A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system

Abstract

Objectives: To compare transurethral resection of prostate (TURP) using monopolar and bipolar transurethral resection in saline (TURIS) system.

Materials and methods: A prospectively randomized study was conducted between January 2004 and January 2005. Patient demographics and indications for surgery were recorded. The safety end points studied were occurrence of complications and decline in postoperative serum sodium (Na(+)) and hemoglobin (Hb) levels. Efficacy end points were resection time, weight of resected prostate tissue, and improvement in International Prostate Symptoms Score (IPSS) and maximum flow rate (Q(max)) in patients' uroflow over 12 mo.

Results: One hundred consecutive patients were randomized and completed the study, with 52 patients in the monopolar TURP group and 48 in the TURIS group. At baseline, the two groups were comparable; they had at least 12 mo of follow-up. Mean resection time and mean weight of resected prostate tissue were comparable for both groups. Declines in the mean postoperative serum Na(+) for TURIS and monopolar TURP groups were 3.2 and 10.7 mmol/l, respectively (p<0.01). However, there was no statistical difference in the decline in postoperative Hb between the two groups. There were two cases of clinically significant transurethral resection syndrome in the monopolar group. Urethral strictures were observed in three cases of TURIS and one patient in the monopolar group. The IPSS and Q(max) improvements were comparable between the two groups at 12 mo of follow-up.

Conclusions: Bipolar TURP using the TURIS system is clinically comparable to monopolar TURP at 1 yr with an improved safety profile.