Hu Yangyang, Dong Xuecheng, Wang Guangchun, Huang Jianhua, Liu Min, Peng Bo
1 Department of Urology, Shanghai Tenth People's Hospital, Tongji University , Shanghai, China .
2 Department of First Clinical Medical College, Nanjing Medical University , Nanjing, Jiangsu, China .
J Endourol. 2016 Jan;30(1):97-101. doi: 10.1089/end.2015.0506. Epub 2015 Sep 9.
To explore the long-term clinical efficacy and safety of transurethral plasmakinetic resection of the prostate (PKRP) for benign prostatic hyperplasia (BPH).
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.
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%.
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.
探讨经尿道前列腺等离子双极电切术（PKRP）治疗良性前列腺增生症（BPH）的长期临床疗效及安全性。
本研究纳入了2006年10月至2009年9月期间接受PKRP治疗的550例BPH患者。所有患者在基线期及随访期（术后3、12、24、36、48、60个月）均接受了最大尿流率（Qmax）、残余尿量（PVR）、生活质量（QoL）、国际前列腺症状评分（IPSS）及膀胱过度活动症症状评分（OABSS）评估。记录手术细节及作为安全指标的术后并发症情况。
共有467例患者完成了5年随访。平均手术时间为36.43分钟，平均导尿时间为48.81小时，平均住院时间为4.21天。术后60个月时，平均Qmax从基线时的6.94 mL/s增至19.28 mL/s，平均PVR从126.33 mL降至10.45 mL，平均IPSS评分从15.79降至7.51，平均QoL评分从4.36降至1.91，平均OABSS评分从6.39降至3.65（P<0.001）。围手术期并发症方面，输血率为2.7%，尿路感染率为3.6%；未发生经尿道电切综合征（TUR综合征）。远期并发症方面，尿道狭窄率为5.4%，膀胱出口梗阻复发率为2.1%，再次手术率为4.5%。
PKRP基于传统的经尿道前列腺单极电切术（TURP），采用双极等离子体系统。我们的结果表明，PKRP治疗BPH的长期临床疗效及安全性显著。特别是尿道狭窄、膀胱出口梗阻复发及再次手术的发生率较低。我们认为PKRP是一种可靠的微创技术，可能是治疗BPH患者的首选术式。
