Bipolar versus monopolar transurethral resection of prostate: randomized controlled study

Area of Science:

• Urology
• Surgical Technology
• Medical Devices

Background:

• Benign prostatic hyperplasia (BPH) management often involves transurethral resection of the prostate (TURP).
• Conventional monopolar TURP carries risks, including potential fluid absorption and electrolyte imbalances.
• Bipolar TURP utilizing physiologic saline represents a novel advancement in surgical BPH treatment.

Purpose of the Study:

• To evaluate the efficacy and safety of bipolar TURP.
• To compare bipolar TURP outcomes against conventional monopolar TURP.
• To assess the impact on patient serum sodium levels and postoperative symptoms.

Main Methods:

• A randomized controlled trial involving 60 patients undergoing TURP for BPH.
• Patients were allocated 1:1 to either bipolar TURP (Group 1) or monopolar TURP (Group 2).
• Preoperative and postoperative assessments included symptom scores, uroflowmetry, serum sodium, and hemoglobin levels.

Main Results:

• Both techniques demonstrated comparable efficacy in terms of resected tissue, irrigant volume, and hemoglobin levels.
• Bipolar TURP showed a significantly smaller drop in serum sodium (1.2 mEq/L vs. 4.6 mEq/L).
• Patients undergoing bipolar TURP experienced less postoperative dysuria and similar improvements in symptom scores and uroflow.

Conclusions:

• Bipolar TURP is a safe and effective alternative to monopolar TURP for BPH.
• The bipolar technique mitigates the risk of hyponatremia associated with monopolar TURP.
• Bipolar TURP offers improved patient comfort due to reduced postoperative dysuria.