Abstract: Objective To investigate curative effect of modified plasma kinetic resection of prostate(PKRP) for senile high-risk benign prostatic hyperplasia(BPH) and the risk factors of postoperative bladder neck contracture.
Methods The clinical date of 105 senile high-risk BPH patients in our hospital from January 2017 to January 2019 were retrospectively analyzed,and patients divided into two groups according to different surgical methods,modified group(n=73) and the traditional group(n=32).The outcomes of two groups were compared,and the incidence of postoperative bladder neck contracture in modified group was statistically analyzed.Then the risk factors affecting postoperative bladder neck contracture were analyzed by multivariate Logistic regression model.
Results The operative time,postoperative flushing time,postoperative extubation time and postoperative hospital stay of modified group were significantly shorter than those of traditional group(P<0.05),and the intraoperative blood loss was significantly less than that of traditional group(P<0.05).There was no significant difference in the amount of intraoperative tissue resection between two groups(P>0.05).After surgery,the maximum flow rate(MFR) was significantly increased in both groups,and postvoid residual(PVR) and international prostate symptom score(IPSS) were decreased significantly in both groups,with significant differences within groups(P<0.05).After treatment,MFR of modified group was significantly higher than that of traditional group,and PVR was significantly lower than that of traditional group(P<0.05).There was no significant difference in postoperative complications between groups(P>0.05).Logistic multivariate regression analysis suggested that smoking history and postoperative obstruction of urethral catheters would increase the risk of bladder neck contracture after surgery.
Conclusion Compared with traditional PKRP operation,the modified PKRP has the advantages of shorter operation time,less intraoperative blood loss,and faster postoperative recovery.The effective way to prevent bladder neck contracture includes quitting smoking and keeping catheter smooth.

Key words: modified plasma kinetic resection of prostate, prostate, effect, postoperative bladder neck contracture, risk factor