Transurethral resection of prostate with plasmakinetic energy: 100 months results of a prospective randomized trial

Abstract

Study Type - Therapy (RCT). Level of Evidence 1b. What's known on the subject? and What does the study add? Standard monopolar transurethral resection of prostate (TURP) remains the gold standard surgical treatment of benign prostatic hyperplasia-related lower urinary tract symptoms. Plasmakinetic offers rapid tissue removal and haemostasis during resection with better vision under saline irrigation while eliminating risk of TUR syndrome. Our results show that Plasmakinetic has similar long-term results to standard TURP. • To compare long-term results of transurethral resection of prostate with PlasmaKinetic(®) energy (Plasmakinetic) and standard transurethral resection of prostate (TURP). • During the 2-year period between 2001 and 2002, 101 patients with lower urinary tract symptoms related to benign prostatic hyperplasia were enrolled into the study. • Patients were randomly assigned to either Plasmakinetic or standard TURP groups using computer-generated simple random tables in a 1:1 ratio. • After the publication of initial results, follow-up continued until December 2010. Patients were called by phone and invited for control at 60th and 100th months. • An International Prostate Symptom Score (IPSS) form was completed and uroflowmetry was performed to show the final status of the operation. • Overall, 67 of 101 patients (34 patients in Plasmakinetic group and 33 patients in TURP group) completed the 100th month control. • IPSS increased to 8.5 ± 1.6 and 9.4 ± 0.9 in the Plasmakinetic group and 7.9 ± 1.3 and 8.7 ± 1.2 in the TURP group at 60 and 100 months, respectively. • Mean maximal flow rate increased to 17.2 ± 3.9 mL/s in the Plasmakinetic group and to 16.9 ± 4.1 mL/s at 12 months in the TURP group but decreased to 15.9 ± 2.5 and 15.8 ± 3.0, respectively (P= 0.34) at 100 months. • Reoperation was performed in six patients in the Plasmakinetic group and four patients in the TURP group at the end of 100th month. • Our 100 months results suggest that Plasmakinetic technology can be used as a first-line treatment instead of monopolar TURP.