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European Journal of Medical Research
Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Erectile Dysfunction | Research

Clinical efficacy and complications of transurethral resection of the prostate versus plasmakinetic enucleation of the prostate

Authors: Chong-Yi Yang, Ge-Ming Chen, Yue-Xiang Wu, Wei-Jie Zhang, Jie Wang, Peng-Peng Chen, Zhen-Yuan Lou

Published in: European Journal of Medical Research | Issue 1/2023

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Abstract

Background

Benign prostatic hyperplasia (BPH) is a common disease in elderly males, and many kinds of minimally invasive procedures can be used for the treatment of BPH. However, various procedures have caused some controversies regarding clinical outcomes, so more studies are needed to validate these controversial topics.

Aims

This study aimed to explore differences of clinical efficacy, surgical features, and complications between transurethral resection of the prostate (TURP) and plasmakinetic enucleation of the prostate (PKEP) for BPH.

Methods

A total of eligible 850 cases of BPH underwent TURP (the TURP group, 320 cases) or PKEP (the PKEP group, 530 cases) in the urology department of our hospital from March 2015 to 2018 were involved in this study. Then, the baseline data, surgical characteristics, IPSS, QoL, PVR, Qmax, IIEF-5, and documented complications were compared between the two groups.

Results

The operative time, intraoperative irrigation volume, postoperative hemoglobin, decrease in hemoglobin, postoperative irrigation time and volume, catheterization time, and hospital stay of the PKEP group were significantly less than those of the TURP group (all P < 0.05). At 3 months, 1, 2, and 3 years after operation, no significant differences were observed in IPSS, QoL, PVR, but the results of Qmax and IIEF-5 in the PKEP group were significantly higher than those parameters in the TURP group (all P < 0.05). The incidences of massive blood loss, postoperative secondary bleeding, blood transfusion, capsular perforation, urinary tract irritation, bladder spasm, clot retention, urinary tract infection, transient incontinence, erectile dysfunction, and the incidences of II, III grade of Clavien–Dindo classification in the PKEP group were significantly lower than those of the TURP group (all P < 0.05).

Conclusion

The clinical efficacy of PKEP is compared favorably with TURP during midterm follow-up. Given the merits such as less blood loss and hospital stay, lower complications, PKEP should be given a priority for BPH.
Literature
1.
Cao Q, Wu Y, Guan W, et al. Diagnosis of chronic prostatitis by noninvasive methods in elderly patients with benign prostatic hyperplasia in China. Andrologia. 2021;53:e14055.CrossRefPubMed
2.
Miernik A, Fritzsche J, Libutzki B, et al. Real-world data and treatment patterns of patients with lower urinary tract symptoms due to benign prostatic hyperplasia in Germany: an observational study using health insurance claims data. World J Urol. 2021;39:4381–8.CrossRefPubMed
3.
Tsunemori H, Sugimoto M. Effects of inflammatory prostatitis on the development and progression of benign prostatic hyperplasia: a literature review. Int J Urol. 2021;28:1086–92.CrossRefPubMed
4.
Hu Y, Dong X, Wang G, et al. Five-year follow-up study of transurethral plasmakinetic resection of the prostate for benign prostatic hyperplasia. J Endourol. 2016;30:97–101.CrossRefPubMedPubMedCentral
5.
Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA GUIDELINE PART I-initial work-up and medical management. J Urol. 2021;206:806–17.CrossRefPubMed
6.
Zhao Y, Zhang Y, Li Y, et al. Yohimbine hydrochloride inhibits benign prostatic hyperplasia by downregulating steroid 5α-reductase type 2. Eur J Pharmacol. 2021;908:174334.CrossRefPubMed
7.
Noble SM, Ahern AM, Worthington J, et al. The cost-effectiveness of transurethral resection of the prostate vs thulium laser transurethral vaporesection of the prostate in the UNBLOCS randomised controlled trial for benign prostatic obstruction. BJU Int. 2020;126:595–603.CrossRefPubMed
8.
Sajan A, Mehta T, Desai P, et al. Minimally invasive treatments for benign prostatic hyperplasia: systematic review and network meta-analysis. J Vasc Interv Radiol. 2022;33:359–67.CrossRefPubMed
9.
Franco JV, Jung JH, Imamura M, et al. Minimally invasive treatments for lower urinary tract symptoms in men with benign prostatic hyperplasia: a network meta-analysis. Cochrane Database Syst Rev. 2021;7:CD013656.PubMed
10.
Sun F, Sun X, Shi Q, et al. Transurethral procedures in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis of effectiveness and complications. Medicine (Baltimore). 2018;97: e13360.CrossRefPubMed
11.
Cai F, Chen C, Zhnag J. Application of Clavien-Dindo classification for comparing complications of three endoscopic procedures for benign prostatic hyperplasia. J Southern Med Univ. 2015;35:1344–8.
12.
Yoon PD, Chalasani V, Woo HH. Use of Clavien-Dindo classification in reporting and grading complications after urological surgical procedures: analysis of 2010 to 2012. J Urol. 2013;190:1271–4.CrossRefPubMed
13.
14.
Park J, Cho SY, Cho MC, et al. Changes in erectile function after photoselective vaporization of the prostate with a 120-W green light high-performance system laser: 2-year follow-up. World J Mens Health. 2017;35:156–62.CrossRefPubMedPubMedCentral
15.
Wang B, Zhang S, Sun C, et al. Comparison between a transurethral prostate split and transurethral prostate resection for benign prostatic hyperplasia treatment in a small prostate volume: a prospective controlled study. Ann Transl Med. 2020;8:1016–24.CrossRefPubMedPubMedCentral
16.
Otaola-Arca H, Álvarez-Ardura M, Molina-Escudero R, et al. A prospective randomized study comparing bipolar plasmakinetic transurethral resection of the prostate and monopolar transurethral resection of the prostate for the treatment of benign prostatic hyperplasia: efficacy, sexual function, quality of life, and complications. Int Braz J Urol. 2021;47:131–44.CrossRefPubMed
17.
Liu Y, Cheng Y, Zhuo L, et al. Impact on sexual function of endoscopic enucleation vs transurethral resection of the prostate for lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and meta-analysis. J Endourol. 2020;34:1064–74.CrossRefPubMed
18.
Liu Z, Li YW, Wu WR, et al. Long-term clinical efficacy and safety profile of transurethral resection of prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia. Urology. 2017;103:198–203.CrossRefPubMed
19.
Wang Z, Zhang J, Zhang H, et al. Impact on sexual function of plasma button transurethral vapour enucleation versus plasmakinetic resection of the large prostate >90 ml: results of a prospective, randomized trial. Andrologia. 2020;52:e13390.CrossRefPubMed
20.
Zhang J, Wang Y, Li S, et al. Efficacy and safety evaluation of transurethral resection of the prostate versus plasmakinetic enucleation of the prostate in the treatment of massive benign prostatic hyperplasia. Urol Int. 2021;105:735–42.CrossRefPubMed
21.
Wei Y, Xu N, Chen SH, et al. Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60gr: a retrospective study at a single academic tertiary care center. Int Braz J Urol. 2016;42:747–56.CrossRefPubMedPubMedCentral
22.
Li S, Kwong JS, Zeng XT, et al. Plasmakinetic resection technology for the treatment of benign prostatic hyperplasia: evidence from a systematic review and meta-analysis. Sci Rep. 2015;5:12002–14.CrossRefPubMedPubMedCentral
23.
Bolliger M, Kroehnert JA, Molineus F, et al. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg. 2018;50:256–61.CrossRefPubMedPubMedCentral
24.
Karadeniz MS, Bayazit E, Aksoy O, et al. Bipolar versus monopolar resection of benign prostate hyperplasia: a comparison of plasma electrolytes, hemoglobin and TUR syndrome. Springerplus. 2016;5:1739–46.CrossRefPubMedPubMedCentral
25.
Yang BB, Shen BX, Liu WZ, et al. Medium-term clinical efficacy and complications of plasmakinetic enucleation of the prostate versus transurethral resection of the prostate for benign prostatic hyperplasia. Urology. 2022;164:204–10.CrossRefPubMed
26.
Gu M, Chen Y, Zhan M, et al. Comparison of thermal injury depth of the prostate between plasma kinetic electrode, holmium laser, green light laser and Nd:YAG laser. Int Urol Nephrol. 2021;53:863–7.CrossRefPubMed
27.
He LY, Zhang YC, He JL, et al. The effect of immediate surgical bipolar plasmakinetic transurethral resection of the prostate on prostatic hyperplasia with acute urinary retention. Asian J Androl. 2016;18:134–9.CrossRefPubMed
28.
Barbagli G, Kulkarni SB, Joshi PM, et al. Repair of sphincter urethral strictures preserving urinary continence: surgical technique and outcomes. World J Urol. 2019;37:2473–9.CrossRefPubMed
29.
Tanneru K, Jazayeri SB, Alam MU, et al. An indirect comparison of newer minimally invasive treatments for benign prostatic hyperplasia: a network meta-analysis model. J Endourol. 2021;35:409–16.CrossRefPubMed
30.
Castellani D, Di Rosa M, Pace G, et al. Comparison between thulium laser vapoenucleation and plasmakinetic resection of the prostate in men aged 75 years and older in a real-life setting: a propensity score analysis. Aging Clin Exp Res. 2021;33:1757–63.CrossRefPubMed
31.
Cornu JN. Bipolar, monopolar, photovaporization of the prostate, or holmium laser enucleation of the prostate: how to choose what’s best? Urol Clin North Am. 2016;43:377–84.CrossRefPubMed
32.
Zeng XT, Jin YH, Liu TZ, et al. Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition). Mil Med Res. 2022;9:1–19.
Metadata
Title
Clinical efficacy and complications of transurethral resection of the prostate versus plasmakinetic enucleation of the prostate
Authors
Chong-Yi Yang
Ge-Ming Chen
Yue-Xiang Wu
Wei-Jie Zhang
Jie Wang
Peng-Peng Chen
Zhen-Yuan Lou
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-00989-9

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