BPH 08. Comparison of transurethral plasmakinetic prostate resection and transvesical prostectomy in the treatment of large volume benign prostatic hyperplasia

Objectives: To compare the safety and efficacy of transurethral plasmakinetic prostate resection (PKPR) and transvesical prostectomy (TVP) for the treatment of benign prostatic hyperplasia (BPH) with a prostate volume of 100-149 mL.

Methods: Ninety-nine BPH patients with a prostatic volume of 100-149 mL were randomized into the PKRP and TVP groups. The relevant clinical data were reviewed preoperatively. Patients had follow-up appointments at one, three, six and 12 months postoperatively. The assessment indicators included the international prostate symptom score (IPSS), the quality of life score (QoL), the maximum urinary flow rate (Q_max) and the post-void residual urine volume (PVR). Adverse events were also recorded.

Results: A total of 96 patients completed the 12-month followup. The operative time was longer, but intraoperative blood loss was lower in the PKRP group. Despite a higher blood transfusion rate, 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. Assessment indicators were significantly improved in both groups at one month postoperatively. The improvement in lower urinary tract symptoms was maintained throughout the 12 months after surgery. There were no significant differences in IPSS, QoL, Q_max and PVR between the two groups. The PKRP group had a higher incidence of urethral stricture than the TVP group.

Conclusions: PKRP is a safe and effective treatment method and can achieve the effects of traditional open surgery for the treatment of BPH with a prostate volume of 100-149 mL.