Effects of bipolar and monopolar transurethral resection of the prostate on urinary and erectile function: a prospective randomized comparative study.
OBJECTIVE
To evaluate the outcomes of bipolar vs conventional monopolar transurethral resection of the prostate (TURP) on urinary and erectile function.


METHODS
A total of 286 patients with benign prostatic hyperplasia (BPH) were randomized to bipolar or monopolar conventional TURP treatment groups. Operative and early postoperative variables and complications were recorded and all patients were re-evaluated at 1, 3, 6 and 12 months after surgery using the International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual urine volume (PVR) and the erectile function domain of the International Index of Erectile Function (IIEF-ED). A comparative evaluation of erectile function was performed on 188 preoperatively non-catheterized patients with regular sexual partners.


RESULTS
The operating time was shorter in the bipolar TURP group. Postoperative bleeding and blood transfusion requirements did not significantly differ between the two groups. Sodium levels were significantly lower in the monopolar group than in the bipolar group. Transuretheral resection syndrome developed in two (1.4%) patients in the monopolar group. Both groups had similar and significantly improved IPSS values, maximum urinary flow rate values and PVR measurement. ED worsened in 32 (17.0%) patients, improved in 53 (28.2%) patients, and was unchanged in 103 (54.8%) patients. Changes in the IIEF scores during the follow-up period were similar between the bipolar and monopolar groups.


CONCLUSIONS
Bipolar TURP is a safe and effective procedure that is associated with a significantly shorter operating time, a smaller reduction in serum sodium levels and a similar efficacy compared with conventional monopolar TURP.
Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey. takman36@gmail.com
Tolga
T
Akman
Murat
M
Binbay
Erdem
E
Tekinarslan
Abdulkadir
A
Tepeler
Muzaffer
M
Akcay
Faruk
F
Ozgor
Mesut
M
Ugurlu
Ahmet
A
Muslumanoglu
D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D007172:Erectile Dysfunction / Q000517:prevention & control*; D006801:Humans; D008297:Male; D061646:Operative Time; D011182:Postoperative Care; D019106:Postoperative Hemorrhage / Q000209:etiology; D011300:Preoperative Care; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D020728:Transurethral Resection of Prostate / Q000379:methods*; D001748:Urinary Bladder Neck Obstruction / Q000503:physiopathology / Q000601:surgery; D016055:Urinary Retention / Q000517:prevention & control*; D014563:Urodynamics / Q000502:physiology