Transurethral greenlight photoselective vaporization of the prostate versus transurethral plasma kinetic resection of the prostate for the treatment of prostatic hyperplasia patients with different volumes

Objective To compare the clinical effectiveness of transurethral greenlight photoselective vaporization of the prostate (PVP) and transurethral plasma kinetic resection of the prostate (TUPKP) for the treatment of prostatic hyperplasia patients with different volumes. Methods A total of 233 patients who were diagnosed with benign prostatic hyperplasia in Department of Urology, the First Affiliated Hospital of Bengbu Medical College from January 2019 to January 2022 were selected. According to the corresponding operation type, they were divided into two groups: a PVP group (n=127) and a TUPKP group (n=106). The prostate volume of patients in each group was estimated based on prostate ultrasound or MRI data, and the patients were subdivided into group A (<30 mL), group B (30-80 mL), and group C (>80 mL) for comparative study. Results Groups A and B showed remarkably less hemoglobin drop values after PVP than those after TUPKP (P＜0.01), whereas the hemoglobin drop value after PVP in Group C were not statistically different when compared with that after TUPKP (P＞0.05). Groups A and B presented remarkably shorter surgical duration of PVP than TUPKP (P＜0.01), whereas the surgical duration of PVP in Group C was not statistically different compared with that after TUPKP (P＞0.05). Furthermore, after PVP, patients in groups A, B and C showed remarkable decreases in bladder irrigation time, indwelling catheterization time, and the length of hospitalization stay, compared with those after TUPKP (P＜0.01). In terms of complications, the incidence of electroresection syndrome in the PVP group was lower than that in the TUPKP group (P＜0.05). There was no statistical difference in the incidence of obturator nerve reflex, urinary incontinence, urethral stricture, and bladder neck contracture between the two groups (P＞0.05). Conclusions Compared with traditional TUPKP, PVP is an emerging surgical approach for the treatment of prostatic hyperplasia, with significant advantages in operation duration, bleeding, and complications, especially for patients with small-sized prostate.