Safety and efficacy of bipolar TURP in management of benign prostatic hyperplasia

Abstract

Objectives The aim of this study was to evaluate the safety and clinical efficacy of bipolar transurethral resection of the prostate (TURP) in the treatment of symptomatic benign prostatic hyperplasia as compared with standard monopolar TURP. Background Monopolar TURP, which was considered the gold standard surgical therapy for men with lower urinary tract symptoms due to benign prostatic hyperplasia, was recently challenged by bipolar TURP, which uses bipolar energy for transurethral prostate resection in saline media, thus avoiding the need for glycine irrigation and its associated complications. Materials and methods From October 2011 to October 2013, 70 consecutive patients with symptomatic benign prostate hyperplasia were randomized into a prospective study comparing the two modalities. Resection time, resected volume, resection speed, and ratio were analyzed in both groups. Blood loss and volume of decline of hemoglobin and sodium values were determined. Postoperative catheter time and hospital stay were also recorded. Intraoperative and postoperative complications and the need for blood transfusion were noted. The improvements in International prostate symptoms score, Qmax , and postvoid residual urine after 1 and 3 months were also recorded for all patients. Results Comparative data on International prostate symptoms score, maximum flow rate (Qmax ), and postvoid residual urine volume showed a significant improvement with respect to baseline values in both groups, but the differences between the two groups were insignificant except for Qmax at 3 months' follow-up. Resection speed and ratio, intraoperative blood loss, serum sodium loss, postoperative catheterization time, hospital stay, and complication rate were significantly better in the bipolar group. Conclusion Bipolar TURP is safer than monopolar TURP because of lower risk for TUR syndrome, less intraoperative bleeding, and lower incidence of postoperative complications.