Comparative Study of Monopolar and Bipolar Transurethral Resection in Patients with Benign Prostatic Adenoma

Abstract

A prospective controlled study at Al-Diwaniya Urological center was compared two procedures (M-TURP and B-TURP-PLASMA ADGE). A total of 120 men were included in our study for 2 years. In 60 men with M-TURP, their age ranged from 49-89 years, size of prostate /mL ranged from 35 to 90, IPSS ranged from 8 to 34, and their SPSA ranged from 0.1–3.4 ng/mL. In the other 60 men with B-TURP (plasma edge), their ages ranged from 47 to 89 years, the size of prostate/ml ranged from 36 to 90, IPSS ranged from 9 to 34, and their S.PSA were ranged from 0.1 to 3.8 ng/mL. There was no significant difference in mean age, mean prostate size, mean IPSS, mean serum PSA, mean maximum flow rate (Q max), mean residual volume, mean hemoglobin (Hb), mean serum sodium, mean serum potassium, mean serum chloride and, mean serum creatinine (p > 0.05). There was a significant difference in the mean duration of operation between the monopolar group and plasma edge group (p = 0.019), in such a way that the duration is less in the plasma edge group, 56.75 ± 9.02 minutes versus 53.10 ± 7.73 minutes. The intra-operative level of Hb was significantly higher in a monopolar group than in the plasma edge group, 13.87 ± 1.87 g/dL versus 15.06 ± 1.28 g/dL, respectively (p is less than 0.001). There was no significant difference in intra-operative mean serum sodium, potassium, chloride, and creatinine between both groups (p > 0.05). The mean duration of hospital admission was more in the monopolar group compared with the plasma edge group, 1.57 ± 0.83 days versus 1.03 ± 0.18 days, respectively, in a highly significant manner (p is less than 0.001). Mean Hb level was significantly lower in the monopolar group compared to the plasma edge group, 14.00 ± 1.64 g/dL versus 15.03 ± 1.26 g/dL, respectively (p is less than 0.001). Mean IPSS was significantly lower in the monopolar group compared to the plasma edge group, 26.18 ± 4.12 versus 28.05 ± 4.09, respectively (p = 0.014). Maximum flow rate (Q max) was significantly more in the monopolar group in comparison to the plasma edge group, 16.62 ± 1.89 versus 15.03 ± 2.20, respectively (p is less than 0.001). There was no significant difference in the rate of urethral stricture between the monopolar group and plasma edge group, 1 (1.7%) versus 1 (1.7%), respectively (p = 1.000). In addition, there was no significant difference in the rate of repetition of TURP between the monopolar group and plasma edge group, 1 (1.7%) versus 1 (1.7%), respectively (p = 1.000). Our study showed that there was a shorter duration of the procedure, less bleeding, shorter duration of admission, and improvement in IPSS and Qmax.