was found between them, however. PKEP is a safe and effective method for the transurethral management of BPH. Compared with PKRP, the main advantage of PKEP is the decreased risk of blood loss and transient incontinence.