Objective: To evaluate surgical complications and outcomes based on prostate size in patients with benign prostatic hyperplasia (BPH) treated with plasmakinetic enucleation of the prostate (PKEP).
Methods: A retrospective review was conducted of PKEP performed between July 2008 and January 2013. According to the prostate size on preoperative transrectal ultrasonography measurement, patients were divided into three groups: group 1: <40 ml, group 2: 40-80 ml and group 3: >80 ml. Baseline, perioperative and postoperative data were obtained.
Results: There were significant differences among the three groups regarding the mean operative time (p < 0.001) and the mean resected tissue weight (p < 0.001). But enucleation efficiency (p < 0.001) in gm tissue per minute increased significantly as prostate size increased. Mean hemoglobin decrease (p > 0.05), mean postoperative irrigation time (p > 0.05), mean catheter time (p > 0.05) and mean hospital stay (p > 0.05) did not differ significantly among three groups. The three groups had a similar and significant postoperative improvement in International Prostate Symptom Score, quality of life, maximum uroflow rate and post-void residual urine volume independent of prostate size (p < 0.001), but no significant difference was found among three groups at the 12-month follow-up (p > 0.05). Perioperative and postoperative complications did not depend on prostate size (p > 0.05).
Conclusions: Although patients with a larger BPH required significantly longer operation time in PKEP, prostate size did not affect perioperative and postoperative complications or micturition improvement.