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Objective@#To compare the safety and effectiveness of shovel-shaped electrode transurethral plasmakinetic enucleation of the prostate (PKEP) with those of plasmakinetic resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH).@*METHODS@#We retrospectively analyzed the clinical data about 78 BPH patients received in Shanghai Ninth People's Hospital from June 2016 to January 2017, 39 treated by shovel-shaped electrode PKEP and the other 39 by PKRP. We observed the patients for 6 months postoperatively and compared the effects and safety of the two surgical strategies.@*RESULTS@#No statistically significant difference was observed between the PKEP and PKRP groups in the operation time (［69.3 ± 8.8］ vs ［72.2 ± 7.9］ min, P = 0.126), but the former, as compared with the latter, showed a markedly less postoperative loss of hemoglobin (［3.9 ± 2.8］ vs ［13.9 ± 5.2］ g/L, P 0.05) and other postoperative complications.@*CONCLUSIONS@#Both PKEP and PKRP are effective methods for the treatment of BPH, but PKEP is worthier of clinical recommendation for a better safety profile, more thorough removal of the prostate tissue, less blood loss, shorter hospital stay, and better improved quality of life of the patient.
Subject(s)
Humans , Male , China , Electrodes , Equipment Design , Prostatic Hyperplasia , General Surgery , Quality of Life , Retrospective Studies , Transurethral Resection of Prostate , Methods , Treatment OutcomeABSTRACT
Objective To explore the efficacy of four-step method for transurethral enucleation of the prostate . Methods A retrospective analysis was conducted on 120 cases of benign prostate hyperplasia ( BPH) treated with four-step method ( traction, enucleation, resection, and repair ) for transurethral plasmakinetic resection of the prostate in our hospital from January 2012 to February 2014. Results The average operation time was (91.4 ±35.3) min.The intraoperative blood loss was 78.8 ±34.1 ml. The resection of the prostate tissue weight was (32.1 ±15.7) g.The postoperative bladder infusion time was (1.5 ±0.5) days.The postoperative indwelling catheter time was 3.5 ±0.8 days.The postoperative hospital stay was (5.5 ±0.5) days.No death, blood transfusion, or TURS happened.Follow-up reviews at 3 months after surgery found postoperative international prostatic symptom score (IPSS) was significantly less than the preoperative level [4.5 ±2.2 vs.24.5 ±5.1, t=39.445, P=0.000], postoperative Qmax was significantly higher than preoperative level [(21.5 ±10.5) ml/s vs.(6.0 ±1.9) ml/s, t =15.912, P =0.000], and postoperative residual urine was significantly less than the preoperative level [(12.0 ±2.0) ml vs.(145.0 ±33.0) ml;t=44.069, P =0.000].No retrograde ejaculation, sexual dysfunction, or dysuria happened. Conclusion The four-step method for transurethral enucleation of the prostate is radical , safe, and simple.
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Objective To evaluated the role of transurethral plasmakinetic resection of the prostate ( TUPKRP ) in combination with percutaneous bladder channel lithotripsy with holmium laser in the treatment of benign prostate hyperplasia ( BPH) and bladder stone in senior patients . Methods Seventy-three patients treated during January 2009 to May 2014 were retrospectively reviewed.The patients aged 70-95 years old (mean, 85.6 years old).All of the patients were complicated with one or more diseases of the cardiovascular system .Ultrasound examinations prior to operation showed the sizes of prostates ranging 35-105 g, among which 58 cases showed middle prostatic lobe protruding into the bladder cavity .The sizes of the bladder stones ranged 1.5 -4.5 cm. Results The operations were successful in all the cases .The time of lithotripsy ranged 15-50 min (mean, 24 min), and the time of prostatectomy ranged 40 -135 min (mean, 70 min).No severe complications, such as major bleeding, transurethral resection syndrome, bladder perforation, residual stones, or severe infections, were observed.The urethral catheters were removed 3-5 days after operation, without urine leakage, dysuria, or urinary incontinence.Post-operation pathology of all the cases revealed BPH .The duration of hospitalization was 5-10 d (mean, 6 d).Three months after operation, the international prostate symptom scores were decreased from (23.5 ±5.1) points to (7.5 ±1.6) points (P<0.05), the quality of life (QOL) scores were decreased from (5.1 ± 0.5) points to (2.2 ±0.8) poins (P<0.05), the maximum flow rates (Qmax) were increased from (6.2 ±2.4) ml/s to (17.9 ± 4.2) ml/s (P<0.05), and residual urine volumes were decreased from (185.6 ±29.7) ml to (30.0 ±21.2) ml (P<0.05). Conclusion Transurethral plasmakinetic resection of the prostate in combination with percutaneous bladder channel lithotripsy with holmium laser is safe and effective for the treatment of benign prostate hyperplasia and bladder stone in senior patients .
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Objective To investigate clinical efficacy and safety and complications of transurethral plasmakinetic resection of prostate ( PKRP) for benign prostatic hyperplasia ( BPH) .Methods Totally 186 BPH patients were underwent PKRP .Comparison of clinical parameters before and after operation .Results Following-up at 3 and 6 months after the operation showed that international prostate symptom score ( IP-SS),quality of life(QQL),residual urine volume(RUV) scores increased and maximal urinary flow rate ( Qmax) scores decreased .The incidence of complications was 8.2%.Conclusion PKRP have efficacy in the treatment of BPH , and PKRP is safer and less complications .
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Objective To investigate the influence of transurethral plasmakinetic resection of the prostate(PKRP)on sexual function. Methods From January 2007 to December 2007.165 patients received PKRP,who had sexual active and completed the follow-up data forms before and after surgery.The average age of this cohort was 71 years(from 55 to 79 years).The average history of disease was 5.5(3-15)years while the average prostate volume 57(33-82)g,IPSS(26.4±2.6),quality of lire score(5.54±0.50),the maximum flow rate(7.04±4.10)ml/s,the average residual 120(55～250)ml.45 cases were complicated with urinary retention,and bladder stones 45 cases.15 cases with prostate stones.Their sexual function was assessed by the international index of erectile function,ejaculation function and sexual satisfaction before and 6 months after surgery by questionnaires,and compared the respective scores using SPSS14.0 and χ2 test. Results All of 165 patients,the IIEF-5 improved from(23.4±4.7)point to(24.1±4.9)point 6 months after operation(P>0.05),there was not significant.The abnormal ejaculation rate increased from 18.8%(31/165 patients)to 75.2%(124/165 patients)(P<0.001)after PKRP,respectively.The retrograde ejaculation rate increased from 11.6% (19/165 patients) to 64.2%(106/165 patients) after PKRP, respectively.There was a significant difference.128 patients (77.6 % ) and 132 patients (80.0 % ) were satisfied with their sexual active before and after 6 months PKRP, respectively. Conclusions The results of this study confirmed that PKRP has no negative influence on the quality of erections measured by IIEF-5.The loss of ejaculatory function has no influence on patients sexual active.
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Objective To compare the clinical effects of transurethral plasmakinetic resection(TUPR) with transurethral resection of the prostate(TURP) for benign prostatic hyperplasia.Methods From October 2003 to July 2006,a total of 127 patients with benign prostatic hyperplasia was divided the into the TURP Group(n=62) and the TUPR Group(n=61) according to random number table by computer.1 case of neurogenic bladder and 3 cases of TURP failure were ruled out the study.Results As compared with the RTRP Group,the TUPR Group had less intraoperative blood loss[(78.5?46.2)ml vs(115.0?43.5)ml,t=4.511,P=0.000] and more weight of resected prostate[(60.5?29.3)g vs(45.9?30.5)g,t=2.709,P=0.008].The operation time in the two groups was similar[(93.4?35.5)min vs(81.3?46.3)min,t=1.629,P=0.106].There were no statistic differences in international prostate symptom score,quality of life,Qmax,residual urine and complication rate(2/61 vs 5/62).Conclusions Compared with TURP,transurethral plasmakinetic resection of the prostate has the advantages of less blood loss and more entire resection of the prostate,so it might be more effective.