Two-year Outcome of High-risk Benign Prostate Hyperplasia Patients Treated With Transurethral Prostate Resection by Plasmakinetic or Conventional Procedure

作者:Lv Lei; Wang Liang*; Fan Min; Ju Wen; Pang Zili; Zhu Zhaohui; Li Bing; Xiao Yajun; Zeng Fuqing
来源:Urology, 2012, 80(2): 389-394.
DOI:10.1016/j.urology.2012.02.078

摘要

OBJECTIVE To perform a systematic comparison of transurethral plasmakinetic resection of the prostate (PKRP) to conventional transurethral resection of the prostate for treating benign prostate hyperplasia (BPH) in aged high-risk patients.
METHODS Three hundred twenty-nine symptomatic patients diagnosed with BPH underwent endourological treatment by transurethral resection of the prostate (n = 136) or PKRP (n = 193). Preoperative and postoperative assessments were conducted for the International Prostate Symptom Scores, quality of life (QoL), postvoid residual urine (PVRU) volumes, maximal urine flow rates (Q(max.)), and prostate-specific antigen. Perioperative data were collected for operative time, weight of resected tissue, blood loss, cases of open surgery, duration of bladder irrigation, and duration of catheter use. Patients were re-evaluated at postoperative months 3, 6, 12, 18, and 24. Postoperative complications were recorded.
RESULTS In the perioperative period, no significant differences were found between the 2 surgery groups for weight of resected tissue or cases of open surgery. However, PKRP was associated with significantly shorter operative time, duration of bladder irrigation, and duration of catheter use, as well as less blood loss. At the 2-year follow-up, both procedures were found to have significantly improved International Prostate Symptom Scores, QoL, Q(max.), PVRU, and prostate-specific antigen. In addition, each procedure was associated with some postoperative complications, some of which were significantly reduced in one over the other, such as secondary hemorrhage in PKRP.
CONCLUSION The currently available endourological treatments, transurethral resection of the prostate, and PKRP, are safe and effective therapies for treating aged high-risk patients with benign prostatic hyperplasia (BPH), although PKRP is superior in many aspects, including perioperative outcomes. UROLOGY 80: 389-395, 2012.