Five-Year Follow-Up Study of Transurethral Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia

Abstract

Purpose: To explore the long-term clinical efficacy and safety of transurethral plasmakinetic resection of the prostate (PKRP) for benign prostatic hyperplasia (BPH). Patients and Methods: A total of 550 patients with BPH who had undergone PKRP from October 2006 to September 2009 were enrolled in this study. All patients were evaluated at baseline and follow-up (3,12,24, 36, 48, 60 months postoperatively) by peak flow rate (Qmax), postvoid residual (PVR), quality of life (QoL), International Prostate Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS). Operative details and postoperative complications regarded as safety outcomes were documented. Results: A total of 467 patients completed the 5-year follow-up. The mean duration of surgery was 36.43 minutes, mean catheterization time was 48.81 hours, mean hospital stay was 4.21 days. At 60 months postoperatively, the mean Qmax increased from 6.94 mL/s at baseline to 19.28 mL/s, the mean PVR decreased from 126.33 mL to 10.45 mL, the mean IPSS score decreased from 15.79 to 7.51, the mean QoL score decreased from 4.36 to 1.91, and the mean OABSS score decreased from 6.39 to 3.65 (P < 0.001), respectively. In perioperative complications, the blood transfusion rate was 2.7%, urinary tract infection rate was 3.6%; no transurethral resection syndrome (TUR syndrome) occurred. In late complications, urethral stricture rate was 5.4%, recurrent bladder outlet obstruction rate was 2.1%, and the reoperation rate was 4.5%. Conclusions: PKRP is based on conventional monopolar transurethral resection of the prostate (TURP) and uses a bipolar plasmakinetic system. Our results indicate that the long-term clinical efficacy and safety of PKRP for BPH are remarkable. In particular, the incidence of urethral stricture, recurrent bladder outlet obstruction, and reoperation is low. We suggest that PKRP is a reliable minimally invasive technique that may be the preferred procedure for the treatment of patients with BPH.

Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate

“…This concurs with figures from contemporary studies in which PK-TURP-related US rates were between 2.5% and 5.4% [2910132122]. It is noteworthy that in our study more than three-quarters of US cases presented within the first 2 years of PK-TURP.…”

From gold standard to platinum standard in BPH surgery: a perspective from a tertiary care center of the Indian subcontinent

“…7 In one analysis, where 467 patients completed 5 years follow up, results of 177.8% increase in Qmax, 91.7% decrease in PVRU, 52.4% decrease in IPSS, 56.2% decrease in QoL and 42.8% decrease in overactive bladder symptom score compared to baseline were observed. 8 Studies comparing monopolar and bipolar TURP reported similar and durable long term efficacy of either procedures. [9][10][11][12] Nonetheless, in one prospective study, where 36 patients finished 6 years follow up, authors concluded that Qmax and IPSS values were notably inferior to b-TURP compared to m-TURP (P<0.05).…”

The RevoLix™ 2 μm Continuous Wave Laser Vaporesection for the Treatment of Benign Prostatic Hyperplasia: Five-Year Follow-Up

“…In some recent studies, the urethral stricture rate of monopolar TURP was 6.6%, 14 and the rate of PKRP was 5.4%. 10 The rates of HoLEP and KTP were 2.6% and 4.4%, respectively. 12,15 In our study, the incidence of urethral stricture was 2.7% (4/146).…”

“…It is reported that the recurrent bladder outlet obstruction incidence of TURP was 2.1-4.4%. 10,16 The rates of HoLEP and KTP were 1.6% and 3.6%, respectively. 12,15 The reasons included incomplete resection of the prostate gland and the natural course of the disease.…”

“…9 Hu et al also reported a blood transfusion rate of 2.7% for PKRP. 10 Comparatively, the blood transfusion rate occurred in 1% and 0.4% for Holmium laser enucleation of the prostate (HoLEP) and potassium titanyl phosphate (KTP) respectively. 11,12 The 2 lm CW laser achieves good hemostasis and it is equally hemostatic as the KTP laser.…”