title: Bipolar transurethral resection versus monopolar transurethral resection for benign prostatic hypertrophy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of monopolar (M-TURP) and bipolar (B-TURP) transurethral resection of the prostate in benign prostatic hypertrophy (BPH) patients.
  
  
  METHODS
  Eligible randomized controlled trials (RCTs) were identified from electronic databases without language restrictions. Database search, quality assessment, and data extraction were independently performed. The primary postoperative outcomes of topical M-TURP and B-TURP were maximum flow rate (Qmax) and/or International Prostate Symptom Score (IPSS). Safety was estimated by TUR syndrome; need for transfusion; clot retention; bladder neck contracture (BNC); urethral stricture (US); and catheter removal time. Efficacy and safety were investigated using the Review Manager.
  
  
  RESULTS
  Thirty-one trials met the inclusion criteria. Pooled analysis revealed significant difference in efficacy between the M-TURP and B-TURP groups. Safety analysis revealed significant improvement in the TUR syndrome with B-TURP than with M-TURP. Pooled analysis revealed that clot retention was significantly higher in M-TURP than in B-TURP. Moreover, pooled analysis revealed no significant difference between both groups in the blood transfusion frequency or late complications (urethral strictures) and bladder neck constriction.
  
  
  CONCLUSIONS
  This systematic review indicates that B-TURP was significantly better in the result of Qmax and for decreasing the incidence of TUR syndrome and clot retention. No significant differences were observed in the nature of adverse events such as transfusions, retention after catheter removal, and urethral complications between both groups. Thus, B-TURP is the next generation "gold standard" for benign prostatic obstruction (BPO) because it is associated with a lower rate of clinically relevant complications such as TUR syndrome and clot retention.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University , Chengdu, P.R. China .
authors.forename: Yin
authors.initials: Y
authors.lastname: Tang
authors.forename: Jinhong
authors.initials: J
authors.lastname: Li
authors.forename: Chuanxiao
authors.initials: C
authors.lastname: Pu
authors.forename: YunJin
authors.initials: Y
authors.lastname: Bai
authors.forename: HaiChao
authors.initials: H
authors.lastname: Yuan
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Ping
authors.initials: P
authors.lastname: Han
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D014525:Urethral Stricture / Q000209:etiology; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology
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