Transurethral Bipolar Plasma Kinetics Enucleation versus Transurethral Bipolar Plasma Kinetics Resection in the Treatment of Prostate Hyperplasia: A Randomized Controlled Trial_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Junfeng ^1,2 , TAN Zhaohui ² , LI Sanxiang ² , LI Xinzhi ² , CHI Ning ² ,  LIU Chunxiao ¹

1. Department of Urology, Zhujiang Hospital, Nanfang Medical University, Guangzhou 510280, Guangdong, China;2. Inner Mongolia People’s Hospital, Hohhot 010020, Inner Mongolia Autonomous Region, China;

Corresponding author：

LIU Chunxiao, Email: 2294474817@qq.com

Keywords：

良性前列腺增生症; 经尿道双极等离子前列腺剜除术; 经尿道双极等离子电切术; 随机对照试验

DOI：

10.7507/1672-2531.20130241

Video：

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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 (P gt;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.

Citation： LIU Junfeng,TAN Zhaohui,LI Sanxiang,LI Xinzhi,CHI Ning,LIU Chunxiao. Transurethral Bipolar Plasma Kinetics Enucleation versus Transurethral Bipolar Plasma Kinetics Resection in the Treatment of Prostate Hyperplasia: A Randomized Controlled Trial. Chinese Journal of Evidence-Based Medicine, 2013, 13(12): 1405-1408. doi: 10.7507/1672-2531.20130241 Copy

1.	那彦群, 叶长群, 孙光. 中国泌尿外科疾病诊断治疗指南. 2011版. 北京: 人民卫生出版社, 2011: 154.
2.	刘春晓. 传统经尿道前列腺电切术不应再是前列腺增生腔内治疗的金标准. 现代泌尿外科杂志, 2012, 17(3): 298-299.
3.	Rassweiler J, Teber D, Kuntz R, et al. Complications of transurethral resection of the prostate (TURP)--incidence, management, and prevention. Eur Urol, 2006, 50(5): 969-979.
4.	Varkarakis J, Bartsch G, Horninger W, et al. Long-term morbidity and mortality of transurethral prostatectomy: a 10-year follow-up. Prostate, 2004, 58(3): 248-251.
5.	卞军, 刘春晓, 郑少波, 等. 经尿道前列腺等离子腔内剜除术与切除术治疗前列腺增生的临床对照研究. 南方医科大学学报, 2008, 28(5): 742-745.
6.	Liu C, Zheng S, Li H, et al. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol, 2010, 184(6): 2440-2445.
7.	Zhao Z, Zeng G, Zhong W, et al. A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol, 2010, 58(5): 752-758.
8.	Zhang KY, Xing JC, Chen BS, et al. Bipolar plasmakinetic transurethral resection of the prostate vs. transurethral enucleation and resection of the prostate: pre- and postoperative comparisons of parameters used in assessing benign prostatic enlargement. Singapore Med J, 2011, 52(10): 747-751.
9.	杨德林, 柯昌兴, 王剑松, 等. 等离子电切术中不同方法治疗前列腺增生症 (附1900例报告). 中华腔镜泌尿外科杂志 (电子版), 2009, 3(1): 37-42.
10.	包志强. 经尿道前列腺等离子腔内剜除术在治疗前列腺增生症中的应用. 吉林医学, 2011, 32(32): 6836-6837.
11.	李胜, 曾宪涛, 郭毅, 等. 经尿道等离子腔内剜除术与经尿道等离子双极电切术比较治疗良性前列腺增生的Meta分析. 中国循证医学杂志, 2011, (10): 1172-1183.
12.	郑少波, 刘春晓, 徐亚文. 前列腺腔内逆行剥离法在经尿道前列腺汽化切除术中的应用. 第一军医大学学报, 2005, (6): 734-735.
13.	郑少波, 刘春晓, 徐亚文, 等. 腔内剜除法在经尿道前列腺汽化电切术中的应用. 中华泌尿外科杂志, 2005, (8): 558-561.
14.	Erturhan S, Erbagci A, Seckiner I, et al. Plasmakinetic resection of the prostate versus standard transurethral resection of the prostate: a prospective randomized trial with 1-year follow-up. Prostate Cancer Prostatic Dis, 2007, 10(1): 97-100.
15.	林荣凯, 张诚华, 董少良,等. 前列腺钬激光剜除术术后尿失禁分析.亚太传统医药, 2008, 4(10): 121-122.
16.	林宝东. 等离子前列腺电切术和剜除术治疗前列腺增生症术后尿失禁发生率的比较研究. 中国医学创新, 2013, 10(12): 33-34.
17.	杨德林, 柯昌兴, 王剑松, 等. 经尿道等离子逆行剜除电切术治疗中重度良性前列腺增生1200例报告. 中华男科学杂志, 2009, 15(3): 273-275.
18.	杨龙, 崔喆. 尿道前列腺剜除术与电切术疗效比较. 中国中西医结合外科杂志, 2012, 18(2): 145-147.
19.	罗文清, 王明, 苟欣, 等. 经尿道前列腺剜除术与电切术治疗高危良性前列腺增生的安全性和疗效比较. 重庆医科大学学报, 2011, 36(12): 1524-1527.
20.	苏燕胜, 刘娜, 陆向东. 经尿道前列腺腔内剜除术与电切术治疗前列腺增生症的疗效比较. 西北国防医学杂志, 2013, 34(3): 227-229.
21.	林宁峰, 刘昌明, 李国敏. 经尿道等离子前列腺电切术和剜除术治疗前列腺增生的临床疗效比较. 当代医学, 2011, 17(27): 58-60.
22.	赵春雷, 姜庆, 郑昌建, 等. 钬激光剜除术治疗良性前列腺增生症疗效及安全性的Meta 分析. 激光杂志, 2012, 33(5): 56-58.
23.	盛旭俊, 陈建华, 王伟明, 等. 经尿道等离子双极电刀前列腺剜除术治疗良性前列腺增生. 中华男科学杂志, 2011, 17(5): 440-443.
24.	魏学斌, 徐留玉, 黄世明, 等. 两种经尿道前列腺切除术的疗效比较. 中华腔镜泌尿外科杂志 (电子版), 2009, 3(2): 129-132.

1. 那彦群, 叶长群, 孙光. 中国泌尿外科疾病诊断治疗指南. 2011版. 北京: 人民卫生出版社, 2011: 154.
2. 刘春晓. 传统经尿道前列腺电切术不应再是前列腺增生腔内治疗的金标准. 现代泌尿外科杂志, 2012, 17(3): 298-299.
3. Rassweiler J, Teber D, Kuntz R, et al. Complications of transurethral resection of the prostate (TURP)--incidence, management, and prevention. Eur Urol, 2006, 50(5): 969-979.
4. Varkarakis J, Bartsch G, Horninger W, et al. Long-term morbidity and mortality of transurethral prostatectomy: a 10-year follow-up. Prostate, 2004, 58(3): 248-251.
5. 卞军, 刘春晓, 郑少波, 等. 经尿道前列腺等离子腔内剜除术与切除术治疗前列腺增生的临床对照研究. 南方医科大学学报, 2008, 28(5): 742-745.
6. Liu C, Zheng S, Li H, et al. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics. J Urol, 2010, 184(6): 2440-2445.
7. Zhao Z, Zeng G, Zhong W, et al. A prospective, randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia: three-year follow-up results. Eur Urol, 2010, 58(5): 752-758.
8. Zhang KY, Xing JC, Chen BS, et al. Bipolar plasmakinetic transurethral resection of the prostate vs. transurethral enucleation and resection of the prostate: pre- and postoperative comparisons of parameters used in assessing benign prostatic enlargement. Singapore Med J, 2011, 52(10): 747-751.
9. 杨德林, 柯昌兴, 王剑松, 等. 等离子电切术中不同方法治疗前列腺增生症 (附1900例报告). 中华腔镜泌尿外科杂志 (电子版), 2009, 3(1): 37-42.
10. 包志强. 经尿道前列腺等离子腔内剜除术在治疗前列腺增生症中的应用. 吉林医学, 2011, 32(32): 6836-6837.
11. 李胜, 曾宪涛, 郭毅, 等. 经尿道等离子腔内剜除术与经尿道等离子双极电切术比较治疗良性前列腺增生的Meta分析. 中国循证医学杂志, 2011, (10): 1172-1183.
12. 郑少波, 刘春晓, 徐亚文. 前列腺腔内逆行剥离法在经尿道前列腺汽化切除术中的应用. 第一军医大学学报, 2005, (6): 734-735.
13. 郑少波, 刘春晓, 徐亚文, 等. 腔内剜除法在经尿道前列腺汽化电切术中的应用. 中华泌尿外科杂志, 2005, (8): 558-561.
14. Erturhan S, Erbagci A, Seckiner I, et al. Plasmakinetic resection of the prostate versus standard transurethral resection of the prostate: a prospective randomized trial with 1-year follow-up. Prostate Cancer Prostatic Dis, 2007, 10(1): 97-100.
15. 林荣凯, 张诚华, 董少良,等. 前列腺钬激光剜除术术后尿失禁分析.亚太传统医药, 2008, 4(10): 121-122.
16. 林宝东. 等离子前列腺电切术和剜除术治疗前列腺增生症术后尿失禁发生率的比较研究. 中国医学创新, 2013, 10(12): 33-34.
17. 杨德林, 柯昌兴, 王剑松, 等. 经尿道等离子逆行剜除电切术治疗中重度良性前列腺增生1200例报告. 中华男科学杂志, 2009, 15(3): 273-275.
18. 杨龙, 崔喆. 尿道前列腺剜除术与电切术疗效比较. 中国中西医结合外科杂志, 2012, 18(2): 145-147.
19. 罗文清, 王明, 苟欣, 等. 经尿道前列腺剜除术与电切术治疗高危良性前列腺增生的安全性和疗效比较. 重庆医科大学学报, 2011, 36(12): 1524-1527.
20. 苏燕胜, 刘娜, 陆向东. 经尿道前列腺腔内剜除术与电切术治疗前列腺增生症的疗效比较. 西北国防医学杂志, 2013, 34(3): 227-229.
21. 林宁峰, 刘昌明, 李国敏. 经尿道等离子前列腺电切术和剜除术治疗前列腺增生的临床疗效比较. 当代医学, 2011, 17(27): 58-60.
22. 赵春雷, 姜庆, 郑昌建, 等. 钬激光剜除术治疗良性前列腺增生症疗效及安全性的Meta 分析. 激光杂志, 2012, 33(5): 56-58.
23. 盛旭俊, 陈建华, 王伟明, 等. 经尿道等离子双极电刀前列腺剜除术治疗良性前列腺增生. 中华男科学杂志, 2011, 17(5): 440-443.
24. 魏学斌, 徐留玉, 黄世明, 等. 两种经尿道前列腺切除术的疗效比较. 中华腔镜泌尿外科杂志 (电子版), 2009, 3(2): 129-132.

Chinese Journal of Evidence-Based Medicine

Transurethral Bipolar Plasma Kinetics Enucleation versus Transurethral Bipolar Plasma Kinetics Resection in the Treatment of Prostate Hyperplasia: A Randomized Controlled Trial

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