[Transurethral plasmakinetic enucleation of the prostate for benign prostatic hyperplasia].

OBJECTIVE: To evaluate clinical application of transurethral plasmakinetic enucleation of the prostate (PKEP) to the treatment of benign prostatic hyperplasia (BPH). METHODS: A total of 90 BPH patients, aged 59-83 (mean 71) years and with indication of surgery, underwent transurethral resection of the prostate (the TURP group, n=50) and transurethral plasmakinetic enucleation of the prostate (the PKEP group, n=40), respectively. We recorded and analyzed the preoperative prostate volume, IPSS, QOL and Qmax, operation time, intra- and post-operative bleeding and complications, postoperative continuous bladder irrigation, and IPSS, QOL and Qmax at 2 weeks and 6 months after surgery. RESULTS: The preoperative prostate volume and operation time were 58.9 g and 58.8 min in the TURP group versus 58.3 g and 93.0 min in the PKEP group. Mild transurethral resection syndrome (TURS) appeared in 2 TURP receivers, while no abnormality was found in electrocardiogram monitoring in those undergoing PKEP. Continuous bladder irrigation was necessitated in 3 and urgent incontinence of urine occurred in 4 cases of TURP, as compared with 1 and 4 cases in the PKEP group. None of the 90 patients needed blood transfusion. At 2 weeks before and after surgery and 6 months postoperatively, IPSS averaged 19.7, 11.6 and 5.1, QOL 4.6, 3.3 and 1.1, and Qmax 6.3, 13.0 and 18.1 ml/s in the TURP group versus 18.6, 8.4 and 4.9 (IPSS), 4.5, 2.7 and 1.1 (QOL) and 6.9, 14.2 and 19.0 ml/s (Qmax) in the PKEP group. There were significant differences in operation time, IPSS and QOL at 2 weeks postoperatively between the two groups, as well as in IPSS, QOL and Qmax at 6 months before and after surgery (P < 0.01). But no remarkable differences were found in preoperative prostate volume, IPSS, QOL and Qmax, 6-month postoperative IPSS and QOL, and Qmax at 2 weeks and 6 months after surgery between the two groups (P > 0.01). CONCLUSION: Transurethral PKEP is a safe, effective and thorough surgical method to be chosen for the treatment of BPH.

[Experience in treating advanced prostate cancer with bladder outlet obstruction].

BACKGROUND & OBJECTIVE: The incidence and discovery rate of prostate cancer is increased in recent years; with advanced age and multiple organs dysfunction, the advanced prostate cancer patients have poor quality of life. This study was to explore suitable treatment for these patients. METHODS: A total of 80 advanced prostate cancer patients with bladder outlet obstruction were treated by transurethral electrovaporization of the prostate (TVP), plus castration and antiandrogen therapy. Preoperative individualized preparation was performed for each patient. International prostatic symptom score (IPSS), maximum flow rate of urine (Q(max)), prostatic-special antigen (PSA), and ultrasonography were measured before and 3 months after operation. RESULTS: TVP were successful in all cases. Postoperative IPSS was significantly lower than preoperative IPSS in patients with or without urine retention (13+/-3 vs. 31+/-2, 11+/-3 vs. 31+/-2, P<0.01); postoperative Q(max) was significantly higher than preoperative Q(max) in patients with or without urine retention [(19.0+/-3.3) ml/s vs. 0, (19.4+/-2.7) ml/s vs. (8.9+/-3.4) ml/s, P<0.01]. Postoperative PSA was significantly lower than preoperative PSA [(80.4+/-133.4) mg/L vs. (0.1+/-0.4) mg/L, P<0.05]. The volume of prostate was obviously reduced. CONCLUSION: TVP plus castration and endocrine therapy is a safe and effective treatment for advanced prostate cancer patients with bladder outlet obstruction.