Bipolar transurethral resection of the prostate causes deeper coagulation depth and less bleeding than monopolar transurethral prostatectomy

Abstract

Objective: To investigate the hemostatic capability of mono- and bipolar transurethral resection of the prostate by comparing the perioperative blood loss with the coagulation depth achieved with mono- and bipolar transurethral resection of the prostate.

Methods: A total of 136 patients with lower urinary tract symptoms associated with benign prostatic hyperplasia were randomized to undergo transurethral resection of the prostate using either a monopolar system (Karl Storz, Co., Tuttlingen, Germany) or a gyrus PlasmaKinetic bipolar system (Gyrus-ACMI Corporation, Maple Grove, MN). The operative time, resected tissue weight, decline in serum sodium and hemoglobin, postoperative bleeding, and the coagulation depth were compared.

Results: There were no statistically significant differences in operative time, resected tissue weight, and capsular perforation. The decline in hemoglobin and serum sodium was 1.15 ± 0.53 g/dL and 4.57 ± 0.71 mmol/L in monopolar transurethral resection of the prostate group, respectively, whereas they fell only 0.71 ± 0.42 g/dL and 2.02 ± 0.53 mmol/L in the bipolar transurethral resection of the prostate group, respectively (P <.001). The rate of postoperative bleeding was significantly higher in the monopolar transurethral resection of the prostate group (P = .027). The coagulation depths with mono- and bipolar transurethral resection of the prostate were 127.56 ± 27.76 and 148.48 ± 31.64 μm, respectively (P <.001).

Conclusion: Our results demonstrate that bipolar transurethral resection of the prostate causes less intraoperative hemoglobin drop and postoperative bleeding than monopolar transurethral resection of the prostate, which may be associated with the deeper coagulation depth of bipolar transurethral resection of the prostate.