Comparison between Monopolar and Bipolar TURP in Treating Benign Prostatic Hyperplasia: 1-Year Report

Abstract

Purpose. The major complication of traditional monopolar TURP is water intoxication due to absorption of distilled water during extended resection. A newly developed bipolar electrocautery device which uses saline irrigation decreases the risk of TUR syndrome. The aim of this study was to evaluate the efficacy and safety of this bipolar system. Methods. From April to October 2003, a total of 40 patients aged 58 to 86 years (mean: 69.3 yr) were randomized into two comparable groups; one underwent bipolar TURP and the other received monopolar TURP. Pre-operative and post-operative serum sodium concentration, hemoglobin level, resection time, blood loss and weight of specimen were evaluated. Qmax, I-PSS and bladder neck contracture were reassessed at 6-month and 1-year follow-ups. Results. There were no significant differences in hemoglobin level, blood loss, resection time or weight of specimen between the two groups. However, the difference in serum sodium level after operation was significantly greater in the monopolar group (p＜0.001). Conclusions. The bipolar electrocautery device is safer than the traditional monopolar device for the TURP procedure; the bipolar device decreases the risk of TUR syndrome and produces results similar to those obtained with the monopolar device at 6-month and 1 year follow-ups.