OBJECTIVES: The conventional Fr26 resectoscope is difficult to use in patients with benign prostatic hyperplasia (BPH) complicated by urethral stricture. This study aims to evaluate the safety and efficacy of transurethral plasmakinetic resection of the prostate (PKRP) using a small-caliber (Fr18.5) plasmakinetic resectoscope combined with urethral dilation in patients with BPH and mild urethral stricture. METHODS: A retrospective analysis was conducted on 37 patients with BPH and mild urethral stricture treated at the Department of Urology, Hunan Provincial People's Hospital from January 2023 to December 2023. All patients underwent PKRP with a small-caliber plasmakinetic resectoscope, followed by routine placement of a Fr20 three-way Foley catheter for continuous bladder irrigation. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q_max), post-voiding residual urine volume (PVR), and Quality of Life (QOL) scores were compared before and after surgery. Perioperative indicators (intraoperative bleeding, operative time, postoperative catheterization time, and postoperative hospital stay) and complications were recorded. RESULTS: The median age was 69 years, and the median duration of voiding difficulty was 36 months. Median total prostate specific antigen (T-PSA) was 2.095 ng/mL, free prostate specific antigen (F-PSA) 0.561 ng/mL, and F/T ratio 0.3. Median prostate diameter was 48 mm and volume 41 mL. All 37 surgeries were completed successfully: 11 had external meatal stricture, 19 had mild anterior urethral stricture, and 7 had mild posterior urethral stricture (1 patient with a 1 cm pseudo-blind tract near the membranous urethral). Operative time was (2.4±0.7) hours, blood loss was (40±29) mL, median catheterization duration was 7 days, and median hospital stay was 7 days. No cases of postoperative urinary incontinence, recurrent hematuria, or sepsis occurred, and patients were satisfied with the surgical outcome. At 3 to 6 months follow-up, IPSS, Q_max, PVR, and QOL scores significantly improved compared to preoperative levels (all P<0.01), with no cases of urethral stricture progression or new-onset stricture. CONCLUSIONS PKRP using a small-caliber plasmakinetic resectoscope is safe and effective for treating BPH with mild urethral stricture. It offers advantages such as minimal trauma, rapid postoperative recovery, and a lower risk recovery, and a lower risk of aggravating urethral injury.
Humans ; Male ; Prostatic Hyperplasia/complications* ; Urethral Stricture/complications* ; Retrospective Studies ; Aged ; Transurethral Resection of Prostate/instrumentation* ; Middle Aged ; Treatment Outcome ; Quality of Life ; Aged, 80 and over

OBJECTIVE: To summarize the therapeutic effect of coronary stent implantation on elderly patients with coronary heart disease(CHD).METHODS: Ten literatures regarding controlled experiment of treating CHD with coronary stent implantation in elderly patients, writing in Chinese language, published from 1990 to 2008, were selected. The literatures were sorted from experimental grouping, materials, observation methods, results, and conclusions. Simultaneously, the baseline data of subjects in the experiment were analyzed, and the follow up and functional evaluation were included to check the results.RESULTS: The literatures showed that treating CHD with coronary stent implantation in elderly patients was a fast developing and challenging field in interventional cardiology, the therapeutic effect and value of which had been proved by evidence based medicine. However, how to elevate the safety of procedures, increase the successful rate, and prevent restenosis were needed to be exploring in future. The exploration of new drugs, new equipment and inserting technique of scaffold implantation were important to solve the existed problems.CONCLUSION: More elderly patients suffered CHD need treating, but plenty of problems still existed in revascularization,therefore, it is necessary to perform large-scale randomized controlled trials containing different ages and pathologic characters for guiding the clinical practice.