The Clinical Effect of Bipolar and Monopolar Transurethral Resection of the Prostate More Than 60 Milliliters

Abstract

Objective: To compare the effect, safety, and complication rates of monopolar vs bipolar transurethral prostate resection (TURP) in patients with prostate gland larger than 60 mL.

Patients and methods: Patients with prostate gland larger than 60 mL who were scheduled for surgery because of benign prostatic hyperplasia were randomized into bipolar or monopolar TURP arms via software program with a 1:1 ratio. Preoperatively and postoperative sixth hour and first day, hemoglobin and serum sodium levels were measured. International Prostate Symptom Score (IPSS), IPSS-quality of life (IPSS-QoL), and International Index of Erectile Function scores were determined, and maximal flow rate and residual urine volume were calculated in the preoperative period and postoperative sixth month. Postoperative clot formation, blood transfusion rates, and other complications were recorded on a database.

Results: Of 81 patients included in the study, 45 (55.5%) underwent monopolar and 36 (44.5%) underwent bipolar TURP (M-TURP and B-TURP groups, respectively). The only statistically significant change between the preoperative and the postoperative variables was detected in sodium levels, which were -5.0 mmol/L and -1.2 mmol/L in the M-TURP and B-TURP groups, respectively (P = .001). Although 2 of the patients in the M-TURP group experienced transurethral resection syndrome, none of the patients in the B-TURP group experienced this complication (P = .584).

Conclusion: Bipolar and monopolar TURP showed similar effect and safety in patients with prostate glands larger than 60 mL. The only significant difference between the 2 groups was the greater decrease in serum sodium levels in the M-TURP group.