ABSTRACT

Objective

The challenge begins when the prostate is large, but in the grey zone. European Urology Guidelines suggest using transurethral prostate resection (TURp) for large prostates smaller than 80 ml and the use of open prostatectomy (OP) for those larger than 80-100 ml. In this study, we aimed to compare the safety and efficacy of bipolar TURp and OP treatment options to treat large (80-100 ml) prostates.

Material and Method

Patients applied to our clinic with lower urinary tract symptoms (LUTS) and treated with Open Prostatectomy (OP) (Group 1) and Bipolar Plasma Kinetic TURp (Group 2) were included in the study. Patient age, (total and free) prostate-specific antigen (PSA), prostate volume, symptom scores (pre and postoperative) (IPSS), digital rectal examination, prostate volume, uroflowmetry, operative time, post voiding residual volume (PVR), preoperative and postoperative hematocrit and complications were assessed. Results: When groups were compared, mean patient age, prostate volume, PSA levels, preoperative hematocrit levels, IPSS, Qmax, and PVR were similar. After the operations, the difference of IPSS, Qmax, and PVR were significantly better, favoring Group 1 (p=0.000, p=0.000 and 0.05, respectively). However, hospital stay and hematocrit drop were significantly better in favor of Group 2 (p=0.000 and p=0.018).

Conclusion

Even though there are many alternatives for OP and it is considered to be out of fashion, in developing countries, OP may be more suitable than TURp in treating large prostatic glands. Prospective randomized studies on larger cohorts should be performed to validate our findings.