Bipolar plasmakinetic transurethral enucleation and resection versus bipolar plasmakinetic transurethral resection for surgically treating large (≥60 g) prostates: a propensity score-matched analysis with a 3-year follow-up.

Abstract

Background There are extremely limited published studies comparing bipolar plasmakinetic transurethral resection of prostate (BP-TURP) and bipolar plasmakinetic transurethral enucleation and resection of prostate (BP-TUERP) for enlarged prostates. Our purpose is to evaluate the safety and efficiency of BP-TUERP and BP-TURP for large (≥ 60 g) prostates with a 3-year follow-up. Methods We retrospectively identified 229 patients according to inclusion criteria between 2014 and 2016. After applying propensity score matching method, preoperative results and three-year follow-up outcomes in International Prostate Symptom Score (IPSS), urinary peek flow rate (Qmax), postvoid residual urine (PVRU) volume and quality of life (QoL) score were compared. Results Finally, within the well-balanced matched cohort, the BP-TUERP was significantly associated with longer mean operating time (OT) (p = 0.039), shorter mean catheter time (CT) (p = 0.001) and lower mean hemoglobin decrease (p = 0.002) with more prostatic tissue removed (p = 0.001) than the BP-TURP, but the median hospital stay lengths and the short- and long-term complication rates were similar between the two series. The patients in the BP-TUERP group had better long-term outcomes in IPSS, Qmax and PVRU volume than these in the BP-TURP group, but not in QoL score. Conclusions For patients with large (≥ 60 g) prostates, BP-TUERP and BP-TURP are safe options, but the former is a more effective choice in long-term follow-up outcomes. BP-TUERP is related to reduced CT and hemoglobin decrease with more removal of prostatic tissue at the expense of longer OT than BP-TURP.