Long-term Clinical Efficacy and Safety Profile of Transurethral Resection of Prostate Versus Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia

Liu, Zhe; Li, Yuan Wei; Wu, Wan Rui; Lü, Qiang

doi:10.1016/j.urology.2017.02.006

Cited by 24 publications

(18 citation statements)

References 27 publications

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“…In the ThuLEP group, IIEF‐5 scores improved to baseline at 3 months, but did not recover in the TURP group over the 12‐month follow‐up period. Previously, both monopolar and bipolar TURP have been reported to be associated with a decline in IIEF‐5 after surgery 18 . In a systematic review and meta‐analysis of postoperative erectile function after endoscopic surgeries for BPH, laser enucleation of the prostate was associated with better preservation of erectile function than TURP during long‐term follow up, but no significant difference was noted in short‐term follow up 19 .…”

Section: Discussionmentioning

confidence: 92%

“…Previously, both monopolar and bipolar TURP have been reported to be associated with a decline in IIEF-5 after surgery. 18 In a systematic review and meta-analysis of postoperative erectile function after endoscopic surgeries for BPH, laser enucleation of the prostate was associated with better preservation of erectile function than TURP during long-term follow up, but no significant difference was noted in short-term follow up. 19 The difference was attributed to the difference of the surgical techniques related to the spread of heat to the erectile nerve and/ or small size of the evaluated population.…”

Section: Discussionmentioning

confidence: 97%

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Functional outcomes of transurethral thulium laser enucleation versus bipolar transurethral resection for benign prostatic hyperplasia over a period of 12 months: A prospective randomized study

et al. 2020

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To evaluate functional outcomes over a year for benign prostatic hyperplasia treated with thulium laser enucleation of the prostate or bipolar transurethral resection of the prostate. Methods: In this study, we prospectively included 140 patients who were treated for benign prostatic hyperplasia from April 2017 to February 2019. A randomization list was used for non-blind assignment to treatment groups (thulium laser enucleation of the prostate or bipolar transurethral resection of the prostate). The International Prostate Symptom Score, International Prostate Symptom Score quality of life, Overactive Bladder Symptom Score, uroflowmetry and International Index of Erectile Function-5 were used for the assessment of outcomes. Scores were taken before treatment, and at 1, 3, 6, 9 and 12 months after treatment. Results: Preoperatively, characteristics of patients in the thulium laser enucleation of the prostate group (n = 70) and the bipolar transurethral resection of the prostate group (n = 70) did not significantly differ. The thulium laser enucleation of the prostate group had a lower median decrease in hemoglobin (0.10 g/dL vs 0.69 g/dL, P < 0.0001) and shorter median catheterization (2 days vs 3 days, P < 0.0001) than the bipolar transurethral resection of the prostate group. Both groups had significantly improved International Prostate Symptom Score, International Prostate Symptom Score quality of life, Overactive Bladder Symptom Score, maximum flow rate and residual urine compared with preoperative values. In the thulium laser enucleation of the prostate group, erectile function was significantly impaired at 1 month post-treatment compared with pretreatment, but improved to baseline at 3 months; however, the transurethral resection of the prostate group did not recover. However, total energy (P = 0.001) and laser irradiation time (P = 0.025) were significantly different between the patients who had preserved erectile function and those who did not after the treatment in the thulium laser enucleation of the prostate group. Conclusions: Thulium laser enucleation of the prostate is superior to bipolar transurethral resection of the prostate in resection efficacy, hemostasis, catheterization time and preservation of erectile function. However, excessive laser irradiation time in thulium laser enucleation of the prostate has the possibility to delay improvement of overactive bladder symptoms and decrease sexual function.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Functional outcomes of transurethral thulium laser enucleation versus bipolar transurethral resection for benign prostatic hyperplasia over a period of 12 months: A prospective randomized study

et al. 2020

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“…19 Both monopolar and bipolar TURP have been reported to be associated with a mild decline in postoperative IIEF-5 scores with no difference in long-term follow-up. 28 However, it is necessary to take into consideration that the population investigated in these studies often already suffers from preoperative ED. In fact, only few studies specifically analyzed the incidence of de novo ED in a prospective fashion.…”

Section: Discussionmentioning

confidence: 99%

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Liu

Cheng

Zhuo

et al. 2020

Journal of Endourology

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Introduction: Although the transurethral resection of the prostate (TURP) has been regarded as the gold standard surgical option for lower urinary tract symptoms due to benign prostatic hyperplasia, the endoscopic enucleation of the prostate (EEP) with novel techniques is also recommended. However, whether there are differences on male sexual functions after these two procedures is still controversial. We performed this metaanalysis to investigate the impact on erectile function (EF) and ejaculation of EEP and TURP, and to explore the potential superiority between these two approaches. Materials and Methods: Literature search was conducted on Medline, Embase, and the Cochrane library, to obtain all relevant randomized controlled trials published before December 13, 2018. Outcome data were pooled and analyzed with Review Manager 5.3 to compare the International Index of Erectile Function 5 (IIEF-5) scores and retrograde ejaculation (RE) rates from short-to long-term follow-ups. Results: Ten articles with 1435 patients were included. EEP group showed higher IIEF-5 scores than TURP group with mean difference (MD) = 1.00, confidence interval (95% CI): 0.95-1.05 at 48 months and MD = 1.08, 95% CI: 1.03-1.13 at ‡60 months, respectively. In subgroup analysis, the holmium laser enucleation of the prostate showed significantly better IIEF scores than TURP group at 48 months (MD = 1.00, 95% CI: 0.95-1.05) and ‡72 months (MD = 1.08, 95% CI: 1.03-1.13). Additionally, no significant difference in RE rate was found between EEP and TURP (risk ratio = 1.02, 95% CI: 0.85-1.23). Conclusions: Compared with TURP, EEP may produce a more durable benefit for postoperative preservation of EF at long-term stage.

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“…In TURP group, the clot evacuation rate was higher (19% vs. 0), because of the hemostatic advantage of TUPKP (Dunsmuir et al, 2003). The results of several studies showed that the operation time of TUPKP is about 39 minutes to 56 minutes, the intraoperative bleeding volume is 144 mL to 174 mL, and the incidence of postoperative bleeding is 1.47% to 3.3% (El-Shaer et al, 2017; Liu et al, 2017; Zou et al, 2018). According to several meta-analyses, the probability of TUPKP requiring blood transfusion is 1.14% to 1.85% (Mamoulakis et al, 2009; Li et al, 2015; Wang et al, 2015a).…”

Section: Discussionmentioning

confidence: 99%

A Preliminary, Multicenter, Prospective and Real World Study on the Hemostasis, Coagulation, and Safety of Hemocoagulase Bothrops Atrox in Patients Undergoing Transurethral Bipolar Plasmakinetic Prostatectomy

Wang

et al. 2019

Front. Pharmacol.

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Objective: To evaluate the hemostasis and coagulation effect of Hemocoagulase Bothrops Atrox in benign prostatic hyperplasia (BPH) patients undergoing transurethral bipolar plasmakinetic prostatectomy (TUPKP). Methods: This study adopted a multicenter, prospective, and real world design. BPH patients undergoing TUPKP were divided into two groups according to whether they adopted Hemocoagulase Bothrops Atrox (group B) or not (group A) during perioperative period. The electronic clinical data on every included subject, including the international prostate symptom score (IPSS) and the quality of life scale (QoL), maximum urinary flow rate (Qmax), complete blood count, coagulation screening test and adverse events, were measured and compared between the two groups. Results: Finally, 695 patients, 443 in group A and 252 in group B were included. Baseline characteristics showed no significant difference between two groups. In group A, compared with baseline, IPSS decreased 15.66 (95% CI = −16.45 to −14.87), QoL decreased 3.08 (95% CI = −3.30 to −2.87), prothrombin time prolonged 1.02 s (95% CI = 0.56 to 1.48), while white blood cells, neutrophils, lymphocytes, and hemoglobin also significantly changed; white blood cells, neutrophils and platelets increased, while lymphocytes decreased by 0.14×109/L (95% CI = −0.21 to −0.08) before discharge. In group B, compared with baseline, IPSS decreased 16.12 (95% CI = −17.02 to −15.21), QoL decreased 3.32 (95% CI = −3.56 to −3.07), and white blood cells, neutrophils, lymphocytes, and hemoglobin were also significantly changed, along with white blood cells and lymphocytes that tested before discharge (p < 0.01); however, prothrombin time was not significant prolonged (MD= 0.48, 95% CI = −0.05 to 1.01). When compared with group A and group B, the average hospitalization time in group A was longer than group B (p < 0.01), transfusion risk was similar in the two groups (OR = 1.582, 95% CI = 0.552 to 4.538). Parameters had no substantial difference between the two subgroups whether prostate volume was more than 80 mL or not. Conclusion: Our study indicated that Hemocoagulase Bothrops Atrox can shorten the prothrombin time, hospitalization time and is probably safe among BPH patients undergoing TUPKP, exhibiting fine hemostasis and coagulation efficacy, and would not be influenced by prostate volume.

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Long-term Clinical Efficacy and Safety Profile of Transurethral Resection of Prostate Versus Plasmakinetic Resection of the Prostate for Benign Prostatic Hyperplasia

Cited by 24 publications

References 27 publications

Functional outcomes of transurethral thulium laser enucleation versus bipolar transurethral resection for benign prostatic hyperplasia over a period of 12 months: A prospective randomized study

Functional outcomes of transurethral thulium laser enucleation versus bipolar transurethral resection for benign prostatic hyperplasia over a period of 12 months: A prospective randomized study

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

A Preliminary, Multicenter, Prospective and Real World Study on the Hemostasis, Coagulation, and Safety of Hemocoagulase Bothrops Atrox in Patients Undergoing Transurethral Bipolar Plasmakinetic Prostatectomy

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