Application of morcellator in transurethral bipolar plasmakinetic anatomical enucleation of the prostate / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the safety and therapeutic effect of morcellator in transurethral bipolar plasmakinetic anatomical enucleation (TUPKAEP) of benign prostate hyperplasia (BPH).</p><p><b>METHODS</b>The clinical data of 47 patients with BPH receiving TUPKAEP between January and July, 2015 were analyzed. During the operation, morcellator was used to smash the enucleated BPH which was aspirated with subatmospheric pressure in 29 cases, and the tissue was smashed with bipolar electrosurgical loop slicing from top to bottom and aspirated by ellic suction in 18 cases.</p><p><b>RESULTS</b>s The procedures were completed successfully in all the 47 cases. The time used for adenoma dissociation was 2.24∓1.09 with morcellator at the speed of 18.43∓6.01 g/min, and was 17.19∓11.74 min with bipolar electrosurgical loop at the speed of 1.91∓0.65 g/min; the mean total operation time was significantly shorter in morcellator group (28.13∓14.71 vs 43.22∓25.39 min). The 2 groups showed no significant difference in postoperative continuous bladder irrigation time, postoperative indwelling time of urinary catheter or postoperative hospital stay.</p><p><b>CONCLUSION</b>s Morcellator is safe and feasible for application in TUPKAEP and helps to shorten the operation time.</p>

Transurethral bipolar plasmakinetic enucleation and resection versus transurethral bipolar plasmakinetic resection of the prostate for BPH: a randomized controlled trial on the incidence of postoperative urinary incontinence / 中华男科学杂志

<p><b>OBJECTIVE</b>To compare the incidence rates of postoperative urinary incontinence between transurethral bipolar plasmakinetic enucleation and resection of the prostate (PKERP) and transurethral bipolar plasmakinetic resection of the prostate (PKRP), and provide evidence for the clinical application of PKERP.</p><p><b>METHODS</b>Totally, 180 BPH patients were equally and randomly assigned to undergo PKERP and PKRP, respectively. We measured the urinary incontinence of the patients by pad test at 24 hours after extubation and every week after surgery for 4 weeks. Meanwhile, we recorded and compared the PSA level, prostate volume, Qmax, residual urine, IPSS, QOL, and the results of pad test between the two groups before and after surgery.</p><p><b>RESULTS</b>The incidence rates of urinary incontinence in the PKERP and PKRP groups were 35.56% and 18.89% (P < 0.01) at 24 hours after extubation, 20.00% and 7.78% at 1 week after surgery (P < 0.05), and 3.33% and 2.22% at 2 weeks. There was no significant difference in the severity of urinary incontinence between the two groups at any time point (P > 0.05). No permanent urinary incontinence was observed in either group.</p><p><b>CONCLUSION</b>Compared with PKRP, PKERP has a higher incidence rate of short-term urinary incontinence in the treatment of BPH, but not that of genuine incontinence, with similar severity and recovery time.</p>

Early removal of the urethral catheter after transurethral plasma kinetic resection of the prostate in the treatment of BPH / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and effect of early removal of the urethral catheter after transurethral plasma kinetic resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>We equally randomized 128 BPH patients treated by PKRP to an experimental group and a control group, urethral catheters removed at 1 -2 days for the former and at 5 -7 days for the latter. We compared the relevant indexes and clinical effects between the two groups.</p><p><b>RESULTS</b>The baseline data were not significantly different between the two groups. Compared with the controls, the experimental group showed a significantly shorter postoperative hospital stay ([6.8 +/- 1.9] d vs [3.7 +/- 1.5] d, P < 0.05) and lower infection rate (25.0% vs 10.9%, P < 0.05). All the patients were followed up for 3 -6 months postoperatively. At 3 months after surgery, both the experimental and the control groups showed remarkable improvement in the International Prostatic Symptoms Scores (4. 9 +/- 2. 2 vs 5. 3 +/- 2. 3), maximum urine flow rate ([21.5+/- 5.6 ] ml/s vs [19.1 +/-4.9 ] ml/s) , and residual urine ( [ 16.8+/- 10.3 ] ml vs [18.9 +/- 12.3 ] ml), but with no significant differences between the two (P > 0.05) , and no significant differences were observed in postoperative complications (P >0.05).</p><p><b>CONCLUSION</b>Early removal of the urethral catheter after PKRP, with its advantages of shorter postoperative hospital stay, lower infection rate, and no influence on the long-term effect, deserves to be recommended as a routine method in the treatment of BPH.</p>

Transurethral enucleation of the prostate for treatment of benign prostatic hyperplasia in patients less than 50 years old / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of transurethral enucleation of the prostate for treatment of benign prostatic hyperplasia in patients below 50 years of age.</p><p><b>METHODS</b>Twelve patients with benign prostatic hyperplasia patients (mean age 48.2 years, range 46-49 years) underwent transurethral enucleation of the prostate. The middle lobe and two lateral lobes were enucleated with the preprosthetic sphincter and anterior fibromuscular stroma preserved during the operation. The patients were followed up to evaluate the lower urinary tract symptoms and sexual activity after the surgery.</p><p><b>RESULTS</b>The 12 patients were followed up for 3 to 6 months. The symptoms of lower urinary tract obstruction were improved obviously after the surgery, and the International Prostate Symptom Score (IPSS) decreased from 24±5.1 to 8.8±1.4 and peak urine flow rate (Qmax) increased from 8.1±4.2 ml/s to 20.1±4.2 ml/s at 3 months postoperatively. All the 12 cases had residual urine (12-44 ml) preoperatively, but after the surgery, only 4 still had residual urine of less than 30 ml. All the patients had normal erection function postoperatively, and 10 had normal ejaculation; the other 2 patients recovered normal ejaculation 3 and 5 months after the operation, respectively.</p><p><b>CONCLUSIONS</b>Transurethral enucleation can alleviate the low urinary tract obstruction symptom and improve the sexual function by avoiding preprosthetic sphincter injury in relatively young patients with benign prostatic hyperplasia.</p>