PURPOSE: To compare monopolar versus bipolar transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH) focussing on functional outcome, and rates of bleeding complications and TURP syndrome.
MATERIAL AND METHODS: One-hundred and thirty-seven BPH patients (mean age 67 yrs, range 47-91 yrs) were prospectively randomly assigned to undergo monopolar TURP (M-TURP) (n=67) or bipolar TURP (B-TURP) (n=70). Patient characteristics of the 2 groups were similar. Haemoglobin (as a marker of blood loss) was measured pre- and perioperatively; the international prostate symptom score (IPSS), IPSS-quality of life (IPSS-QoL) score, maximal flow rate, and postvoid residual urine volume were assessed preoperatively, and 3 and 12 months postoperatively. Duration of surgery, indwelling catheter and hospitalisation were also documented, as were postoperative clot retention requiring removal by catheterization or surgery, and rates of bladder neck and/or urethral strictures.
RESULTS: No significant perioperative differences were found in duration of surgery, catheterisation or hospitalisation, or in blood loss or blood transfusion and TURP-syndrome rates. Postoperatively there were no significant differences in IPSS or IPSS-QoL scores, or rates of rehospitalisation, clot retention, blood transfusions, reoperation or urethral strictures. Bladder neck strictures, however, occurred significantly more often in the bipolar group (8.5% vs 0%; p=0.02). Three and 12-month follow-ups showed significant and equal improvement in micturition in the 2 groups.
CONCLUSIONS: Both B- and M-TURP are effective and safe techniques for surgical treatment of BPH. The only significant difference between them was a significantly higher rate of bladder neck strictures with B-TURP.
Written by:
Stucki P, Marini L, Mattei A, Xafis K, Boldini M, Danuser H. Are you the author?
Klinik für Urologie, Luzerner Kantonsspital, Luzern, Switzerland.
Reference: J Urol. 2014 Nov 20. pii: S0022-5347(14)04936-2.
doi: 10.1016/j.juro.2014.08.137
PubMed Abstract
PMID: 25464004