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BACKGROUND	Studies have demonstrated that plasmakinetic enucleation of the prostate ( PKEP ) and open prostatectomy ( OP ) have equivalent short-term efficacy for large prostates , but no comparison concerning their long-term results was reported .
OBJECTIVE	To demonstrate the noninferiority of PKEP to OP concerning maximum urinary flow rate ( Qmax ) at 1 yr postoperatively and to compare the long-term results of both procedures .
METHODS	From 2004 to 2007 , 160 patients with prostates > 100g were randomized to receive PKEP or OP .
METHODS	A total of 153 patients ( 95.6 % ) completed the noninferiority study , and 123 patients ( 76.9 % ) finished a 6-yr follow-up assessment .
METHODS	The PKEP procedures were performed with 27F Karl Storz continuous flow resectoscopy and the Gyrus PlasmaKinetic device .
METHODS	OP was performed by a suprapubic transvesical approach .
METHODS	The primary end point was Qmax at 1 yr postoperatively .
METHODS	Secondary end points included other perioperative parameters and postoperative micturition variables .
METHODS	The student t test , Mann-Whitney U test , chi-square test , or Fisher exact probability test was used as appropriate .
CONCLUSIONS	PKEP was noninferior to OP regarding Qmax at 1 yr postoperatively .
CONCLUSIONS	Compared with OP , PKEP was associated with less perioperative hemoglobin decrease , shorter catheterization time , and shorter postoperative hospital stay ( 1.0 vs 3.2 g/dl , 40 vs 148h , and 3 vs 8 d , respectively ; p < 0.001 for all ) , as well as fewer short-term complications ( 22.5 % vs 42.5 % , p = 0.031 ) .
CONCLUSIONS	On intention-to-treat analysis , both the PKEP and OP groups had equivalent Qmax ( 25.27.0 ml/s vs 25.77.6 ml/s , respectively ; p = 0.688 ) , International Prostate Symptom Score ( 3.5 [ 2-5 ] vs 3 [ 2-5 ] , respectively p = 0.755 ) , quality of life ( 2 [ 1-3 ] vs 2 [ 1-3 ] , respectively ; p = 0.950 ) , and postvoid residual urine ( 20 [ 9-33 .5 ] vs 16.5 [ 7-31 ] ml , respectively ; p = 0.469 ) at 72 mo postoperatively .
CONCLUSIONS	No patients required reoperation because of recurrence of BPH .
CONCLUSIONS	The relatively small sample size is the limitation .
CONCLUSIONS	PKEP is a durable procedure with short - to long-term micturition improvement equivalent to OP and significantly lower perioperative morbidity .
RESULTS	We compared PKEP with OP for large prostates and found that PKEP is less invasive , with short - to long-term micturition improvement equivalent to OP .
BACKGROUND	Plasmakinetic Enucleation of the Prostate and Open Prostatectomy to Treat Large Prostates .
BACKGROUND	ClinicalTrials.gov identifier NCT01952912 .
BACKGROUND	http://www.clinicaltrials.gov/ct2/show/NCT01952912?term=NCT016301952912&rank=1 .

