CU 63. Transurethral plasmakinetic enucleation of prostate and suprapubic small cut for treatment of senior and high risk patient with benign prostatic hyperplasia and bladder stones

Objective: To discuss the safety and efficiency of transurethral plasmakinetic enucleation of prostate(TUPKEP) and suprapubic small cut for treatment of senior and high risk patient with benign prostatic hyperplasia and bladder stones.

Methods: 54 senior and high risk patients with benign prostatic hyperplasia and bladder stones are treated by TUPKEP and suprapubic small cut. The patients are 70-92 years old [mean (78±0.6) years old]. Weigh of resected prostate was 52-106 gram [mean (74.2±0.5) gram] and diameter of bladder stones was 2.3-4.8 cm [mean (3.4±0.3) cm], the surgical incision length was 3-6 cm [mean (4.2±0.3) cm]. Results: The operation was successfully performed in all the 54 cases, with no TURS, shock, myocardial infarct, cerebral infarction, cerebral hemorrhage, permanent urinary incontinence, surgical Site Infection. 6 patients with temporal urinary incontinence recover in 4-30 days [mean (8.4±1.2) days] after operation. The operative time was 45-58 min [mean (49.6±3.4) min], the total blood loss was 22-106 mL [mean (46.9±4.2) mL], the amount of the wash fluid during the operation was 5-11 L [mean (8.4±0.3) L], the wash time after the operation was 8-69 hours [mean (31.7±1.5) hours], the amount of the wash fluid after the operation was 4-22 L [mean (6.7±0.4) L], catheters are keeped for 96-168 hours [mean (128.7±6.5) hours], Q_max increased from (4.6±0.5) mL/s to (19.4±1.3) mL/s. IPSS decreased form (23.6±1.4) to (10.8±0.9) and QOL decreased form (5.1±0.5) to (1.6±0.3). The changes of Q_max, IPSS and QOL were statistically significant (P<0.05).

Conclusions: TUPKEP and suprapubic small cut for treatment of senior and high risk patient with benign prostatic hyperplasia and bladder stones is safe and effective and it should be widely used.