Did prostate size affect the complication and outcome of plasmakinetic enucleation of the prostate?

Abstract

To evaluate surgical complications and outcomes based on prostate size in patients with benign prostatic hyperplasia (BPH) treated with plasmakinetic enucleation of the prostate (PKEP). A retrospective review was conducted of PKEP performed between July 2008 and January 2013. According to the prostate size on preoperative transrectal ultrasonography measurement, patients were divided into three groups: group 1: <40 ml, group 2: 40-80 ml and group 3: >80 ml. Baseline, perioperative and postoperative data were obtained. There were significant differences among the three groups regarding the mean operative time (p < 0.001) and the mean resected tissue weight (p < 0.001). But enucleation efficiency (p < 0.001) in gm tissue per minute increased significantly as prostate size increased. Mean hemoglobin decrease (p > 0.05), mean postoperative irrigation time (p > 0.05), mean catheter time (p > 0.05) and mean hospital stay (p > 0.05) did not differ significantly among three groups. The three groups had a similar and significant postoperative improvement in International Prostate Symptom Score, quality of life, maximum uroflow rate and post-void residual urine volume independent of prostate size (p < 0.001), but no significant difference was found among three groups at the 12-month follow-up (p > 0.05). Perioperative and postoperative complications did not depend on prostate size (p > 0.05). Although patients with a larger BPH required significantly longer operation time in PKEP, prostate size did not affect perioperative and postoperative complications or micturition improvement.