Benign Prostatic Hyperplasia: Enucleation versus Resection Using Plasmakinetic Energy: A Prospective Randomized Study at Zagazig University Hospital

Background: Transuretheral resection of the prostate (TURP) has been the gold standard endoscopic treatment for bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH). New technologies have been developed to minimize the morbidity of TURP. Recently, the Gyrus Plasma Kinetic (PK) System is the first bipolar device used in urological practice, as a new modality in treatment of BPH. Objective: To evaluate the efficacy and safety of plasmakinetic enucleation compared to plasmakinetic resection of the prostate in the management of BOO induced by BPH. Patients and Methods: This study was conducted on 58 volunteers from Department of Urology, Faculty of Medicine, Zagazig University between January 2018, and January 2020. Patients were randomized to either plasmakinetic enucleation of the prostate (PKEP) group or plasmakinetic resection of the prostate (PKRP) group. All patients were indicated for surgical treatment (prostate size ≥ 60 g and ≤ 120 g). Results: There were no statistically significant differences between the two groups preoperatively. PKEP resulted in a greater volume of prostatic tissue removal than the PKRP. Tissue retrieved/total operative time in PKEP group was greater than in PKRP group (0.69gm/min vs 0.67 gm/min respectively). The mean indwelling uretheral catheter time was shorter in PKEP group (34.7 ±4.40 hrs.) than in PKRP (48.79 ±4.31 hrs.). Regarding postoperative complication (early and late), there were no statistically significant differences between the two groups. Conclusions: We concluded that regarding, surgical safety and efficacy PKEP is comparable to PKRP for prostates (60-120 ml). Either PKEP or PKRP can be on an equal footing to TURP as an endoscopic management of BPH.