Objective: To evaluate the clinical effects of plasmakinetic enucleation of the prostate (PKERP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of BPH.
Methods: We retrospectively analyzed the clinical data on 78 BPH patients treated by PKERP (n = 38) or HoLEP (n = 40) from January 2016 to October 2017. We recorded the operation time, intraoperative hemoglobin level, catheter-indwelling time, bladder irrigation time, hospital stay, 6-month postoperative IPSS, quality of life (QOL), maximum urinary flow rate (Qmax), postvoid residual urine (PVR), PSA level, International Index of Erectile Function (IIEF) and postoperative complications, and compared the obtained parameters between the two groups and some of them with the baseline.
Results: In comparison with the baseline, both the PKERP and HoLEP groups showed statistically significant differences at 6 months after surgery in the QOL score (4.82 ± 0.56 and 4.70 ± 0.67 vs 2.44 ± 0.69 and 2.92 ± 0.49, P < 0.01), IPSS (19.52 ± 4.96 and 19.44 ± 4.08 vs 9.56 ± 2.5 and 9.81 ± 2.5, P < 0.01), Qmax (［4.54 ± 1.86］ and ［4.42 ± 2.89］ ml/s vs ［17.72 ± 3.46］ and ［17.27 ± 4.42］ ml/s, P < 0.01), and PVR (［83.73±55.33］ and ［109.65 ± 89.58］ ml vs ［19.93 ± 11.07］ and ［18.31 ± 15.03］ ml, P < 0.01). Statistically significant differences were also found between the PKERP and HoLEP groups in the reduced hemoglobin level (［21.04 ± 16.96］ vs ［7.88 ± 6.65］ g/dl, P = 0.01), catheter-indwelling time (［7.67 ± 2.27］ vs ［3.93 ± 2.18］ d, P = 0.01), bladder irrigation time (［1.67 ± 0.62］ vs ［1.3 ± 0.54］ d, P = 0.05), hospital stay (［4.22 ± 1.55］ vs ［3.26 ± 0.9］ d, P = 0.01), and 6-month postoperative QOL score (［2.44 ± 0.69］ vs ［2.92 ± 0.49］, P = 0.05), but not in the other parameters.
Conclusions: Both PKERP and HoLEP are safe and effective for the treatment of BPH, the former more feasible in primary hospitals, while the latter with the advantages of less bleeding, shorter catheterization and hospital stay, and higher 6-month postoperative QOL score.
Keywords: holmium laser enucleation of the prostate; plasmakinetic enucleation resection of the prostate; benign prostatic hyperplasia.