A multicentre single-blind randomized controlled trial comparing bipolar and monopolar transurethral resection of the prostate

Abstract

Introduction: Monopolar transurethral resection of the prostate(TURP) is the gold standard surgical therapy for men with lower urinarytract symptoms due to benign prostatic hyperplasia. Althoughgenerally considered safer, TURP experience is limited in Canada.Methods: Forty-three patients from 5 Canadian centres were randomizedto TURP with either bipolar or monopolar platforms.Patients underwent baseline determinations of American UrologicalAssociation (AUA) symptom score, peak urinary flow rate, postvoidresidual bladder volume and transrectal ultrasound prostatevolume. Primary outcome measures were improvement in AUAsymptom score, quality of life assessment and bother assessment.Secondary outcomes included procedural times, duration of catheterization,length of hospitalization, complications and the degreeof thermal artifact in tissue specimens. Patients were followed for6 months.Results: Twenty-two patients were treated with bipolar and 21 withmonopolar TURP. Preoperative demographics were not statisticallydifferent between groups. Postoperative data collection times wereequivalent in AUA symptom, quality of life, bother and sexualfunction assessments. No differences were observed in the proceduretime (60.7 min, bipolar vs. 47.4, monopolar) or the durationof urethral catheterization (1.5 days, bipolar vs. 1.1, monopolar).More patients in the bipolar group were discharged on the sameday of surgery. There were no differences in the degree of tissuethermal artifact or complication rate.Conclusion: This trial suggests equivalent short-term outcomes formen undergoing monopolar or bipolar TURP.