Comparative outcomes of plasmakinetic versus monopolar transurethral resection of benign prostatic hyperplasia: 7 years' results

Abstract

Objective: We compared results from the standard monopolar or the bipolar plasmakinetic method for the transurethral resection of the prostate (TURP) due to benign prostatic hyperplasia (BPH) at 4 and 7 years after surgery (medium to long term). Material and methods:A retrospective analysis was performed on the complete data from 124 patients who were alive and had 7 years of regular follow-up. Of those 124 patients with BPH, 65 (52%) underwent monopolar TURP (M-TURP) and 59 (48%) underwent plasmakinetic TURP (P-TURP). During the followup period, the International Prostate Symptom Score (IPSS), the maximal flow rate (Qmax) measured using uroflowmetry and the prostate specific antigen (PSA) values were recorded. Patients in whom alpha blockers were administered due to the growth of postoperative adenoma and who had been operated on due to urethral stricture, bladder neck contracture or a growing adenoma were also noted and recorded.Results: There was no statistically significant difference between M-TURP and P-TURP groups in any pre-operative or post-operative follow-up parameter at 4 or 7 years post-surgery. Specifically, PSA, IPSS and Qmax values; urethrotomies performed; alpha-blocker use; and the frequency of re-operations were statistically insignificant (p>0.05). Conclusion:Our study demonstrated that when medium-to long-term results are compared, P-TURP and M-TURP appear to result in similar IPSS scores, Qmax values, complication rates and retreatment rates. Larger prospective studies are required to corroborate these results.

Prospective Randomized Comparison of Monopolar TURP, Bipolar TURP and Photoselective Vaporization of the Prostate in Patients with Benign Prostatic Obstruction: 36 Months Outcome

“…Regarding long term complications, studies reported different rates of urethral stricture, bladder neck contracture, residual prostate requiring reoperation, UTI, dysuria, erectile dysfunction, retrograde ejaculation among others . We observed similar rates of complications, including dysuria, UTI and urethral stricture among patients of the three groups at 36 months follow up.…”

“…In Broggi et al's prospective single centre study of PVP, where 77 patients completed 4 years follow up, an 82.5% increase in Qmax and 79.1, 69.8, 43.8 and 22.9% decrease in IPSS, PVR volume, PSA and prostate volume, respectively, were reported . Studies comparing monopolar and bipolar TURP reported similar and durable long term efficacy of either procedures . However, in Koca et al's prospective randomized study, where 36 patients completed 72 months follow up, they observed that IPSS and Qmax values were significantly inferior to bipolar TURP compared to monopolar TURP ( P < 0.05) .…”

From gold standard to platinum standard in BPH surgery: a perspective from a tertiary care center of the Indian subcontinent

“…8 Studies comparing monopolar and bipolar TURP reported similar and durable long term efficacy of either procedures. [9][10][11][12] Nonetheless, in one prospective study, where 36 patients finished 6 years follow up, authors concluded that Qmax and IPSS values were notably inferior to b-TURP compared to m-TURP (P<0.05). 13 In a meta-analysis of 9 RCT's, 448 and 441 patients underwent PVP and m-TURP respectively, where it was concluded that functional outcomes were similar in six studies, favoured m-TURP in two and PVP in one study.…”