| dc.description.abstract | Objective: To generate high-quality data comparing the clinical effi cacy and safety
profi le between monopolar transurethral resection of the prostate (M-TURP) and bipolar
plasmakinetic resection of the prostate (PK-TURP) for benign prostatic hyperplasia (BPH).
Materials and Methods: Prospective, randomized, single-blinded study conducted in a
tertiary-care public institution (Dec/2014-Aug/2016). Inclusion criteria: prostate of <80g
in patients with drug-refractory lower urinary tract symptoms (LUTS), complications
derived from BPH, or both. Exclusion criteria: a history of pelvic surgery/radiotherapy,
neurogenic bladder dysfunction or documented/suspected prostate carcinoma. Treatment
effi cacy evaluated at 1, 3, 6 and 12 months. Effi cacy outcomes: international prostate
symptom score (IPSS), quality-of-life (QoL) score, international index of erectile function-5
(IIEF-5), maximum urinary fl ow rate (Qmax), postvoid residual urine (PVRU) volume, and
prostate volume (PV). Complications and sequelae also assessed. Comparisons performed
with parametric/non-parametric tests.
Results: Out of the 100 hundred patients, 84 qualifi ed for the analysis (45 M-TURP/39
PK-TURP). No signifi cant differences found in baseline characteristics or operative data,
except for a longer operative time in PK-TURP (MD:7.9min; 95%CI:0.13-15.74; p=0.04).
No differences found in IPSS, Qmax or PVRU volume. QoL score at 12 months was
higher in PK-TURP (MD:0,9points; 95%CI:0.18-1.64; p=0.01). No differences in sexual
function, PV, complications or sequelae were found. This study is “rigorous” (Jadadscale) and has a low risk of bias (Cochrane-Handbook).
Conclusions: Based on this controlled trial, there is not signifi cant variation in
effectiveness and safety between M-TURP and PK-TURP for the treatment of BPH. The
small difference in QoL between PK-TURP and M-TURP at the one-year follow-up is not
perceivable by the patients and, therefore, not clinically relevant. | |
