title: A prospective randomized comparative study of monopolar and bipolar transurethral resection of the prostate and photoselective vaporization of the prostate in patients who present with benign prostatic obstruction: a single center experience.
abstract: OBJECTIVE
  The first prospective randomized study to compare the safety and short-term efficacy of monopolar transurethral resection of the prostate (TURP), bipolar TURP, and photoselective vaporization of the prostate (PVP) using GreenLight high-performance system 120W laser in patients who presented with benign prostatic obstruction (BPO).
  
  
  METHODS
  The 186 consecutive patients who presented with BPO and who were planned for surgery were randomized into three groups: Group A, patients who underwent monopolar TURP; group B, patients who underwent bipolar TURP; and group C, patients who underwent PVP. All three groups were subdivided into two subgroups based on prostate volume: Subgroup 1 >20 cc and <50 cc, and subgroup 2, between 50 and 80 cc. Patients preoperative, perioperative, and follow-up data were recorded and analyzed.
  
  
  RESULTS
  The baseline characteristics of the three groups and subgroups 1 and 2 were comparable. The number of patients in whom postoperative irrigation was instituted, amount of fluid used for postoperative irrigation, duration of postoperative irrigation, postoperative hemoglobin concentration, and duration of catheterization were significantly in favor of group C patients except for the mean operative time, which was significantly longer among them. All three groups demonstrated an increase in International Prostate Symptom Score, quality of life score, and maximum flow rate and decrease in prostate volume and postvoid residual urine at 12-month follow-up. The mean Intgernational Index of Erectile Function-5 score did not show improvement in any group. The need for blood transfusion and clot retention necessitating intervention were significantly lower among group C patients compared with group A, whereas these values for group B patients did not reach significant level compared with either group A or C. These complications were comparable among subgroup 1 patients, whereas subgroup 2 patients had shown results in favor of subgroup C2.
  
  
  CONCLUSIONS
  Monopolar TURP, bipolar TURP, and PVP are equally efficacious at 12-month follow-up. PVP has added advantages of lesser blood loss, lesser need for blood transfusion (especially for prostate volume 50-80 cc), and shorter catheterization time.
authors.affiliation: Department of Urology, VMMC and Safdarjung Hospital , New Delhi, India .
authors.forename: Anup
authors.initials: A
authors.lastname: Kumar
authors.forename: Pawan
authors.initials: P
authors.lastname: Vasudeva
authors.forename: Niraj
authors.initials: N
authors.lastname: Kumar
authors.forename: Biswajit
authors.initials: B
authors.lastname: Nanda
authors.forename: Sanjeev K
authors.initials: SK
authors.lastname: Jha
authors.forename: Nayhan
authors.initials: N
authors.lastname: Mohanty
mesh_terms: D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery*; D011469:Prostatic Diseases / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome