ORIGINAL ARTICLE   Free access

Minerva Urologica e Nefrologica 2019 June;71(3):286-93

DOI: 10.23736/S0393-2249.19.03282-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Comparison of bipolar plasmakinetic transurethral enucleation and resection of prostate gland in patients receiving anticoagulants and/or platelet aggregation inhibitors

Priyanka RAI ¹, Alok SRIVASTAVA ² ✉, Sanjeet SINGH ², Ishwar R. DHAYAL ²

¹ Department of Surgery, Dr. Ram Manohar Lohia Institute of Medical Sciences (Dr.RMLIMS), Lucknow, India; ² Department of Urology and Renal Transplant, Dr. Ram Manohar Lohia Institute of Medical Sciences (Dr.RMLIMS), Lucknow, India

BACKGROUND: The aim of this study was to evaluate the safety and efficacy of bipolar plasmakinetic enucleation of the prostate (BPEP) and bipolar plasmakinetic transurethral resection of prostate (B-TURP) for patients on oral anticoagulants (OA) and/or platelet aggregation inhibitors (PAI) with benign prostatic obstruction (BPO) and having a gland size of >60 g.
METHODS: Patient database of our hospital for the period of May 2012 to September 2017 was retrospectively reviewed for BPH patients with a gland size of >60 g who either underwent BPEP or B-TURP and were on OA and/or PAI. Patient demographic, perioperative, and follow-up data were analyzed.
RESULTS: There were no significant differences between the two surgical groups preoperatively. The mean operative time was lower in the BPEP group however, no statistical difference was found between them (P=0.77). There was significant difference in the mean resected tissue weight (52.11±17.92 vs. 77.19±17.78 g, P value ≤0.001), irrigation time and total hospital stay in favor of BPEP group. The blood loss observed in the B-TURP group and BPEP group was 2.57±0.36 and 1.45±0.44 g/dL, respectively, which was statistically significant (P<0.033). Eight and three patients of B-TURP and BPEP groups needed blood transfusion respectively. All patients were followed up for 12 months postoperatively. Both groups resulted in a significant improvement from baseline in terms of IPSS, QoL, Q-max, and PVRU volume values. No significant difference was found between them, however.
CONCLUSIONS: Both procedures are safe and effective options in patients who are on OA and/or PAI but BPEP is better in terms of low clot retention rate, less irrigation time and decreased hospital stay.

KEY WORDS: Transurethral resection of prostate; Anticoagulants; Surgery