Transurethral Plasmakinetic Enucleation of Prostate Versus Transurethral Resection of Prostate
Transurethral Plasmakinetic Enucleation of Prostate Versus Transurethral Resection of Prostate
The study is a multicentric randomized control trial with 4-year follow-up comparing
 perioperative and postoperative outcomes for transurethral plasmakinetic enucleation of
 prostate(TUKEP) and transurethral resection of prostate(TURP). The investigators recruit
 patient with benign prostatic hyperplasia(BPH) as the object of study. TURP is set as control
 group . Meanwhile TUKEP is set as test group. Six affiliated hospitals will participate in
 this study. Through analyzing the perioperative and postoperative data between TUKEP group
 and TURP group, The investigators purpose demonstrating superiority of safety, efficacy and
 economic benefit in TUKEP group.
Benign prostatic hyperplasia (BPH) is the most common disease of middle aged and elderly
 people which cause urinary tract symptoms (LUTS). transurethral resection of prostate(TURP) ,
 began to replace the traditional open surgery in 1930s, still is as the "gold standard"
 operation for surgical treatment of BPH. However, compared with the traditional open
 operation, TURP has the following flaws:(1), due to the incomplete resection , maximum flow
 rate(Qmax) after TURP is lower than Qmax after open surgery. (2), there are serious
 complications, such as water intoxication and hemorrhage. (3) TURP has limitation to large
 prostate.

 Transurethral plasmakinetic enucleation of prostate(TUKEP), an operation mode devised by Liu
 Chunxiao Team in southern medical university urology department, have offset the advantage of
 TURP. The theory of the operation is using transurethral resectoscope instead of the finger
 in the open operation, to find the surgical capsule of prostate and to peel the hyperplastic
 prostate gland visually in a antidromic way. One the one hand, TUKEP effectively solve the
 situation that It should repeatedly cut and stop bleeding and difficultly find the surgical
 capsule in TURP, which obviously reduce the rate of bleeding, prostatic capsula perforation,
 transurethral resection syndrome(TURS) and External sphincter injury. On the other hand,
 TUKEP is the minimally invasive surgery. It also achieves the effect of open surgery
 resolving the residual gland and reoperation post TURP.

 The investigators plan to setup a a multicentric randomized control trial with 4-year
 follow-up comparing perioperative and postoperative outcomes for TUKEP and TURP. Through
 analyzing the perioperative and postoperative data between TUKEP group and TURP group, The
 purpose demonstrating superiority of safety, efficacy and economic benefit in TUKEP group.
Inclusion Criteria:

 1. Diagnose as BPH

 2. Between 50 and 80 year-old

 3. Prostate volume less than 120g

 4. Meet any conditions (1). International Prostate Symptom Score (IPSS),≥12 quality of
 life score (QOL) ≥4分 (2).Maximum urinary flow rate (Qmax) 15 ml/s or less (urine flow
 more than 150 ml) (3).Medication is not efficient (4).Repeated urinary retention
 (extubation failure more than one) (5).Schafer≥grade 2

 5. The American association of anesthesia score (ASA) class 1 to 3

 6. Sign the informed consent voluntarily and will be willing to follow-up

 Exclusion Criteria:

 1. Combined with central nervous system lesions (such as cerebrovascular accident,
 Parkinson, multiple sclerosis, cauda equina injury, spinal cord lesions, etc.) and
 neurogenic bladder;

 2. The combination of advanced malignant tumor or chronic wasting disease;

 3. Patients with severe cardiopulmonary disease or severe mental disorders;

 4. Acute urinary tract infection, urethral stricture;

 5. There is a history of prostate and bladder surgery;

 6. Combined with severe coagulopathy;

 7. Postoperative pathology confirmed prostate cancer;

 8. Poor compliance, and can not be followed up.