Article Data

  • Views 719
  • Dowloads 152

Original Research

Open Access

Modified plasmakinetic enucleation and resection of the prostate by three glands: proposal of a novel anatomical treatment for benign prostatic hyperplasia

  • Shaolei Nie1,2
  • Jun Wang2
  • Yufeng Peng2
  • Jianming Lou1,*,
  • Yipeng Xu3,4,5,*,

1The Graduate School, Zhejiang Chinese Medical University, 310000 Hangzhou, Zhejiang, China

2Department of Urology, QuZhou Kecheng Hospital, 324000 Quzhou, Zhejiang, China

3Department of Urology, Zhejiang Cancer Hospital, 310000 Hangzhou, Zhejiang, China

4The Key Laboratory of Zhejiang Province for Aptamers and Theranostics, 310022 Hangzhou, Zhejiang, China

5Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, 310022 Hangzhou, Zhejiang, China

DOI: 10.22514/jomh.2023.034 Vol.19,Issue 4,April 2023 pp.51-57

Submitted: 06 December 2022 Accepted: 22 February 2023

Published: 30 April 2023

*Corresponding Author(s): Jianming Lou E-mail:
*Corresponding Author(s): Yipeng Xu E-mail:


Transurethral resection of the prostate (TURP) cannot completely resect hyperplastic tissues and is often associated with high recurrence rate and short recurrence interval. Western and Chinese scholars have reported higher incidences of stress urinary incontinence (SUI) with traditional enucleations. This study investigated the potential applicability of Modified Plasmakinetic Enucleation and Resection of the Prostate by three glands (MPKERP) in treating benign prostatic hyperplasia (BPH). Between April 2020 and June 2021, 28 patients underwent MPKERP for BPH. The surgical procedures included (1) surgical capsule exploration; (2) moderate range enucleation; (3) middle gland enucleation; (4) sector resection at 12 o’clock in the lithotomy position; (5) cut residual distal urethral mucosa; (6) lateral hyperplastic glands enucleation. All 28 patients recovered well after the surgery, and the curative effect was satisfactory. The average operation time was 68.9 ± 21.8 min, the average weight of excised glands was 62.5 ± 19.1 g, the average indwelling catheter time was 4.6 ± 0.6 d, and the average bladder washing time was 28.6 ± 9.5 h. The average postoperative 1-day hemoglobin decrease was 10.2 ± 9.8 g/L. Only one severe hyperplasia patient had transient SUI (incidence rate: 3.6%). No complications, such as urethral stricture, dysuria, urinary incontinence and urinary retention, were reported during follow-up. International Prostate Symptoms Score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax) and post-void residual volume (PVR) significantly improved three months after surgery (p < 0.0001). The MPKERP can enucleate and resect the hyperplastic glands anatomically in an orderly manner and pay attention to expanding space, reducing resistance, reducing the damage of pushing and pulling, protecting the urethral sphincter complex (USC), and reducing the incidence of urinary incontinence. Altogether, our findings support MPKERP as an improved surgical technique worthy of promotion, and it is more suitable for grass-roots hospitals that lack hardware equipment.


Benign prostatic hyperplasia (BPH); Modified plasmakinetic enucleation and resection of prostate by three glands (MPKERP); Stress urinary incontinence (SUI); Urethral sphincter complex (USC); Space; Resistance; Push and pull injury

Cite and Share

Shaolei Nie,Jun Wang,Yufeng Peng,Jianming Lou,Yipeng Xu. Modified plasmakinetic enucleation and resection of the prostate by three glands: proposal of a novel anatomical treatment for benign prostatic hyperplasia. Journal of Men's Health. 2023. 19(4);51-57.


[1] Strebel RT, Kaplan SA. The state of TURP through a historical lens. World Journal of Urology. 2021; 39: 2255–2262.

[2] Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. European Urology. 2006; 50: 969–980.

[3] Miernik A, Gratzke C. Current Treatment for Benign Prostatic Hyperpla-sia. Deutsches Ärzteblatt International. 2020; 117: 843–854.

[4] Xu P, Xu A, Chen B, Zheng S, Xu Y, Li H, et al. Bipolar transurethral enucleation and resection of the prostate: whether it is ready to supersede TURP? Asian Journal of Urology. 2018; 5: 48–54.

[5] Zhu L, Chen S, Yang S, Wu M, Ge R, Wu W, et al. Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 mL: a prospective, randomized trial with 5-year followup. The Journal of Urology. 2013; 189: 1427–31.

[6] Luo YH, Shen JH, Guan RY, Li H, Wang J. Plasmakinetic enucleation of the prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: comparison of outcomes according to prostate size in 310 patients. Urology. 2014; 84: 904–10.

[7] Bebi C, Turetti M, Lievore E, Ripa F, Rocchini L, Spinelli MG, et al. Bipolar transurethral enucleation of the prostate: is it a size-independent endoscopic treatment option for symptomatic benign prostatic hyperplasia? PLoS One. 2021; 16: e0253083.

[8] Buckley BS, Lapitan MCM, Glazener CM. The effect of urinary incontinence on health utility and health-related quality of life in men following prostate surgery. Neurourology and Urodynamics. 2012; 31: 465–469.

[9] McNeal JE. The zonal anatomy of the prostate. The Prostate. 1981; 2: 35–49.

[10] Koraitim MM. The male urethral sphincter complex revisited: an anatomical concept and its physiological correlate. Journal of Urology. 2008; 179: 1683–1689.

[11] Sinha S, Sinha U, Malis V, Bhargava V, Sakamoto K, Rajasekaran M. Exploration of male urethral sphincter complex using diffusion tensor imaging (DTI)-based fiber-tracking. Journal of Magnetic Resonance Imaging. 2018; 48: 1002–1011.

[12] Li X, He F, Huang C, Zhang L, Liu Q, Song J. Development and validation of a nomogram for predicting early stress urinary incontinence following endoscopic enucleation of the prostate. World Journal of Urology. 2021; 39: 3447–3453.

[13] Walz J, Burnett AL, Costello AJ, Eastham JA, Graefen M, Guillonneau B, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. European Urology. 2010; 57: 179–92.

[14] Endo F, Shiga Y, Minagawa S, Iwabuchi T, Fujisaki A, Yashi M, et al. Anteroposterior dissection HoLEP: a modification to prevent transient stress urinary incontinence. Urology. 2010; 76: 1451–5.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus: CiteScore 0.7 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (

Submission Turnaround Time