Comparison of PKRP and TUVP in the treatment of high-risk BPH and analysis of postoperative influencing factors.

Objective: This study aims to compare the efficacy of plasma kinetic loop resection of the prostate (PKRP) and transurethral vaporization of the prostate (TUVP) for the treatment of high-risk benign prostatic hyperplasia (BPH), and analyze the influence of the related factors on the operation of BPH. Methods: A total of 108 high-risk BPH patients diagnosed in our hospital from March 2018 to September 2021 were selected and randomly divided into an observation group and a control group, with 54 cases in each group. The control group was treated with TUVP, and the observation group was treated with PKRP. The international prostate symptom score (IPSS), quality of life (QOL) index, maximum urine flow rate (Qmax), and residual urine volume (RU) were observed before and after treatment. The general information such as age, educational level, residence, and residence status of the patient, as well as clinical information such as surgical method, nocturia frequency, preoperative IPSS score, RU, medical history, and prostate texture, were also recorded. All patients were followed up for 1 month, and complications were recorded. Results: The IPSS score, QOL score, and RU of patients in the two groups were lower after treatment than those before treatment, and the Qmax was higher than that before treatment (P < 0.05). The IPSS score, QOL score, and RU of the observation group were lower than those of the control group, and the Qmax was higher than that of the control group (P < 0.05). The incidence of postoperative complications in the observation group was lower than in the control group (P < 0.05). Univariate analysis showed that the patient's age, surgical method, nocturia frequency, preoperative IPSS score, RU, medical history, and prostatic texture all could affect the postoperative condition of patients with BPH (P < 0.05). Multivariate logistic analysis showed that the patient's age, surgical method, nocturia frequency, preoperative IPSS score, RU, and medical history were the independent influencing factors of the postoperative condition of patients with BPH (P < 0.05). Conclusion: PKRP in the treatment of high-risk BPH patients can effectively reduce the IPSS score, QOL score, and RU and significantly increase Qmax, with fewer complications and a good prognosis. Patients' postoperative recovery was related to their age, surgical method, nocturia frequency, preoperative IPSS score, RU, and medical history. Therefore, choosing PKRP to treat high-risk BPH patients can effectively improve the postoperative urethral functional recovery of patients and reduce the occurrence of complications.

Clinical Study on the Application of Preserved Urethral Mucosa at the Prostatic Apex in Transurethral Plasmakinetic Resection of the Prostate.

Objective: To explore the differences in the clinical efficacy, complications, and safety of transurethral plasmakinetic resection of the prostate (PKRP) by the conventional approach versus the approach preserving the urethral mucosa at the prostatic apex in the treatment of benign prostatic hyperplasia (BPH). Methods: A total of 90 patients with PKRP admitted to the First Hospital of Qinhuangdao from December 2018 to March 2021 were selected and divided into a control group (conventional PKRP, n = 45) and an observation group (PKRP with preserved urethral mucosa at the prostatic apex, n = 45). The clinical efficacy, safety, and sexual function of the groups were evaluated using the patients' International Prostate Symptom Score (IPSS), quality of life (QoL), prostate volume, maximum flow rate (Qmax), post-void residual (PVR), blood loss, surgical resection efficiency, and surgical complication data. Results: The differences in the preoperative indicators, glandectomy quality, and glandectomy rate between the groups were not statistically significant (P > 0.05). However, in the observation group, the surgery time and blood loss were significantly lower compared with the control group, and the resection efficiency was significantly higher, with statistical significance (P < 0.05). In the follow-up, one month after surgery, the IPSS and QoL were lower in the observation group than in the control group, and the differences were statistically significant (P < 0.05); three months after surgery, the PVR, IPSS, QoL, and Qmax scores were similar between the groups, with no statistical significance (P > 0.05). In terms of surgical complications, the incidences of urinary incontinence and other complications after catheter extraction were significantly lower in the observation group than in the control group, and the differences between the groups were statistically significant (P < 0.05). Conclusion: Compared with conventional PKRP, PKRP with preserved urethral mucosa at the prostatic apex can lead to immediate urinary continence after catheter extraction, reduce intraoperative blood loss, and shorten the surgery time, thus improving the surgical efficiency.

Transurethral plasmakinetic resection versus enucleation for benign prostatic hyperplasia: comparison of intraoperative safety profiles based on endoscopic surgical monitoring system.

OBJECTIVE: To compare the intraoperative safety profiles of transurethral plasmakinetic resection of the prostate (PK-TURP) with transurethral plasmakinetic endoscopic enucleation of the prostate (PK-EEP) in the treatment of benign prostatic hyperplasia (BPH) based on endoscopic surgical monitoring system (ESMS). METHODS: A total of 128 patients who were diagnosed with BPH were stratified based on prostate volume (PV) and accepted PK-EEP or PK-TURP treatment at 1:1 ratio. The ESMS as a novel method was used to monitor blood loss and fluid absorption during the operation. Clinical parameters such as intraoperative blood loss volume, fluid absorption volume, operation time, tissue weight of resection, preoperative and postoperative red blood cell count (RBC), hemoglobin concentration (HB), hematocrit (HCT), electrolyte, postoperative bladder irrigation time, indwelling catheter time, hospital stay time and other associated complications were documented and compared between two groups. RESULTS: No significant differences in majority of baseline characteristics were observed among patients with different prostate volumes between two surgical methods. For patients with prostate volume < 40 ml, the average operation time of patients who received PK-EEP treatment was much more than those who received PK-TURP (P = 0.003). On the other hand, for patients with prostate volume > 40 ml, the PK-TURP surgery was associated with a significant increase in intraoperative blood loss (P = 0.021, in PV 40-80 ml group; P = 0.014, in PV > 80 ml group), fluid absorption (P = 0.011, in PV 40-80 ml group; P = 0.006, in PV > 80 ml group) and postoperative bladder irrigation time as well as indwelling catheter time but decrease in resected tissue weight compared to the PK-EEP treatment. CONCLUSION: The ESMS plays an important role in comparison of intraoperative safety profiles between PK-TURP and PK-EEP. Our data suggest that PK-TURP treatment is associated with a decreased operation time in patients with prostate volume < 40 ml and the PK-EEP treatment is associated with decreased intraoperative blood loss, fluid absorption and increased tissue resection for patients with prostate volume > 40 ml. Our results indicate that the size of prostate should be considered when choosing the right operation method.

[Transurethral 180 W front-firing GreenLight laser vaporization of the prostate for the treatment of benign prostatic hyperplasia].

OBJECTIVE: To evaluate the clinical effect and safety of transurethral 180 W front-firing GreenLight laser vaporization of the prostate (PVP) in the treatment of benign prostatic hyperplasia (BPH). METHODS: A total of 61 BPH patients underwent 180W front-firing GreenLight laser PVP (n = 30, the PVP group) or transurethral plasmakinetic resection of the prostate (n = 31, the control group) from March to December 2019. We collected the pre-, intra- and post-operative clinical data and compared them between the two groups of patients. RESULTS: Operations were successfully completed in all the cases with no blood transfusion or serious complications. Compared with the controls, the patients of the PVP group showed remarkably less intra-operative blood loss (ï¼»62.3 ± 15.9ï¼½ vs ï¼»48.8 ± 9.6ï¼½ ml, P < 0.05), shorter operation time (ï¼»75.0 ± 9.9ï¼½ vs ï¼»57.5 ± 19.0ï¼½ min, P < 0.05), postoperative bladder lavage time (ï¼»64.4 ± 10.5ï¼½ vs ï¼»25.2 ± 11.5ï¼½ h, P < 0.05), catheter-indwelling time (ï¼»5.1 ± 0.5ï¼½ vs ï¼»2.5 ± 0.5ï¼½ d, P < 0.05) and hospitalization time (ï¼»7.3 ± 1.7ï¼½ vs ï¼»4.1 ± 0.6ï¼½ d, P < 0.05), and a lower incidence of postoperative hematuria (12.9% ï¼»4/31ï¼½ vs 0% ï¼»0/30ï¼½, P < 0.05). No statistically significant differences, however, were found between the two groups in the incidence rates of capsular perforation, transurethral resection syndrome (TURS), urinary incontinence, urethral stricture and post-extubation urinary retention. Significant improvement was observed in IPSS, QOL, Qmax and PVR in both groups post-operatively (P < 0.05). CONCLUSIONS: Compared with transurethral plasmakinetic resection of the prostate, 180W front-firing GreenLight laser PVP, with the advantages of less bleeding, shorter catheter-indwelling time and faster recovery, is safer and more effective for the treatment of BPH, with no need for drug withdrawal for those taking anticoagulants, and especially applicable to the elderly and high-risk patients.

[Shovel-shaped electrode transurethral plasmakinetic enucleation versus plasmakinetic resection of the prostate in the treatment of benign prostatic hyperplasia].

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 (ï¼»69.3 ± 8.8ï¼½ vs ï¼»72.2 ± 7.9ï¼½ min, P = 0.126), but the former, as compared with the latter, showed a markedly less postoperative loss of hemoglobin (ï¼»3.9 ± 2.8ï¼½ vs ï¼»13.9 ± 5.2ï¼½ g/L, P <0.001) and shorter bladder irrigation time (ï¼»12.5 ± 1.2ï¼½ vs ï¼»43.4 ± 2.8ï¼½ h, P <0.001), catheterization time (ï¼»64.0 ± 4.5ï¼½ vs ï¼»84.8 ± 3.0ï¼½ h, P <0.001) and hospital stay (ï¼»3.1 ± 0.3ï¼½ vs ï¼»5.5 ± 0.4ï¼½ d, P <0.001). There were no statistically significant differences between the PKEP and PKRP groups in the postoperative maximum urinary flow rate (Qmax) (ï¼»21.62 ± 1.07ï¼½ vs ï¼»21.03 ± 0.96ï¼½ ml/s, P = 0.12), International Prostate Symptoms Score (IPSS) (5.85 ± 0.90 vs 6.03 ± 0.81, P = 0.279), quality of life score (QoL) (2.0 ± 0.73 vs 2.28 ± 0.72, P = 0.09), postvoid residual urine volume (PVR) (ï¼»19.59 ± 6.01ï¼½ vs ï¼»20.21 ± 5.16ï¼½ ml, P = 0.629), or the incidence rates of urinary incontinence (2.56% ï¼»1/39ï¼½ vs 7.69% ï¼»3/39ï¼½, 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.

Transurethral balloon dilatation of the Prostate and Transurethral Plasmakinetic resection of the Prostate in the treatment of Prostatic Hyperplasia.

BACKGROUND & OBJECTIVE: With the aggravation of global aging, benign prostate hyperplasia tends to have a higher incidence and has been the most common disease in urinary surgery. It is usually treated by surgery. Our objective was to select an effective treatment scheme, the clinical efficacy and relevant indicators of transurethral balloon dilatation of the prostate (TUDP) and transurethral plasmakinetic resection of the prostate (PKRP) in the treatment of benign prostate hyperplasia were emphatically compared. METHODS: Ninety-eight patients with benign prostate hyperplasia who were admitted to the hospital of between May 2014 and July 2016 were selected and divided into a TUDP group (n=49) and PKRP (n=49) using random number table. The intraoperative blood loss, duration of surgery, international prostate symptom score (IPSS), quality of life (QOL), post-void residual urine (PVR) and complications of the two groups were observed. RESULTS: The results demonstrated that the postoperative blood loss and duration of surgery of the patients in the PKRP group were significantly higher than those of the TUDP group (P<0.05); the IPSS, QOL and PVR of the patients in the two groups after surgery were much lower than those before surgery (P<0.05); the IPSS, QOL and PVR of the patients in the PKRP group were significantly lower than those in the TUDP group after surgery (P<0.05). The incidence of postoperative complications of the PKRP group was 38.8%, which was apparently higher than 14.3% in the TUDP group (P<0.05). CONCLUSION: PKRP has better efficacy than TUDP in treating benign prostatic hyperplasia, but QOL was poor and there are many complications. Proper surgical procedure should be selected according to the specific disease condition of patients.

Shovel-shaped electrode transurethral plasmakinetic enucleation versus plasmakinetic resection of the prostate in the treatment of benign prostatic hyperplasia / 中华男科学杂志

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.

Bipolar Plasma Kinetic Prostatectomy Combined with Holmium Laser Percutaneous Nephrolithotomy for Senior High Risk Patients with Benign Prostate Hyperplasia and Complicated Bladder Stone / 中国微创外科杂志

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 .

Four-step Method for Transurethral Plasmakinetic Resection of the Prostate：a Report of 120 Cases / 中国微创外科杂志

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.

Comparison of transurethral plasmakinetic and transvesical prostatectomy in treatment of 100-149 mL benign prostatic hyperplasia.

OBJECTIVE: To compare the safety and efficacy of transurethral plasmakinetic resection of the prostate (PKRP) versus transvesical prostatectomy (TVP) in the treatment of large-volume benign prostatic hyperplasia (LV-BPH) (100-149 mL). METHODS: Ninety-nine BPH patients who had a prostate volume of 100-149 mL were divided into two groups to undergo PKRP or TVP. Preoperative clinical data were analyzed. Patients had follow-up appointments at 1 month, 3 months, 6 months, and 12 months postoperatively. Outcome measures included the International Prostate Symptom Score, quality of life score, maximum urinary flow rate, and postvoid residual urine volume. Adverse effects were also recorded. RESULTS: A total of 96 patients completed the 12-month follow-up. The operative time was longer, but intraoperative blood loss was lower in the PKRP group. Despite a higher percentage of patients requiring a blood transfusion, there was an obvious advantage in gland removal rate in the TVP group. The duration of postoperative catheterization, bladder irrigation, and hospital stay was significantly shorter in the PKRP group. Outcome measures were significantly improved in both groups 1 month postoperatively. The improvement in lower urinary tract symptoms was maintained throughout the 12 months after surgery. There were no significant differences in International Prostate Symptom Score, quality of life, maximum urinary flow rate, and postvoid residual urine volume between the two groups. CONCLUSION: PKRP has the advantage over TVP of being minimally invasive in the treatment of LV-BPH while achieving the same postoperative outcomes.

A clinical research of transurethral plasmakinetic resection of prostate for benign prostatic hyperpla-sia / 中国医师杂志

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 .

Sexual function changes after transurethral plasmakinetic resection of the prostate / 中华泌尿外科杂志

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.

A Comparison of the Clinical Effects Between Transurethral Plasmakinetic Resection and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia / 中国微创外科杂志

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.