Comparison of bipolar plasmakinetic resection of prostate versus photoselective vaporization of prostate by a three year retrospective observational study

Xu Cheng,Mou Peng,Yijian Li,Peng Xu,Yinhuai Wang,Da Ren,Lizhi Zhou,Chuying Qin,Shuiqing Wu

doi:10.1038/s41598-021-89623-4

Abstract

Comprehensive evaluation of photoselective vaporization of the prostate (PVP) versus plasmakinetic resection of the prostate (PKRP) in treating benign prostatic hyperplasia (BPH) is inadequate. This single-centre, retrospective observational study was designed to compare their efficacy, complications and sexual function. A total of 215 patients under PVP or PKRP were included in the study, propensity score matching (PSM) was performed to match the baseline characteristics of the two groups, and perioperative and three-year follow-up data were compared between them. Finally, 120 patients (60 for PVP and 60 for PKRP) were matched after PSM. Compared with the PKRP group, the intraoperative haemoglobin loss was lower (9.08 vs 13.75 g/L, P < 0.001) and the duration of catheterization and postoperative hospital stay were shorter (2.97 vs 4.10 day, P < 0.001; 3.95 vs 5.13 day, P < 0.001, respectively), but the operation time was longer (56.72 vs 49, 90 min, P < 0.001) in the PVP group. Urination measurements were improved for both groups after surgery, although no significant differences were found between them during follow-up. Sexual function after surgery was partly increased; however, frequent retrograde and discomfortable ejaculation occurred in both groups. In addition, dysuria incidence and retreatment were higher in the PVP group at 12 months. In conclusion, PVP is safe and effective in relieving BPH-related lower urinary tract symptoms with less perioperative blood loss and earlier recovery without inferior sexual function effects. However, the study is potentially affected by residual unmeasured confounding.

Highlights

Comprehensive evaluation of photoselective vaporization of the prostate (PVP) versus plasmakinetic resection of the prostate (PKRP) in treating benign prostatic hyperplasia (BPH) is inadequate
Some studies have shown that the efficacy of PKRP or PVP is similar to that of TURP, but the incidence of related complications is much lower than that of TURP6, 16–18
Liu reported that PKRP was superior to TURP in terms of serum sodium reduction, hospital stay, blood transfusion rate, TURS and urethral stricture incidence, while there was no significant difference in IIEF-5 or retrograde e jaculation[19]

Summary

Methods

Patients who underwent surgical treatment for BPH between January 2014 and August 2016 at the Second Xiangya Hospital of Central South University were retrospectively analysed. This study was approved by the ethics committee of the Second Xiangya Hospital of Central South University, and informed consent was obtained from all included participants. The inclusion criteria were as follows: (1) age > 50 years old; (2) moderate to severe LUTSs that seriously affect the quality of life of patients, an International Prostate Symptom Score (IPSS) > 7 points, and a maximal urinary flow rate (Qmax) < 15 ml/s; (3) drug treatment failure; (4) prostate volume < 100 g; and (5) an IPSS and quality of life (QoL) score that could be completed independently and effectively. The study was approved by the ethics committees at the Second Xiangya Hospital of Central South University. This study was reported according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines for cohort studies

Result

Findings

Discussion