Comparison of therapeutic effects between transurethral plasma kinetic enucleation of prostate and transurethral resection of prostate on benign prostatic hyperplasia / 中华老年医学杂志

ABSTRACT

Objective To compare the clinical efficacy and safety between transurethral plasma kinetic enucleation of prostate(TUPKEP) and transurethral resection of prostate(TURP) on benign prostatic hyperplasia(BPH). Methods One hundred and forty two BPH patients were divided into two groupsTUPKEP group (72 cases) and TURP group (70 cases). Seventy two cases aged 52-90 years[mean age (70. 5±7.6) years] with prostate weight of 27-126 g [mean weight (75. 6±10. 3)g] underwent TUPKEP, and seventy cases aged 51-87 years[mean age (70. 2±6. 8) years] with prostate weight of 25-118 g[mean weight (73.8±9.9)g] underwent TURP. There were no significant differences in age, weight of the prostate, international prostate symptom score(IPSS), residual urine volume(RUV) ,maximum urinary flow rate (Qmax) and quality of life (QOL) scores between the two groups before operation (t=0. 2873, 1.0612, 1. 0832,0. 9522,0. 0000, 1. 0774;P=0. 7743,0. 2904, 0. 2806,0. 3426,1. 0000,0. 2832). The operative time, intraoperative blood loss, the preserved time of installing catheter, hospitalization time, postoperative morbidity rate and efficacy were compared between the two groups. Results The operation success rates were 100. 0% (72/72) in TUPKEP group and 98.6% (69/70) in TURP group. The average operation time were (46.2±6.4)min and (58. 4±9. 6)min (t±8. 9404, P=0.0000), and the mean intraoperative blood loss were (105.9± 12.2)ml and (148.6±14.3) ml(t=19. 1608, P=0.0000) in TUPKEP and TURP groups respectively. The mean preserved time of installing catheter were (3. 5±1.0)d and (5.0±1.0)d(t= 8. 9364, P=0. 0000), and the average hospitalization time were (5.1±1.9) d and (7.0±2.6) d (t= 4. 9819,P=0.0000)in the two groups, respectively. In TUPKEP group, there was one case of temporary urinary incontinence, two cases of secondary prostate hemorrhage and one case of external orifice stricture of urethra, with a complication rate of 5.56%. In TURP group, there were two cases of transurethral resection syndrome (TURS), one case of urinary extravasation, two cases of temporary urinary incontinence, three cases of secondary prostate hemorrhage and two cases of external orifice stricture of urethra, with a complication rate of 14.29% . Compared with preoperation, Qmax was obviously increased and IPSS,RUV, QOL scores were decreased after follow- up for 3 months, but there were no significant differences in these parameters between the two conditions(t=1. 1131,0. 2543,1. 2959,0. 7252;P=0. 2676,0. 7996,0. 1971,0. 4696). Canclusions TUPKEP and TURP have similar efficacy in the treatment of BPH, but TUPKEP is a method with shorter operation time, less blood loss, lower postoperative complication rate and more safety than TURP.