Plasmakinetic Enucleation of the Prostate Versus Transvesical Open Prostatectomy for Benign Prostatic Hyperplasia >80 mL: 12-Month Follow-up Results of a Randomized Clinical Trial

Abstract

To prospectively evaluate perioperative results and 12-month follow-up after plasmakinetic enucleation of the prostate (PKEP) and transvesical open prostatectomy (OP) for benign prostatic hyperplasia (BPH) >80 mL. A total of 83 patients with a prostate >80 mL were randomized to either PKEP or OP. Perioperative and postoperative outcome data were obtained during a 12-month follow-up. No statistical differences were observed in the preoperative data. Both groups resulted in a similar and significant postoperative improvement in International Prostate Symptom Score (IPSS), quality of life (QOL), maximum uroflow rate (Qmax), postvoid residual (PVR) urine volume and prostate specific antigen (PSA), but no significant difference was found between the groups at the 12-month follow-up. Compared to OP, operation time (111.2 ± 27.1 minutes vs 109.6 ± 28.2 minutes, P= .708) were not significantly different between the groups, but blood loss was significantly less (10.2 ± 4.5 g/l vs 15.1 ± 4.3 g/l, P<.001), and bladder irrigation (2.4 ± 1.0 days vs 4.3 ± 1.1 days, P<.001), catheterization time (3.3 ± 1.1 days vs 6.2 ± 1.3 days, P<.001), and hospital stay (5.4 ± 1.2 days vs 9.3 ± 1.1 days, P<.001) were significantly shorter in the PKEP group. Effects on erectile function were similar in both groups, but adverse events were less frequent in the PKEP group. PKEP can be performed safely and is an equally effective procedure for treatment of large BPH with OP, with minimal complications and faster postoperative recovery. The PKEP helps to reduce the morbidity associated with OP and may become the attractive alternative to OP for patients with large BPH.