title: Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 ml: a prospective, randomized trial with 5-year followup.
abstract: OBJECTIVE
  We compared the perioperative and postoperative characteristics of prostate PlasmaKinetic™ enucleation and bipolar transurethral resection for large volume benign prostatic hyperplasia.
  
  
  METHODS
  In this prospective, randomized, controlled trial 80 patients with benign prostatic hyperplasia and a prostate of larger than 70 ml were randomly assigned to prostate bipolar transurethral resection or PlasmaKinetic enucleation. Operative time, resected adenoma weight, changes in hemoglobin, catheterization time and postoperative hospital stay were recorded and compared. Patients were followed 1, 6, 12, 24, 36, 48 and 60 months after surgery.
  
  
  RESULTS
  Greater resected prostate weight (mean ± SD 64.2 ± 19.0 vs 50.6 ± 20.0 gm, p = 0.03), less blood loss (mean 0.87 ± 0.42 vs 1.74 ± 0.63 gm, p <0.01), and shorter catheterization time (mean 35.5 ± 5.8 vs 60.1 ± 5.8 hours, p <0.01) and postoperative hospital stay (mean 3 vs 4 days, [corrected] p <0.01) were recorded in the enucleation group than in the resection group. The postoperative improvement in International Prostate Symptom Score, quality of life, maximal flow rate and post-void residual urine volume was similar in the 2 groups at 1, 6, 12 and 24 months but significantly better in the enucleation group at 36, 48 and 60 months. During the 5-year followup no patient in the enucleation group but 2 in the resection group experienced recurrence.
  
  
  CONCLUSIONS
  For large volume benign prostatic hyperplasia PlasmaKinetic enucleation of the prostate is associated with less blood loss, shorter hospital stay and catheterization time than bipolar transurethral resection of the prostate. Moreover, PlasmaKinetic enucleation seems to be superior at long-term followup with fewer reoperations necessary.
authors.affiliation: Department of Urology, Fuzhou General Hospital, Xiamen University, Fujian Medical University, Fuzhou, Fujian, People's Republic of China.
authors.forename: Lingfeng
authors.initials: L
authors.lastname: Zhu
authors.forename: Shushang
authors.initials: S
authors.lastname: Chen
authors.forename: Shunliang
authors.initials: S
authors.lastname: Yang
authors.forename: Meijing
authors.initials: M
authors.lastname: Wu
authors.forename: Rong
authors.initials: R
authors.lastname: Ge
authors.forename: Weizhen
authors.initials: W
authors.lastname: Wu
authors.forename: Lianming
authors.initials: L
authors.lastname: Liao
authors.forename: Jianming
authors.initials: J
authors.lastname: Tan
mesh_terms: D004598:Electrosurgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods