Bipolar energy in the treatment of benign prostatic hyperplasia: a current systematic review of the literature.
BACKGROUND
For decades, the monopolar transurethral resection of the prostate has been established as the minimally invasive surgical treatment for patients with benign prostatic hyperplasia (BPH). In recent years, new technologies and devices emerged to reduce the morbidity and improve outcomes for this treatment approach. Bipolar energy introduced the use of saline irrigation and laser technology increased the urological armamentarium to treat BPH. We performed a systematic review of the literature regarding bipolar technology for the treatment of BPH.


METHODS
A MEDLINE database search using the PRISMA methodology. Selected literature was restricted to articles published in English and published between 2005 and 2015. Articles regarding techniques using bipolar energy were included, while manuscripts that used a different technique, hybrid techniques, or techniques other than bipolar resection, bipolar vaporization, and bipolar enucleation were excluded.


RESULTS
The use of bipolar energy in the endoscopic treatment of BPH presented a significant reduction in operative time, perioperative complications, shorter catheterization time, reduced number of blood products transfused, and shorter hospital stay compared to standard techniques. Postoperative outcomes showed that bipolar energy was safe and offered significant outcome improvement when compared to traditional monopolar transurethral resection of the prostate (TURP).


CONCLUSIONS
The use of bipolar energy in the surgical treatment of patients with BPH is safe and is associated with improvements in perioperative outcomes. Short and mid-term functional outcomes are comparable to standard techniques, but long term functional outcomes need better clinical evaluation.
Division of Urology, Denver Health Medical Center, Denver, Colorado, USA.
Rodrigo Donalisio
RD
da Silva
Luke
L
Bidikov
Walker
W
Michaels
Diedra
D
Gustafson
Wilson R
WR
Molina
Fernando J
FJ
Kim
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D012965:Sodium Chloride / Q000627:therapeutic use*; D020728:Transurethral Resection of Prostate / Q000379:methods; D016896:Treatment Outcome; D014835:Volatilization
D012965:Sodium Chloride