Transurethral Bipolar Plasmakinetic Resection Of The Prostate In67Patients With Large-volume Benign Prostatic Hyperplasia

Objective: To explore the clinical efficacy and safety of the transurethral bipolarplasmakinetic resection of the prostate (PKRP) in patients with large-volume benignprostatic hyperplasia (＞80ml) and summarize the experience of the surgery.Methods: A total of67BPH patients, each of whom had a prostate larger than80ml, underwent PKRP from2009to2012in our hospital. Their average age was(69.4±7.3) years and the mean prostate volume was (102.1±26.2) ml. Recorded andanalyzed the operation time, intraoperative blood loss, postoperative hospitalizationtime and its complications. The indices such as international prostate symptom score(IPSS), quality of life score (QOL), maximum urinary flow rate (Qmax) weremonitored and statistically analyzed three and six month after the surgery.Results: All of the patients were operated successfully with an average operationtime of (114.1±26.6) minutes, ranging from70to180minutes. The removedprostate weighed (92.5±13.6) g. Intraoperative blood loss was (133.5±36.8) ml.Postoperative hospitalization time was (8.5±1.9) days. A6-month follow-up wasmade and the international prostate symptom score (IPSS), maximum urinary flowrate (Qmax), residual urine volume (RUV), and quality of life (QOL) respectivelywere (26.4±2.9),(5.6±4.1) ml/s,(160.2±41.4)ml, and (5.4±0.8) before operation,but (8.5±2.7),(17.8±2.4)ml/s,(18.7±8.3)ml, and (1.9±0.5) respectively after6 months. Four indicators had significant difference compared with those preoperative(P<0.05). Three cases of patients with urinary tract infection occurred, and they allrecovered after the anti-infection treatment for3to5days. Temporary incontinenceoccurred in2patients, who recovered after levator ani exercise for2to6weeks.Because of the large hemorrhage in the operation, one patient was treated with2units of red blood cells concentrate. One patient with urethral meatus stricture wasdilated and improved after treatment for three times. There were no cases ofoperative death, conversion to open surgery, permanent incontinence, transurethralresection syndrome or obturator nerve reflex.Conclusion: PKRP is a safe and effective therapy for BPH patients with prostatevolume larger than80ml under the condition of perioperative well preparation andskillful operation.