A prospective, randomized clinical trial comparing bipolar plasma kinetic resection of the prostate versus conventional monopolar transurethral resection of the prostate in the treatment of benign prostatic hyperplasia.
OBJECTIVE
For treatment of benign prostatic hyperplasia (BPH), Plasma Kinetic loop Resection of the Prostate (PKRP) is an alternative to conventional monopolar transurethral resection of prostate (TURP). We compared outcomes with the two treatments in a randomized trial.


METHODS
Over a one-year period, we randomly assigned patients with an indication for surgery for BPH and who met inclusion criteria to treatment with either PKRP or TURP. We measured prostate volume by transrectal ultrasound, relief of bladder outlet obstruction, operative time, decline in serum sodium and hemoglobin, weight of resected prostatic chips, duration of catheterization and hospital stay. Patients were evaluated one month after discharge for obstructive symptoms. Complications were also recorded.


RESULTS
Of 102 patients enrolled, 51 underwent PKRP and 51 underwent TURP. Relief of obstructive symptoms and mean operative time showed no statistically significant difference. The PKRP group had a smaller decline in hemoglobin than the TURP group (0.6 g/dL vs 1.8 g/dL, P=.01), a lower reduction in serum sodium levels (1.03 mmol/L vs 5.01 mmol/L, P=.01), a shorter catheterization time (37.2 hours versus 57.7 hours, P=.03) and a shorter hospital stay (1.5 days versus 2.6 days, P=.02). One patient in the bipolar PKRP group needed recatheterization versus four patients in the TURP group.


CONCLUSIONS
PKRP reduces morbidity with an outcome similar to conventional monopolar TURP in the treatment of BPH.
Division of Urology, Department of Surgery, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. chrisckho2002@yahoo.com
Christopher Ho Chee
CH
Kong
M Fadzli
MF
Ibrahim
Zulkifli Md
ZM
Zainuddin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012964:Sodium / Q000097:blood; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology; D014546:Urinary Catheterization
D006454:Hemoglobins; D012964:Sodium