Bipolar plasmakinetic transurethral resection of the prostate vs. transurethral enucleation and resection of the prostate: pre- and postoperative comparisons of parameters used in assessing benign prostatic enlargement.

Background: Transurethral enucleation and resection of the prostate (TUERP) may offer a better treatment for benign prostatic enlargement. We compared the perioperative parameters and outcome following bipolar plasmakinetic transurethral resection of the prostate (TURP) and TUERP.

Methods: Data from two independent institutions were reviewed retrospectively. 50 and 45 consecutive patients were enrolled in the TURP and TUERP groups, respectively. Pre- and postoperative parameters, including prostatic specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPSS), quality of life (QOL) score, uroflowmetry and prostate volume (PV), were compared.

Results: Age at surgery, preoperative PSA (5.8 +/- 4.0 versus 7.6 +/- 5.9 ng/ml) and PV (55.8 +/- 31.6 versus 53.2 +/- 26.8 g) showed no significant difference (p-value greater than 0.05). However, postoperative PSA (2.8 +/- 3.0 versus 0.8 +/- 0.4 ng/ml; p-value less than 0.05) and PV (15.2 +/- 7.7 versus 10.5 +/- 5.4 g; p-value less than 0.01) differed significantly between the TURP and TUERP groups, respectively. There were no significant differences in IPSS, QOL and Qmax between the two groups during follow-up (p-value is 0.62, 0.68 and 0.13, respectively). However, for the TUERP group, the postoperative post-void residual urine volume (PVR) was significantly better (13.8 +/- 19.5 versus 25.2 +/- 18.7 ml; p-value less than 0.01).

Conclusions: The TUERP technique achieved more complete resection than TURP, with a smaller post procedure PV and lower PSA and PVR after surgery. This may predict better long-term results for patients who had TUERP.