Monopolar Transurethral Resection Research Articles

Comparing the incidence of Bladder Neck Stenosis post monopolar Transurethral Resection of the Prostate; small prostates versus larger prostates in the black African population

Monopolar Transurethral Resection of the Prostate (TURP) is the commonly done procedure for surgical removal of the prostate after open prostatectomy in our subregion. It is still a novel procedure in our subregion, as very few centers offer this procedure. It is generally believed that the size of the prostate may influence the development of complications of bladder neck stenosis. This is a dreaded complication, which requires further surgical procedure to correct in a resource-poor environment. We decided to compare the incidence of Bladder Neck Stenosis (BNS) in small vs larger prostates following monopolar TURP in our black African subregion. We prospectively studied 194 patients who underwent TURP in our facility from 2015 to 2022 that satisfied the inclusion criteria. Eighty-five participants (43.81%) had a small prostate (Transrectal Ultrasound, TRUS, weight <30 g), and 109 participants (56.19%) had a large prostate (TRUS weight >30 g). Overall, ten participants (5.15%) had postoperative BNS. Participants with smaller prostates had more incidence of bladder neck contracture than those with larger prostates, although this did not reach statistical significance, Fisher’s Exact test p=0.338. Multifactorial reasons and not prostate size alone may be responsible for BNS. There may be a need for larger-scale standardized studies on prostate size effect on BNS.

Intraprostatic Injection of Tranexamic Acid Decrease Blood Loss During Monopolar Transurethral Resection of the Prostate: A Randomized Controlled Clinical Trial

ObjectiveTo assess the role of intraprostatic injection of tranexamic acid (TXA) in reducing blood loss during transurethral resection of the prostate (TURP). MethodsWe conducted a randomized, controlled, double-blind trial involving 60 patients with benign prostatic hyperplasia (BPH) aged 50–85 years, undergoing monopolar TURP. Patients' prostatic weights ranged from 50 to 80 grams. They were divided equally into two groups: Group I received an intraprostatic injection of 1 gram of TXA (Cyklokapron) dissolved in 50 ml of 0.9% saline at multiple sites, while Group II (control) received a 60 ml saline injection. Comprehensive clinical assessments and standard laboratory tests, including screenings for TXA hypersensitivity, were performed for all patients. ResultsGroup I exhibited significantly lower intraoperative blood loss and hemoglobin concentration in irrigation fluid immediately post-surgery and at the 6-hour postoperative mark compared to Group II (P < 0.05). Coagulation parameters—activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen level (FB), and thrombin clotting time (TT)—showed no significant differences between the groups preoperatively or at 6 and 24 hours postoperatively. No thromboembolic events or other complications were reported in either group. ConclusionThe intraprostatic injection of TXA during monopolar TURP is safe, with minimal adverse effects, and effectively reduces blood loss.

Assessing safety and feasibility of monopolar transurethral resection of the prostate without post-operative catheter traction: A randomized controlled trial.

Traction on the per-urethral catheter is commonly employed after monopolar transurethral resection of the prostate (mTURP) to reduce bleeding. However, its efficacy and impact on postoperative pain remain uncertain. Further, there is limited evidence to suggest any benefit regarding post-operative blood loss. In a randomized controlled trial, 62 patients undergoing mTURP were assigned to either a traction (n = 30) or non-traction (n = 32) group. Blood loss, postoperative pain, and analgesic requirements were assessed between January 2022 and April 2023. {(IHEC-PGR/2021/DM/M.Ch/Jan/02), CTRI Registration: CTRI/2022/01/039199.}. No significant differences were observed between the traction and non-traction groups regarding postoperative blood loss (p-value- 0.632), fall in hemoglobin (p-value- 0.719) and hematocrit (p-value- 0.937) levels, and length of postoperative hospital stay (p-value- 0.797). However, the traction group reported significantly higher postoperative pain scores (p-value < 0.001) and increased analgesic requirements (p-value < 0.001). The study suggests that 12-hours catheter traction after mTURP does not reduce blood loss and is associated with increased postoperative pain.

Comparison of Bipolar and Monopolar Transurethral Resection of the Prostate, Functional Outcomes and Analysis of Factors Predictive of Complications: A Prospective Study

Introduction: In Morocco, RTUP-m is considered the gold standard for the surgical treatment of prostate adenomas, recommended for prostates with a volume suitable for resection in less than 60 minutes. Additionally, the challenge arises when dealing with patients on antiplatelet or anticoagulant medications due to the associated risk of bleeding, hence the significance of RTUP-b. The objective of our study is to compare the functional outcomes and immediate postoperative complications between these two techniques and to identify predictive factors for complications. Methods: This is a prospective randomized study conducted between January 2022 and September 2022. The variables age, BMI, surgical indication, transrectal prostate volume, ASA classification (American Society of Anesthesiologists), previous pharmacological treatments, IPSS score, quality of life index (QLI), maximum flow rate (Qmax) and postoperative complications were collected. The Chi2 test and Student's t-test were used for statistical analysis. Results: Sixty-nine consecutive patients were included, 38 patients in the monopolar TURP group and 31 in the bipolar TURP group. Both groups were homogeneous in their baseline characteristics. The overall pre-surgical IPSS/QLI/Qmax score was 24,03/4,73/9,47. Functional results at 1st and 3rd month are shown in Table 1. For complications, see Table 2 and 3. These differences were not statistically significant (p = 0,427): the most frequent were hematuria (9,4%) and febrile urinary tract infections (9,4%). Only one patient presented hyponatremia due to glycocol reabsorption in the monopolar group. All complications were Clavien 1 or 2. We found no significant differences between the two groups with regard to complications or their predictive factors. Conclusion: Analysis of our data over the first three months reveals no differences between the two techniques in terms of functional results and postoperative complications, and there are no predictive .........

Comparison of holmium laser, bipolar and conventional monopolar transurethral resection of bladder tumour in primary non-muscle invasive bladder cancer.

To compare the efficiency and safety profile of conventional monopolar, bipolar plasmakinetic and holmium laser techniques for transurethral resection of bladder tumour. The prospective comparative study was conducted from July 2019 to May 2021 after approval from the ethicsreview committee of Kafrelsheikh University, Egypt, and comprised patients of either gender with primary non muscle invasive bladder cancer who qualified for transurethral resection of bladder tumour. The patients were stratified into low-risk group A, intermediate risk group B and high-risk group C in accordance with the guidelines of the European Association of Urology. Comprehensive cystoscopy and panendoscopy were done in all cases. Once panendoscopy was done, tumour resection was performed with monopolar resectoscope in group A, plasmakinetic resectoscope in group B and holmium laser in group C). Data was collected at preoperative, peroperative, postoperative and follow-up stages. Data was analysed using SPSS 21. Of the 84 patients, 67(79.76%) were males and 17(20.23%) were females. There were 27(32.14%) patients in group A; 21(77.8%) males and 6(22.2%) females withy mean age 60.63±11.76 years. Group B had 32(38%) patients; 26(81.2%) males and 6(18.8%) females with mean age 65.34±7.55 years. Group C had 25(29.76%) patients; 20(80%) males and 5(20%) females with mean age 59.48±12.6 years. The mean follow-up period was 12.97±2.70 months in group A, 12.81±2.75 monthsin group B and 13.48±3.3 monthsin group C. Visualised complete resection was done in 23(85.8%) group A patients, 29(90.6%) group B patients and 24(96%) group C patients(p=0.018). Visualised complete resection, tumour multiplicity, tumour size, catheter duration, and hospital stay were significant predictors (p<0.05). Survival analysis showed 26(96.3%), 30(93.75%) and 25(100%) cases in groups A, B and C, respectively. Bipolar plasmakinetic and holmium laser techniques were found to be more effective and safer than the conventional monopolar technique for transurethral resection of bladder tumour in patients with primary non-muscle invasive bladder cancer.

Incidence and outcome of transurethral resection of prostate syndrome at a tertiary care hospital

Introduction: Monopolar transurethral resection of prostate (M-TURP) is rarely complicated with the dreaded syndrome the TURP syndrome due to absorption of larger amount of non-electrolyte hypo-osmolar irrigation fluid (1.5% glycine), longer duration of surgery and larger amount of tissue resection. This study aims to find out the incidence and perioperative outcome of TURP syndrome after monopolar TURP. Method: This was a cross sectional study of retrospectively collected data during the period of 4 years from June 1st 2018 to 30th May 2022, in Department of Urology of Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal. Ethical approval was obtained from NAMS ethical committee. Microsoft Excel was used for descriptive analysis of the incidence of TURP syndrome, its relation with amount of resected tissue, duration of resection time, and the outcome (need of blood transfusion, length of hospital stay, mortality). Result: Out of 208 cases of monopolar TURP, 8/208(3.8%) had TURP syndrome. Patients with TURP syndrome were age group 70-85 y. Duration of surgery was &gt;60 min was in 5/8(62.5%), resection weight &gt;20 gm 6/8(75%), blood transfusion 1/8(12.5%), and hospital stay &gt;3 days in all 8/8(100%) cases. Mortality was nil in patients with TURP syndrome. Conclusion: The TURP syndrome was observed in 8/208(3.8%) and it was more common in older (&gt;60y) with longer duration (&gt;60 min) of surgery, and larger amount of prostatic tissue (&gt;20gm) resection.

Bipolar vs Monopolar Transurethral Resection of the Prostate in Iraqi Patients: A Prospective Study

Bipolar vs Monopolar Transurethral Resection of the Prostate in Iraqi Patients: A Prospective Study

Evaluation of sexual function following bipolar vaporization versus monopolar transurethral resection of the prostate

Evaluation of sexual function following bipolar vaporization versus monopolar transurethral resection of the prostate

Comparison of Bipolar and Monopolar Transurethral Resection of Bladder Tumours: A Randomised Clinical Study

Introduction: The standard treatment of Urinary Bladder Cancer (UBC) is Transurethral Resection of Bladder Tumours (TURBT) commonly using a monopolar resection system. Bipolar-TURBT (B-TURBT) is associated with better haemostasis than MonopolarTURBT (M-TURBT). Despite this, there exists controversy whether B-TURBT can completely replace M-TURBT. Aim: To assess the perioperative outcomes of B-TURBT and compare it with the conventional monopolar system (M-TURBT). Materials and Methods: The present randomised clinical study was conducted at the Department of Urology of SCB Medical College, Cuttack between January 2018 and January 2020. Fifty patients of either sex, aged &gt;18 years with urinary bladder tumour size of ≤4 cm were included in the study. Patients were randomly assigned into B-TURBT and M-TURBT treatment groups. Demographic data (age and sex), morphology, location, shape, grade, stages of transitional cell carcinoma, degree of artifact were analysed and compared. Data were analysed using Statistical Package for the Social Sciences (SPSS) version 23.0. The qualitative and quantitative variables between the groups were compared using independent sample t-test and chi-square test, respectively. A p-value&lt;0.05 was considered statistically significant. Results: A total of 50 patients with UBC were evaluated in this study where the majority of patients were male 45 (90.0%) with mean age 60.9 years. The most common morphologies were papillary tumour (28.0%), broad solid mass (22.0%), and papillary solitary (22.0%). Total 25 patients underwent M-TURBT and 25 patients underwent B-TURBT. Older patients (&gt;55 years) had a higher rate of severe artifact compared to younger patients (&lt;55 years). The B-TURBT had a significantly lower rate of artifact compared to M-TURBT (p-value &lt;0.001). The need for secondary procedure was comparatively higher in M-TURBT than in bipolar resection (p-value=0.253). The obturator jerk and bladder perforation were not observed in this study. Conclusion: The B-TURBT had a lower incidence of severe artifact and restaged TURBT as compared to M-TURBT. Thus, B-TURBT is a safer and more effective treatment for patients with UBC.

Comparison of Emergency Room Visits and Rehospitalization for Bleeding Complications following Transurethral Procedures for the Treatment of Benign Prostatic Hyperplasia: A Population-Based Retrospective Cohort Study.

Background: The postoperative bleeding complications associated with laser surgery of the prostate and transurethral resection of the prostate (TURP) were compared. Methods: We used the Taiwan National Health Insurance Research Database to conduct an observational population-based cohort study. All eligible patients who received transurethral procedures between January 2015 and September 2018 were enrolled. Patients who received laser surgery or TURP were matched at a ratio of 1:1 by using propensity score matching, and the association of these procedures with bleeding events was evaluated. Results: A total of 3302 patients who underwent elective transurethral procedures were included. The multivariable Cox regression analysis revealed that diode laser enucleation of the prostate (DiLEP) resulted in significantly higher emergency room risks within 90 days after surgery due to clot retention than the Monopolar transurethral resection of the prostate (M-TURP) (Hazard Ratio: 1.52; 95% Confidence Interval [CI], 1.06–2.16, p = 0.022). Moreover, GreenLight photovaporization of the prostate (PVP) (0.61; 95% CI, 0.38–1.00 p = 0.050) and thulium laser vaporesection of the prostate (ThuVARP) (0.67; 95% CI, 0.47–0.95, p = 0.024) resulted in significantly fewer rehospitalization due to clot retention than did M-TURP. No significant increase in blood clots were observed in patients using comedications and those with different demographic characteristics and comorbidities. Conclusions: Among the investigated six transurethral procedures for Benign prostatic hyperplasia, PVP and ThuVARP were safer than M-TURP because bleeding events and clot retention were less likely to occur, even in patients receiving anticoagulant or antiplatelet therapy. However, DiLEP and holmium laser enucleation of the prostate (HoLEP) did not result in fewer bleeding events than M-TURP.

SAFETY AND EFFICACY OF MONOPOLAR TRANSURETHRAL RESECTION OF PROSTATE IN LABORATORY PARAMETERS

Objective: This study aims to assess the safety and effectiveness of transurethral resection of prostate using preoperative and postoperative laboratory parameters. Material &amp; Methods: This was a retrospective study of all patients treated with transurethral resection of prostate at Karawang Hospital from January – August 2018. The laboratory parameters are measured in the preoperative and postoperative period, including haemoglobin, leucocyte, and electrolyte. The outcomes of the study were the comparison of laboratory parameters before and after monopolar transurethral resection of prostate. Results: A total of 142 patients were enrolled in this retrospective study. The mean age was 68 years. Transurethral resection of prostate was performed in all patients. The mean of preoperative level of haemoglobin was higher compared to postoperative level (13.21 gr/dL vs 12.79 gr/dL; p = 0.000). The mean preoperative level of leucocyte was higher during postoperative time compared to preoperative time (13.450 vs 7503.52 p = 0.000). The sodium level was lower postoperative than preoperative ( 137.76 vs 139.39; p = 0.000 ). The potassium level was higher preoperative than in postoperative (4.12 vs 4.02, p = 0.000 ). The logistic regression was performed and shows no significant association between prostate resected weight and length of surgery compared to laboratory parameters. There was no patient who needed blood transfusion or having electrolyte derangement. Conclusion: Based on laboratory parameters, monopolar transurethral resection of prostate is safe and effective in the treatment of benign prostate hyperplasia.

A systematic review of recorded technical settings used in bipolar and monopolar transurethral resection of bladder tumors

Abstract High-frequency (HF) surgery has been established in medicine for decades and is very popular in transurethral (minimally invasive) surgery. However, the technical settings of generators are almost exclusively based on empirical data. So far, making a well-founded statement about a possible impact of technical parameters in HF surgery is nearly impossible. Therefore, the aim of this research was to systematically review the published data for transurethral resection of bladder tumor (TURBT) to find out, whether the publications consider both sufficiently, technical parameters and physical parameters. It is shown that although technical parameters are reported, they have been insufficiently considered in analyses so far. Further analyses must be performed.

Cluster Analysis Assessment in Proposing a Surgical Technique for Benign Prostatic Enlargement.

Benign prostatic enlargement (BPE) is a common disease in men over 50 years old. The phenotype of patients with BPE is heterogenous, regarding both baseline patient characteristics and disease-related parameters. Treatment can be either medical-conservative or surgical. A great variety of surgical techniques are available for surgical management, with three of the most common being monopolar transurethral resection of the prostate (mTUR-P), bipolar transurethral resection of the prostate (bTUR-P), and bipolar transurethral vaporization of the prostate (bTUVis). The selection of each one of these depends on surgeon reasoning, equipment availability, patient characteristics, and preferences. Since all of these techniques are available in our Urology Department, and surgeons are skilled to perform each one of them, we performed a clustering analysis according to patient pre-operative characteristics, using the k-means algorithm, to compare clustering-related technique assignment with the real-life technique used.

Assessing the Complications of Monopolar Transurethral Resection of the Prostate (M-TURP) Using Clavien-Dindo Complications Grading System.

Benign prostatic hyperplasia (BPH) is one of the most common diseases of ageing men, which increase starting from age 40. Monopolar transurethral resection of the prostate (M-TURP) is the gold standard surgical treatment for BPH between 30 to 80cc. This study is designed to assess complications of TURP based on the Clavien-Dindo post-op complication grading system. A descriptive prospective study of prevalence of complications of M-TURP from May1, 2019 to April 30, 2021 in Tikur Anbessa Specialized Hospital. In this study, 174 patients were assessed pre-operatively, intra-operatively and post-operatively. All BPH patients with bothersome LUTS, bladder stone, recurrent UTI, recurrent acute urinary retention (AUR), renal insufficiency, or failed medical therapy had undergone TURP. We collected it by revising patient's icare/charts and cell phone call. About 174 patients were studied with mean age were 63 years. Intra op complications were noticed in seventeen (9.8%) patients, the most common one was prostate capsule perforation seen in 9 (5.2%) cases followed by severe bleeding in 3(1.7%) patients which needs transfusion and urethral injury. Urinary tract infections developed in eleven (7.8%) of patients. Bulbar urethral stricture and bladder neck contracture developed in 9 (5.2%) and 3 (1.7%) patients each, respectively. Re TURP was done for 7 (4%) of patients. In this study, the overall complication rate of TURP with Clavien-Dindo grading system was 29.3%. Around 96% of the complications were Clavien-Dindo grade I, II and III; managed conservatively or with minimally invasive surgery. This shows M-TURP is a relatively safe procedure.

Transurethral Resection of Prostate Without Traction: A Retrospective Observational Study

Introduction: Application of traction after monopolar transurethral resection of prostate (TURP) is a common practice that causes significant discomfort to the patients. So can we avoid the morbidity of traction in a selected group of the patient where there is no significant hematuria after TURP? Hence we did a retrospective observational study to look for feasibility and safety of traction less TURP.&#x0D; Methods: It is a retrospective observational study conducted in the Department of Urology, Manipal Teaching Hospital from August 2018 to August 2020 in patients who underwent traction less TURP. There was a total of 64 patients who fulfilled the inclusion criteria. All the demographic profiles, preoperative investigations, and perioperative parameters were noted. Postoperatively requirement of reapplication of traction, bladder washes, and application of tranexamic acid for hematuria, clot retention, and blood transfusion were noted. Statistical analysis was done by SPSS version 25.&#x0D; Result: Mean age and prostate size were 71 yrs. and 52 g. Sixteen(25%) patients were on antiplatelet therapy, fourteen(21%) patients had a catheter in situ and 34(53%) patients were on anti-BPH (Benign Prostatic Hyperplasia) medication. There were no patients who require re- traction, bladder washes, or application of intravenous tranexamic acid. There was one (1.56%) patient who had clot retention requiring evacuation and blood transfusion. VAS score after 8 hrs. and 12hrs. was 3.22 and 1.73. Mean hemoglobin fall was 0.81 g%.&#x0D; Conclusion: Traction after monopolar TURP can be safely omitted in carefully operated patients but traction should be reserved for those patients with continuous hematuria.&#x0D;

Can tranexamic acid in irrigation fluid reduce blood loss during monopolar transurethral resection of the prostate? A randomised controlled trial

ABSTRACT Objective To assess the efficacity and safety of using tranexamic acid (TXA) in the irrigation solution during transurethral resection of the prostate (TURP). Patients and Methods A total of 50 patients undergoing TURP for benign prostatic hyperplasia were prospectively randomised in a controlled clinical trial and distributed into two groups. Group A received 0.1% TXA 1000 mg (10 mL) in 1 L of irrigation solution of sterile wash (glycine) during surgery, while Group B received 10 mL distilled water (placebo) in 1 L of irrigation solution of sterile wash (glycine) during surgery. At the end of surgery, a three-way catheter was inserted in the bladder. Group A received local 500 mg of TXA (5 mL), which was dissolved in 100 mL of normal saline solution, while Group B received distilled water (5 mL) dissolved in 100 mL of normal saline solution after which the catheter was clamped. The serum haemoglobin (Hb) concentration, haematocrit (HCT), blood loss volume, Hb concentration in the irrigation fluid, and bladder irrigation volumes were compared between the two groups at three time-points: preoperatively and at 4- and 24-h postoperatively. Coagulation function, complications, thromboembolic events, quality of endoscopic view, surgery duration, and hospital stay were also noted. Results Group A had significantly lower blood loss intraoperatively, and at 4- and 24-h postoperatively compared to the control group (P < 0.05). The serum Hb concentration, HCT, Hb concentration in the irrigation fluid, and bladder irrigation volumes were significantly lower in the TXA group vs the control group (P < 0.001). The shortening of the surgery duration and improvement in the quality of the endoscopic view were significantly noted in the TXA group (P = 0.001). However, no thromboembolic events occurred in either group. Conclusion The use of TXA in the irrigation fluid during TURP and injection into the bladder postoperatively can reduce blood loss and the need for blood transfusion without increasing the risk of thrombosis.

Is bipolar superior to monopolar energy for transurethral resection of bladder tumors?

ObjectivesTo compare bipolar transurethral resection of bladder tumor (B-TURBT) and monopolar transurethral resection of bladder tumor (M-TURBT) in terms of its perioperative clinical and pathological outcomes.BackgroundBladder cancer is the seventh most diagnosed cancer in the male population worldwide. TURBT is considered the initial treatment and the only method to provide specimens for tumor staging and grading.Patients and methodsThis study was conducted at the Urology Department at Menoufia University Hospital during the period of study from April 2018 and April 2020. After consent, newly diagnosed bladder tumor patients who were planned for TURBT at Menoufia University were randomized into two equal groups: B-TURBT and M-TURBT. All patients were evaluated through careful history, physical examination, routine laboratory investigations, ultrasonography, and contrast-enhanced computed tomography. All specimens were examined by a uropathologist who was blinded to the type of energy used.ResultsThere were no statistically significant differences between both groups regarding patients' characteristics, obturator jerk, bladder perforation, completed resection of the tumor, and serum sodium drop. Bipolar resection group showed significantly shorter resection time (P = 0.009), less hemoglobin drop (P = 0.001), less catheterization time (P = 0.044), and less hospitalization time (P = 0.012). Grade 3 tissue artifact on histopathological examination was 16.6 and 23.5% in bipolar and monopolar groups, respectively, with no statistically significant difference.ConclusionBipolar energy in TURBT is a safe and effective modality as the monopolar one. Bipolar resection is superior to the monopolar one in shortening the resection time, hospital stay and catheterization time and less hemoglobin drop. Both techniques have comparable effects on tissue biopsy, other operative data, and perioperative complications.

Monopolar Transurethral Resection of the Prostate Versus Holmium Laser Enucleation in Men with Prostate Volume Greater than 100 mL

Purpose: The surgical treatment for severe benign prostatic hyperplasia is challenging. The aim of our study was to compare the safety and efficacy of monopolar transurethral resection of the prostate (M-TURP) and holmium laser enucleation of the prostate (HOLEP) for prostate size &gt;100 ml. Materials and Methods: We retrospectively evaluated our database of two groups of patients. Thirteen patients underwent M-TURP (group 1), and 27 underwent HOLEP (group 2). Results: The mean prostate size was 163.1 ± 49.0 ml in group 1 and 143.4 ± 40.9 ml in group 2 (P = 0.19). There was no significant difference in resected tissue volume, days of catheter removal, admission days, and postoperative serum hemoglobin between treatment groups. However, in group 1, mean postoperative serum sodium dropped from 137.1 mmol/L to 131.4 mmol/L, which was significantly lower than postoperative serum sodium in group 2 (P &lt; 0.0001). There were more complications in group 1 than group 2, especially for patients undergoing transfusion (76.9% in group 1 and 22.2% in group 2) and with hyponatremia (15.4% in group 1 and 0% in group 2). At 3-month follow-up, the international prostate symptom score, quality of life score, and residual urine volume revealed no significant differences between groups. Conclusion: M-TURP and HOLEP in men with prostate volume greater 100 ml had similar operative time, admission days and postoperative functional outcomes. However, higher transfusion rates and postoperative hyponatremia were noted in the M-TURP group comparing to the HOLEP group.

Bipolar versus Monopolar Transurethral Resection of Prostate in Treatment of Benign Prostatic Enlargement

Introduction: Bipolar transurethral resection (B-TURP) is an effective modality for surgery of Benign Prostatic Obstruction, and has been widely studied for its efficacy and safety against the well-established method; Monopolar Transurethral resection (M-TURP). Objectives: The study aimed to assess the feasibility of B-TURP over M-TURP in terms of hospital stay, resection time, resected tissue volume, changes in hemoglobin and sodium, blood transfusion required, complications like TUR syndrome, clot retention and hemorrhagic episodes. Methodology: An analytical study was done in cases who underwent TURP from August 2018 to August 2020. Parameters like hospital stay, resection time, resected tissue volume, changes in hemoglobin and sodium, blood transfusion required, complications like TUR syndrome, clot retention and hemorrhagic episodes were compared in between B-TURP and M-TURP. Statistical analysis was done using SPSS 22.0 software. Results: Seventy-three patients were compared in this study; 33 had undergone B-TURP and 40 patients had undergone M-TURP. Total hospital stay was slightly lesser in B-TURP. The post-operative Hb in M-TURP was significantly lesser than B-TURP (11.10±1.321 vs 12.24±1.225, P&lt;0.001). Although the drop in hemoglobin was statistically significant in both the groups, the hemoglobin drop was slightly lesser in B-TURP. The mean difference in pre and post-operative hemoglobin was 1.148 in M-TURP and 0.181 in B-TURP. TUR syndrome was significantly higher in M-TURP (6,8.2% vs 0, 0%; P=0.029). There was no significant difference in between resection time, post-operative sodium, post-operative hemorrhagic episodes, clot retention and blood transfusions. Conclusion: Bipolar TURP is safe and effective for transurethral resection of prostate with relative shorter hospital stay, lesser bleeding and TUR syndrome in comparison to Monopolar TURP.

Comparative Analysis of the Effectiveness of Modern Endoscopic Methods of Treatment of BPH

Lower urinary tract symptoms caused by benign prostatic hyperplasia are the most common urological problem among men, affecting about a third of men over the age of 50 Of all surgical treatments, monopolar transurethral resection of the prostate (TURP), in which enlarged prostate tissue is resected piece by piece using a monopolar electrode, has been the standard method since the 1970s. It can significantly improve maximum flow rate (Qmax), urination-related symptoms (based on the International Prostate Symptom Assessment Scale (IPSS)), and health-related quality of life with long-term efficacy compared to medications or other minimally invasive treatments [4]. Since the 2000s, new energy systems for surgery for benign prostatic hyperplasia have rapidly become popular, including systems using bipolar energy and various laser systems such as holmium laser, potassium titanyl phosphate (KTP) laser, thulium laser and diode laser Over the past 10 years, the trend in the surgical treatment of benign prostatic hyperplasia has shifted from monopolar TURP to laser therapy and bipolar TURP. Based on the data on the effectiveness of the HoLEP technique, it becomes clear that HoLEP is ready to replace all these methods as a new standard, based on almost two decades of data that consistently demonstrate its better results and lower complication rate. This review summarizes the available literature by comparing HoLEP and traditional BPH treatments that are widely used and have long-term efficacy data. Despite the fact that there is such a wide arsenal of surgical treatment of BPH, each of these methods has its own advantages and disadvantages. This review article contains a significant portion of the best randomized data directly comparing HoLEP with alternative surgical treatments.