Bipolar versus monopolar transurethral resection of prostate: randomized controlled study.
OBJECTIVE
Transurethral resection of prostate (TURP) using bipolar electrocautery and physiologic saline is a new technical advancement in the field of surgical management of benign prostatic hyperplasia. The purpose of this study was to assess the efficacy and safety of this new technique and to compare the results with those of conventional monopolar TURP.


METHODS
This study included 60 patients who were randomized 1:1 to bipolar (group 1) or monopolar (group 2) TURP. Bipolar TURP was performed with the Vista CTR resectoscope and generator (ACMI Corp.). Preoperatively, patients were assessed by symptom score, uroflow, and transrectal sonography, and the two groups were comparable with regard to these measures and age. The preoperative and postoperative parameters studied included resection time, amount of tissue resected, irrigant amount, blood loss, fluid absorption, and change in serum sodium and hemoglobin. Postoperatively, patients were assessed for symptoms, symptom score, and uroflow rate at 1 and 3 months.


RESULTS
There was no difference in resected tissue amount, irrigant amount, fluid absorption, duration and amount of postoperative irrigation, or fall in hemoglobin. The mean resection rate was 0.61 g/min in group 1 and 0.74 g/min in group 2. Serum Na dropped by 4.6 Eq/L in group 2, whereas it fell only 1.2 mEq/L in group 1 (P < 0.001). Improvement in symptom and QoL scores and Q(max) were similar in the two groups. Postoperative dysuria was less common with bipolar resection.


CONCLUSIONS
Bipolar resection of the prostate is as effective as monopolar TURP. Moreover, it does not lead to any change in serum Na and causes less postoperative dysuria.
Singh
Harbans
H
Department of Urology, Muljibhai Patel Urological Hospital, Nidiad, Gujarat, India 387 001. harbanspruthi@hotmail.com
Desai
Mahesh R
MR
Shrivastav
Prajay
P
Vani
Kishor
K
D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004867:Equipment Design; D004869:Equipment Safety; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010149:Postoperative Pain; D011183:Postoperative Complications; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013523:Surgical Equipment; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome