To explore the procedures and efficacy of plasmakinetic anatomical enucleation of the prostate with cylindrical electrode.

Retrospective analysis was performed on the clinical data and operating procedure of patients who received plasmakinetic anatomical enucleation of the prostate with cylindrical electrode in Shanghai ChangZheng Hospital from June 2018 to December 2019. Statistical analysis was performed about age, prostate volume, operation time, time of bladder irrigation, postoperative hospitalization, catheter retention time and occurrence of urinary incontinence. International prostate symptom score (IPSS), international index of erectile function 5(IIEF-5), peak urinary flow rate (Q_max), postvoid residual urine volume (RUV), and quality of life score (QOL) were compared between pre-operation and 3 months after surgery.

There were a total of 90 patients in this group, the average age was (69±9) years, the volume was (67±16) ml. All the patients successfully completed the operation without transfering to open surgery or other surgical procedure. No patient received blood transfusion during perioperation period. No transurethral resection syndrome, rectal and bladder perforation, ureteral injury and other serious complications occurred. The operation time was (65±12) min, the time of bladder irrigation was (20.0±6.5) h, the postoperative hospitalization was (3.3±0.8) d, the catheter retention time was (6.6±1.3) d. Postoperative follow-up time was 10-28 months, with an average of (18±5) months, there were urinary incontinence in 6 cases and recovered within 2 weeks. IPSS [(8.0±2.5) vs (24.2±5.6)], Q_max [(18.5±3.8) vs (8.0±4.8)] ml/s, RUV [(18.9±4.1) vs (109.3±14.8)] ml, QOL [(4.3±0.7) vs (1.8±0.6)] in 3 months after surgery were significantly improved compared with preoperation (P<0.05). There was no statistically significant difference in the IIEF-5 (13.4±3.9 vs 12.6±3.5) of the 41 patients with regular sex life (P=0.015). There were no recurrence or reoperation cases during the follow-up period.

The cylindrical electrode has good effect in tissue cutting and hemostasis, and the operation is direct and controllable, in line with the finger dissection operation habits. Plasmakinetic enucleation of the prostate with cylindrical electrode is safe and feasible, which can significantly improve the condition of urination and quality of life, but not significantly affect sexual function. The complication rate and recurrence rate were low.