Bipolar versus Monopolar Transurethral Resection of Prostate: Randomized Controlled Study

Abstract

Transurethral resection of prostate (TURP) using bipolar electrocautery and physiologic saline is a new technical advancement in the field of surgical management of benign prostatic hyperplasia. The purpose of this study was to assess the efficacy and safety of this new technique and to compare the results with those of conventional monopolar TURP. This study included 60 patients who were randomized 1:1 to bipolar (group 1) or monopolar (group 2) TURP. Bipolar TURP was performed with the Vista CTR resectoscope and generator (ACMI Corp.). Preoperatively, patients were assessed by symptom score, uroflow, and transrectal sonography, and the two groups were comparable with regard to these measures and age. The preoperative and postoperative parameters studied included resection time, amount of tissue resected, irrigant amount, blood loss, fluid absorption, and change in serum sodium and hemoglobin. Postoperatively, patients were assessed for symptoms, symptom score, and uroflow rate at 1 and 3 months. There was no difference in resected tissue amount, irrigant amount, fluid absorption, duration and amount of postoperative irrigation, or fall in hemoglobin. The mean resection rate was 0.61 g/min in group 1 and 0.74 g/min in group 2. Serum Na dropped by 4.6 Eq/L in group 2, whereas it fell only 1.2 mEq/L in group 1 (P < 0.001). Improvement in symptom and QoL scores and Q(max) were similar in the two groups. Postoperative dysuria was less common with bipolar resection. Bipolar resection of the prostate is as effective as monopolar TURP. Moreover, it does not lead to any change in serum Na and causes less postoperative dysuria.