Two-year outcome of high-risk benign prostate hyperplasia patients treated with transurethral prostate resection by plasmakinetic or conventional procedure.
OBJECTIVE
To perform a systematic comparison of transurethral plasmakinetic resection of the prostate (PKRP) to conventional transurethral resection of the prostate for treating benign prostate hyperplasia (BPH) in aged high-risk patients.


METHODS
Three hundred twenty-nine symptomatic patients diagnosed with BPH underwent endourological treatment by transurethral resection of the prostate (n = 136) or PKRP (n = 193). Preoperative and postoperative assessments were conducted for the International Prostate Symptom Scores, quality of life (QoL), postvoid residual urine (PVRU) volumes, maximal urine flow rates (Q(max.)), and prostate-specific antigen. Perioperative data were collected for operative time, weight of resected tissue, blood loss, cases of open surgery, duration of bladder irrigation, and duration of catheter use. Patients were re-evaluated at postoperative months 3, 6, 12, 18, and 24. Postoperative complications were recorded.


RESULTS
In the perioperative period, no significant differences were found between the 2 surgery groups for weight of resected tissue or cases of open surgery. However, PKRP was associated with significantly shorter operative time, duration of bladder irrigation, and duration of catheter use, as well as less blood loss. At the 2-year follow-up, both procedures were found to have significantly improved International Prostate Symptom Scores, QoL, Q(max.), PVRU, and prostate-specific antigen. In addition, each procedure was associated with some postoperative complications, some of which were significantly reduced in one over the other, such as secondary hemorrhage in PKRP.


CONCLUSIONS
The currently available endourological treatments, transurethral resection of the prostate, and PKRP, are safe and effective therapies for treating aged high-risk patients with benign prostatic hyperplasia (BPH), although PKRP is superior in many aspects, including perioperative outcomes.
Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
Lei
L
Lv
Liang
L
Wang
Min
M
Fan
Wen
W
Ju
Zili
Z
Pang
Zhaohui
Z
Zhu
Bing
B
Li
Yajun
Y
Xiao
Fuqing
F
Zeng
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome