Bipolar transurethral resection in saline vs traditional monopolar resection of the prostate: results of a randomized trial with a 2‐year follow‐up

Abstract

To present 2-year follow-up data of a randomized clinical trial comparing bipolar transurethral resection in saline (TURIS) with monopolar transurethral resection of the prostate (TURP). In all, 100 consecutive patients with benign prostatic hyperplasia (BPH) were randomized to TURIS or TURP. The breath ethanol test was used before and every 10 min during surgery to assess fluid absorption. Complications and treatment efficacy were evaluated after surgery. The operative duration and resected tissue weight were similar between the groups. The mean decreases in serum sodium and haemoglobin after surgery were significantly less in the TURIS group. The mean (standard deviation) irrigant absorbed was significantly less in TURIS than in the TURP group, at 208 (344) mL vs 512 (706) mL respectively (P < 0.001). In both the TURIS and TURP groups there were significant improvements in International Prostate Symptoms Scores and maximum urinary flow rates. The acute and late complications in the groups were statistically similar. Bipolar TURIS seems to be a safe and effective procedure, which is associated with significantly less fluid absorption and similar efficacy as traditional monopolar TURP.