Objective To compare the effectiveness and safety of transurethral plasma kinetic enucleation of the prostate (TPKEP) and transurethral resection of the plasma (TURP) in patients with benign prostate hyperplasia (BPH) on the basis of bipolar plasma kinetic technology. Methods Eighty BPH patients who met the included criteria were assigned to two groups according to block balanced randomization, of which, 40 received TPKEP and the others received PKRP. We conducted statistical analysis after recording the clinical outcomes including international prostate symptom score (IPSS), quality of life (QOL), maximum flow (Qmax), post void residual urine volume (PVR), rates of prostate coated perforation, blood loss in the operation, duration of operation, time of bladder irrigation, duration of indwelling catheter, post-operative adverse effects, etc. Results The two groups were consistent at baseline before operation. The results of the analysis of clinical outcomes showed that, the TPKEP group was superior to the TURP group in prostate coated perforation (2 cases vs. 8 cases), hemoglobin in flushing fluid (index of blood loss, 10.95±5.02 g vs. 15.8±5.86 g), duration of operation (45.13±11.22 min vs. 53.33±8.69 min), time of bladder irrigation (12.58±2.77 h vs. 22.1±2.33 h), duration of indwelling catheter (65.13±10.67 h vs. 84.5±5.67 h), post-operative irritation sign of the bladder and urethra (5 cases vs. 12 cases), and the event of indwelling catheter after removal (0 cases vs. 4 cases), with significant differences; however, the TPKEP group was higher than the TURP group in the incidence of transient uracratia (10 cases vs. 3 cases), with a significant difference. The results of a 6-month follow-up showed that, no significant difference was found between the two groups in IPSS (2.78±1.03 vs. 2.40±1.13), QOL (1.28±0.45 vs. 1.45±0.51), Qmax (21.10±2.68 vs. 20.58±2.57), and PVR (2.82±2.90 vs. 2.18±2.27), respectively (Pgt;0.05). Long-term uracratia, urethrostenosis and secondary bleeding were not observed after operation in both groups. Conclusions TPKEP and TURP were alike in the short-term effectiveness of operation. TPKEP is safer than the TURP, which is regarded as a fairly ideal method for treating symptomatic BPH. However, the long-term effectiveness of TPKEP is yet to be further proved by large-scale randomized controlled trials with long-term follow-up.
【摘要】 目的 探讨采用不同方法经尿道前列腺等离子双极电切术（plasmakinetic resection of prostate，PKRP）的方法及疗效。 方法 2008年7月-2009年12月，应用不同方法行PKRP治疗156例前列腺增生。患者年龄59~87岁，平均74岁。病程20 d~18年。前列腺重量22~100 g，平均38 g。采用单纯顺行电切法治疗38例，部分剜除分割切除法治疗76例，完全剜除法治疗42例。 结果 156例手术均获成功，手术时间平均90 min。获得前列腺组织12~87 g，平均35 g。术后留置导尿管平均5.5 d，住院时间平均6.5 d。术后组织病理学诊断为良性前列腺增生152例，前列腺癌4例。拔除尿管后均能自主排尿，部分患者术后有尿道刺激症状；术后1个月内出现尿道外口狭窄3例，经尿道扩张治愈。随访时间1~12个月，平均6个月。短期尿失禁3例，时间分别为1周、1个月及3个月；无长期尿失禁。术后3个月国际前列腺症状评分（IPSS）症状评分平均减少24分，生活质量评分平均减少3分。 结论 PKRP安全、有效、并发症少，可针对患者情况采用不同切割方法，效果更佳。【Abstract】 Objective To explore the effects and methods of transurethral plasmakinetic resection of prostate(PKRP). Methods A total of 156 patients with prostatic hyperplasia were treated with various methods of transurethral PKRP from July 2008 to December 2009. Patient’s age ranged from 59 to 87 years,74 years on average. The disease duration was 20 days to 18 years.Method one:anterograde resection in 38 patients; method two:partition retrograde enucleation in 76 patients; method three:completely retrograde enucleation in 42 patients. Results All of the swgeries were successful. The mean duration of the operation was 90 minutes.The collected prostatic specimens were 12-87 g,35 g on average. The mean catheter remaining dwation was 5.5 days.The mean postoperative hospital stay was 6.5 days. Conclusions PKRP is safe and effective. It is effective with various methods of transurethral plasmakinetic resection of prostate.