title: Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36-month outcomes.
abstract: OBJECTIVE
  Monopolar transurethral resection of the prostate (TURP) is the gold standard surgical treatment for bothersome moderate to severe lower urinary tract symptoms (LUTS) secondary to benign prostate obstruction. The aim of the study is to compare monopolar versus bipolar TURP focusing on operative and functional outcomes, and evaluating complications with a long-term follow-up.
  
  
  METHODS
  From January 2007 to July 2014, a total of 497 patients were randomized and prospectively scheduled to undergo bipolar (251) or monopolar (246) TURP. International prostate symptom score (IPSS), IPSS-Quality of life (QoL), post-void residual and maximum flow rate were assessed preoperatively and postoperatively at 3, 12, 24 and 36 months. Operative time, length of catheterization and hospitalization were all recorded. Complications were classified and reported.
  
  
  RESULTS
  All patients completed the 36-month follow-up visit. Perioperative results showed no statistical significance between the two groups in terms of catheterization days, post-void residual, IPSS, IPSS-QoL score. The hospitalization length was found statistically significant in favor of the bipolar group. The 3-, 12-, 24- and 36-month follow-up showed significant and equal improvements in LUTS related to BPO in the two treatment groups. Regarding TURP complications, significant differences were observed in relation to urethral strictures, blood transfusion and TUR syndrome in favor of the bipolar group.
  
  
  CONCLUSIONS
  Monopolar and bipolar TURP are safe and effective techniques for BPH management. Bipolar TURP in our prospective study reported the same efficacy of monopolar prostate resection, with a significant reduction of related complications.
authors.affiliation: Urology Unit, Department of Special Surgery, Mutah University, Karak, Jordan.|Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
authors.forename: Samer Fathi
authors.initials: SF
authors.lastname: Al-Rawashdah
authors.affiliation: Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy. antopast@hotmail.com.|Uroresearch, No Profit Research Association, Latina, Italy. antopast@hotmail.com.
authors.forename: Antonio Luigi
authors.initials: AL
authors.lastname: Pastore
authors.affiliation: Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
authors.forename: Yazan Al
authors.initials: YA
authors.lastname: Salhi
authors.affiliation: Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fuschi
authors.affiliation: Pathology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Petrozza
authors.affiliation: Department of Urology, Sapienza University of Rome, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Maurizi
authors.affiliation: Department of Urology and Andrology, University of Perugia, Perugia, Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Illiano
authors.affiliation: Department of Urology and Andrology, University of Perugia, Perugia, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Costantini
authors.affiliation: Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.|Uroresearch, No Profit Research Association, Latina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palleschi
authors.affiliation: Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.|Uroresearch, No Profit Research Association, Latina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carbone
mesh_terms: D000368:Aged; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis / Q000209:etiology; D008297:Male; D009929:Organ Size; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D011788:Quality of Life; D063189:Symptom Assessment; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D014524:Urethral Obstruction / Q000175:diagnosis / Q000209:etiology
keywords: Benign outlet obstruction; Bipolar; Complications; Monopolar; Transurethral resection of prostate