ABSTRACT
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.
Subject(s)
Humans , Male , China , Electrodes , Equipment Design , Prostatic Hyperplasia , General Surgery , Quality of Life , Retrospective Studies , Transurethral Resection of Prostate , Methods , Treatment OutcomeABSTRACT
Objective@#To explore the strategies of preserving urinary continence in transurethral plasmakinetic enucleation of the prostate (PKEP) for benign prostate hyperplasia (BPH).@*METHODS@#We treated 65 BPH patients by PKEP with preservation of urinary continence (UC-PKEP), which involved protection of the external urethral sphincter in the beginning of surgery, proper preservation of the anterior lobe of the prostate to protect the internal urethral sphincter in the middle, and preservation of the integrity of the bladder neck towards the end. We compared the postoperative status of urinary continence of the patients with that of the 54 BPH cases treated by complete plasmakinetic enucleation of the prostate (Com-PKEP).@*RESULTS@#All the operations were performed successfully with the urinary catheters removed at 5 days after surgery. In comparison with Com-PKEP, UC-PKEP achieved evidently lower incidence rates of urinary incontinence at 24 hours (31.49% vs 13.85%, P 0.05), and 3 months (3.70% vs 0%, P >0.05) after catheter removal. Compared with the baseline, the maximum urinary flow rate (Qmax) was significantly improved postoperatively in both the Com-PKEP (［7.43 ± 3.26］ vs ［20.58 ± 3.22］ ml, P <0.05) and the UC-PKEP group (［8.04 ± 2.28］ vs ［20.66 ± 3.08］ ml, P <0.05).@*CONCLUSIONS@#Transurethral PKEP is a safe and effective method for the management of BPH, during which the strategies of avoiding blunt or sharp damage to the external urethral sphincter in the beginning, properly preserving the anterior lobe of the prostate in the middle and preserving the integrity of the bladder neck towards the end may help to achieve rapid recovery of urinary continence.
Subject(s)
Humans , Male , Organ Sparing Treatments , Methods , Postoperative Period , Prostatic Hyperplasia , General Surgery , Quality of Life , Transurethral Resection of Prostate , Methods , Treatment Outcome , Urethra , Urinary Bladder , Urinary Catheterization , Urinary IncontinenceABSTRACT
Objective To investigate the efficacy and safety of transurethral plasmakinetic enucleation of the prostate (PKEP)combined with suprapubic cystostomy rotary resection in the treatment of large volume(>100 ml)benign prostatic hyperplasia(BPH). Methods From June 2015 to December 2015,28 patients with BPH[volume,(112.6 ±9.8)ml]were given transurethral PKEP.The resected gland was pushed into the bladder and the vesical stoma was extended.Whereafter a 10 mm trocar was introduced via suprapubic cystostomy, and then rotary resection of glands was performed and removed under transurethral observation. Results All the operations were successfully completed.The operating time was(85.8 ±26.5)min,the enucleation time was(38.0 ±11.3)min, and the rotary resection time was(47.5 ±20.2)min.Two patients had much flushing fluid extravasated into retropubic space and were given no special treatment.Two patients suffered the complication of transient stress urine incontinence after removal of catheter,and they were recovered within 4 weeks.Follow-up for 3-6 months found no urethral stricture. The IPSS scores at 3 months after operation were(13.5 ±3.6)points. Conclusion Transurethral PKEP combined with suprapubic cystostomy rotary resection in the treatment of large BPH is safe.