Prospective randomized controlled trial comparing plasmakinetic vaporesection and conventional transurethral resection of the prostate.
OBJECTIVE
Plasmakinetic vaporesection of the prostate (PKVP) using normal saline irrigation has the theoretical advantage of avoiding transurethral resection syndrome and minimizing blood loss. It may also shorten the operative time since tissue is resected instead of just vaporized. The aim of this study was to evaluate the efficiency, safety and advantages of PKVP compared with standard transurethral resection of the prostate (TURP) at a regional acute hospital.


METHODS
A total of 60 consecutive men admitted from a waiting list for surgery for benign prostatic hyperplasia (BPH) were prospectively randomized to either PKVP or TURP. Peri- and postoperative outcome data at 3 months were obtained.


RESULTS
The PKVP loop achieved a fast and sharp cutting action similar to that with the traditional TURP loop. Data analysis was based on 51 patients. There were no significant differences between the methods in resection time, postoperative catheterization time and hospital stay. The mean reductions in serum sodium 2 hours after PKVP and on postoperative day 1 were 0.52 mmol/L and 3.35 mmol/L, respectively, while mean reductions in haemoglobin were 0.36 g/dL and 0.24 g/dL, respectively. There was no significant difference in haemoglobin reductions between PKVP and TURP (p = 0.326 at 2 hours; p = 0.192 on day 1) and serum sodium (p = 0.757 at 2 hours; p = 0.888 on day 1). Both groups achieved comparable improvement in International Prostate Symptom Score (p = 0.862), quality-of-life score (p = 0.169) and peak flow rate (p = 0.96) at 3-month follow-up.


CONCLUSIONS
PKVP achieved comparable results to traditional TURP and was an effective and safe procedure. However, it did not demonstrate obvious advantages over TURP in this acute regional hospital regular TURP list setting.
Fung
Berry Tat-Chow
BT
Division of Urology, Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR, China.
Li
Shu-Keung
SK
Yu
Chris Fong
CF
Lau
Ban-Eng
BE
Hou
Simon See-Ming
SS
D000368:Aged; D004598:Electrosurgery; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012964:Sodium / Q000097:blood; D007507:Therapeutic Irrigation; D020728:Transurethral Resection of Prostate / Q000379:methods
D006454:Hemoglobins; D012964:Sodium