Efficacy and Safety Evaluation of Transurethral Resection of the Prostate versus Plasmakinetic Enucleation of the Prostate in the Treatment of Massive Benign Prostatic Hyperplasia

Zhang, Jian; Wang, Yonghui; Li, Shuang; Jin, Shipeng; Zhang, Shiqing; Zhao, Chao; Yang, Wenzeng; Cui, Shujin; Liu, Yuexin

doi:10.1159/000511116

Cited by 10 publications

(11 citation statements)

References 28 publications

(41 reference statements)

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“…However, some patients may suffer from postoperative bleeding due to the fragility of the fossa at the prostate to surgical interference, which compromises the curative effect [ 4 ]. Therefore, postoperative bleeding of BPH is a major clinical issue to be addressed [ 5 , 6 ]. To date, summaries and analyses of common factors of postoperative bleeding have been made by many scholars, and relevant influencing factors include defecation straining, cough, improper surgical operation, and nursing methods [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Risk Factors and Nursing Strategies for Postoperative Hemorrhage of Benign Prostatic Hyperplasia

Jin

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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This study is to investigate the risk factors analysis and nursing strategies for postoperative bleeding of benign prostatic hyperplasia (BPH). Totally, 240 BPH patients after surgical excision admitted to Hengshui People’s Hospital between January 2019 and January 2020 were recruited. Of the 240 BPH patients, 20 had postoperative bleeding, accounting for 8.3% of all enrollments. Risk factors for postoperative bleeding included large prostate, diabetes, hypertension, urinary tract infection within 1 week before surgery, and the absence of epidural analgesia pumps. There were 87 patients receiving routine nursing (routine group) and 153 patients receiving routine nursing plus hemorrhage prevention care (study group). The study group had fewer cases of postoperative bleeding than the routine group. The influencing factors of postoperative bleeding in patients with prostatic hyperplasia include systemic and local factors, and corresponding hemorrhage prevention care should be performed based on the principle of evidence-based care to reduce the risk of postoperative bleeding.

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Section: Introductionmentioning

confidence: 99%

Analysis of Risk Factors and Nursing Strategies for Postoperative Hemorrhage of Benign Prostatic Hyperplasia

Jin

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…For another, intraoperative bleeding has always been a serious problem in surgery process [ 21 ]. Nevertheless, many previous studies used a simple formula to estimate intraoperative blood loss volume [ 6 , 11 , 22 , 23 ], which might not accurately reflect the real blood loss volume. To better evaluate the blood loss and fluid absorption, the endoscopic surgical monitoring system was developed and used in BPH surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to point out that the study by Ran et al that suggested no difference between PK-EEP and PK-TURP in terms of fluid absorption [ 17 ] failed to stratify the patients based on their prostate volume. The benefits of applying PK-EEP in patients with relatively large prostate volume might be due to the fact that the hyperplastic prostate tissue was peeled off directly along the surgical capsule which could remove more tissue and avoided excessive opening venous sinus in prostate [ 6 ]. So, in our data, for prostate volume > 40 ml with PK-EEP, more tissues were removed, and the blood loss and fluid absorption volume through the intravascular pathway were decreased, therefore reduced the postoperative bladder irrigation and catheterization indwelling period.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, many surgical methods are available for the treatment of BPH, such as transurethral resection of the prostate (TURP), simple prostatectomy, transurethral laser vaporization and enucleation [ 4 ]. For its superior efficacy and convenience, TURP surgery was ever considered a standard treatment method [ 5 , 6 ]. However, the intraoperative complications like bleeding and transurethral resection syndrome (TURS) of TURP remain a concern [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Transurethral plasmakinetic resection versus enucleation for benign prostatic hyperplasia: comparison of intraoperative safety profiles based on endoscopic surgical monitoring system

et al. 2022

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Objective To compare the intraoperative safety profiles of transurethral plasmakinetic resection of the prostate (PK-TURP) with transurethral plasmakinetic endoscopic enucleation of the prostate (PK-EEP) in the treatment of benign prostatic hyperplasia (BPH) based on endoscopic surgical monitoring system (ESMS). Methods A total of 128 patients who were diagnosed with BPH were stratified based on prostate volume (PV) and accepted PK-EEP or PK-TURP treatment at 1:1 ratio. The ESMS as a novel method was used to monitor blood loss and fluid absorption during the operation. Clinical parameters such as intraoperative blood loss volume, fluid absorption volume, operation time, tissue weight of resection, preoperative and postoperative red blood cell count (RBC), hemoglobin concentration (HB), hematocrit (HCT), electrolyte, postoperative bladder irrigation time, indwelling catheter time, hospital stay time and other associated complications were documented and compared between two groups. Results No significant differences in majority of baseline characteristics were observed among patients with different prostate volumes between two surgical methods. For patients with prostate volume < 40 ml, the average operation time of patients who received PK-EEP treatment was much more than those who received PK-TURP (P = 0.003). On the other hand, for patients with prostate volume > 40 ml, the PK-TURP surgery was associated with a significant increase in intraoperative blood loss (P = 0.021, in PV 40–80 ml group; P = 0.014, in PV > 80 ml group), fluid absorption (P = 0.011, in PV 40–80 ml group; P = 0.006, in PV > 80 ml group) and postoperative bladder irrigation time as well as indwelling catheter time but decrease in resected tissue weight compared to the PK-EEP treatment. Conclusion The ESMS plays an important role in comparison of intraoperative safety profiles between PK-TURP and PK-EEP. Our data suggest that PK-TURP treatment is associated with a decreased operation time in patients with prostate volume < 40 ml and the PK-EEP treatment is associated with decreased intraoperative blood loss, fluid absorption and increased tissue resection for patients with prostate volume > 40 ml. Our results indicate that the size of prostate should be considered when choosing the right operation method.

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“… 3 The common complications after prostate surgery due to indwelling catheter and bladder drainage include bladder spasm (BS) and catheter-related bladder discomfort (CRBD). 3 , 4 12.9–28.3% 5 of patients experience BS. Some patients experience both BS and CRBD.…”

Section: Introductionmentioning

confidence: 99%

Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate

Wang¹,

Qiu²,

Shen³

2022

CIA

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Purpose Bladder spasm (BS) and catheter-related bladder discomfort (CRBD) are complications after transurethral holmium laser enucleation of the prostate (HoLEP). The pudendal nerve (PN) innervates the perineum. Therefore, we evaluated whether PN block (PNB) can reduce the incidence of BS and CRBD in patients undergoing HoLEP. Methods In this randomized, parallel, single-blind prospective study, we enrolled 110 patients who were scheduled to undergo HoLEP under general anesthesia. Patients were randomly allocated to the PNB group (ultrasound-guided PNB at the entrance of the pudendal [Alcock’s] canal bilaterally; n = 55) or the control group (general anesthesia only; n = 55). The primary outcome was the incidence of BS and CRBD at 0.5, 1, 2, 4, 6, 12, and 24 hours postoperatively. The CRBD severity, postoperative pain, and analgesic drug use were also assessed. A P value of < 0.05 was considered statistically significant. Results A significantly lower incidence of BS (P = 0.023) and CRBD (P < 0.001) was reported within the first 24 hours postoperatively in the PNB group. The incidence of CRBD above a moderate grade at 0.5 (P < 0.001), 1 (P < 0.001), 2 (P < 0.001), and 4 (P = 0.019) hours postoperatively was significantly lower in the PNB group. Additionally, postoperative pain scores and analgesic drug use were significantly lower in the PNB group. No PNB-related complications were observed. Conclusion PNB at the entrance of the pudendal canal bilaterally resulted in a lower incidence of BS and CRBD, less postoperative pain, and less analgesic drug use in patients undergoing HoLEP without PNB-related side effects. Implication Statement Bladder spasm and catheter-related bladder discomfort can occur in older individuals undergoing transurethral holmium laser enucleation of the prostate. They often result in severe pain and prolonging the hospital stay. We performed a bilateral ultrasound-guided pudendal nerve block at the entrance of the pudendal (Alcock’s) canal and found that the block reduced bladder spasm, catheter-related bladder discomfort, postoperative pain, and use of anesthetics. Besides, pudendal nerve block also decreased the severity of catheter-related bladder discomfort and helped older individuals achieve rapid recovery.

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Efficacy and Safety Evaluation of Transurethral Resection of the Prostate versus Plasmakinetic Enucleation of the Prostate in the Treatment of Massive Benign Prostatic Hyperplasia

Cited by 10 publications

References 28 publications

Analysis of Risk Factors and Nursing Strategies for Postoperative Hemorrhage of Benign Prostatic Hyperplasia

Analysis of Risk Factors and Nursing Strategies for Postoperative Hemorrhage of Benign Prostatic Hyperplasia

Transurethral plasmakinetic resection versus enucleation for benign prostatic hyperplasia: comparison of intraoperative safety profiles based on endoscopic surgical monitoring system

Effect of Pudendal Nerve Block on the Prevention of Postoperative Bladder Spasm and Catheter-Related Bladder Discomfort in Male Patients Undergoing Transurethral Holmium Laser Enucleation of the Prostate

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