Transurethral Plasmakinetic Enucleation Of The Prostate Versus Resection In A Prospective Randomized Controlled Study

Objective:This article treats benign prostatic hyperplasia by transurethral plasma akinetic enucleation of the prostate(PKEP)and transurethral plasmakinetic resection of the prostate(PKRP).prostatic hyperplasia(BPH)patients are comprehensively compared to provide guidance for the selection of clinical surgical treatment options.Method:The data of patients who were treated with Lower urinary tract symptoms(LUTS)in the China-Japan Union Hospital of Jilin University from December 2020 to December 2022 and who were initially diagnosed with BPH in the outpatient clinic were collected,and the patients were randomly assigned to the enucleation group and the electroresection group according to the date of treatment and admitted to the hospital for treatment with the informed consent of the patients.The surgeons are all deputy chief physicians or above professional titles in the first ward of urology,who can skillfully perform transurethral plasma enucleation of the prostate and electroresection.The relevant indicators of the two groups of patients were recorded in detail before,during,after and 3 months after surgery,including body weight,preoperative Hb,preoperative sodium ion,degree of mid-lobe protrusion,whether hypertension and diabetes were compounded,etc.intraoperative and postoperative related data included operation time,excision tissue volume,postoperative HCT,postoperative Hb,etc.the incidence of surgical complications included capsular perforation,postoperative urinary incontinence,postoperative dysuria,etc.and the follow-up data 3 months after surgery included IPSS score 3 months postoperative and Qo L score 3 months after surgery.The collected data were statistically analyzed using SPSS 26 software to compare the clinical efficacy of the two groups.Outcome:Comparing the preoperative general data of the two groups,including age,weight,BMI,t PSA,preoperative HCT,preoperative Hb,preoperative sodium ion,prostate volume,and midlobe protrusion,the analysis results showed no statistical difference between the two groups(P>0.05),indicating that the grouping was better and the data of the two groups were balanced and comparable.There was no significant difference in the comparison results of preoperative comorbidities,including hypertension,diabetes and respiratory diseases between the two groups(P>0.05),and there was no significant difference in the number of cases of preoperative oral 5α-reductase inhibitors(P>0.05),further indicating that the data of the two groups were balanced and comparable.The operation time of the two groups was similar,there was no significant difference(P>0.05);in terms of intraoperative blood loss,the data of PKRP group were higher than those in PKEP group(P<0.05),and the amount of tissue resected,the resection rate(resected tissue volume/operation time)and the resection efficiency(resected tissue volume/prostate volume)were higher than those in the PKRP group,and the differences were statistically significant(P<0.05).There were no significant differences in total length of hospital stay,time spent indwelling catheters,and time to postoperative bladder irrigation between the two groups(P>0.05).There were no significant differences in preoperative Qo L score,IPSS score and sodium ion between the two groups(P>0.05),and there were no significant differences in postoperative Qo L score,IPSS score and sodium ion(P>0.05)between the two groups,and there were significant differences in Qo L score and IPSS score between the two groups before and after surgery(P<0.05).There was no significant difference between preoperative sodium ions and postoperative sodium ions between the two groups(P>0.05).There was 1 case of urinary incontinence in the PKEP group and 2 cases of urinary incontinence in the PKRP group,and there was no significant difference in the comparison by chi-square test,and the P>0.05.Neither group experienced any remaining surgeryrelated complications.Conclusion:1.The surgical efficacy and safety of the two surgical methods are similar,and satisfactory surgical results can be obtained;2.PKEP intraoperative blood loss is less,gland resection amount,resection efficiency and resection rate are higher,which is a better way to treat BPH;3.PKEP can remove more hyperplastic prostate glands,which is more conducive to the detection of incidental prostate cancer and can also reduce the recurrence rate after surgery;4.Compared with PKRP,PKEP has higher requirements for surgeons and a slightly longer learning curve.