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Meta-Analysis
. 2019 Dec 3;12(12):CD009629.
doi: 10.1002/14651858.CD009629.pub4.

Bipolar versus monopolar transurethral resection of the prostate for lower urinary tract symptoms secondary to benign prostatic obstruction

Cameron Edwin Alexander  1 , Malo Mf Scullion  1 , Muhammad Imran Omar  1   2 , Yuhong Yuan  3 , Charalampos Mamoulakis  4 , James Mo N'Dow  5 , Changhao Chen  6 , Thomas Bl Lam  1
Affiliations
Meta-Analysis

Bipolar versus monopolar transurethral resection of the prostate for lower urinary tract symptoms secondary to benign prostatic obstruction

Cameron Edwin Alexander et al. Cochrane Database Syst Rev. .

Abstract

Background: Transurethral resection of the prostate (TURP) is a well-established surgical method for treatment of men with lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO). This has traditionally been provided as monopolar TURP (MTURP), but morbidity associated with MTURP has led to the introduction of other surgical techniques. In bipolar TURP (BTURP), energy is confined between electrodes at the site of the resectoscope, allowing the use of physiological irrigation medium. There remains uncertainty regarding differences between these surgical methods in terms of patient outcomes.

Objectives: To compare the effects of bipolar and monopolar TURP.

Search methods: A comprehensive systematic electronic literature search was carried out up to 19 March 2019 via CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, PubMed, and WHO ICTRP. Handsearching of abstract proceedings of major urological conferences and of reference lists of included trials, systematic reviews, and health technology assessment reports was undertaken to identify other potentially eligible studies. No language restrictions were applied.

Selection criteria: Randomised controlled trials (RCTs) that compared monopolar and bipolar TURP in men (> 18 years) for management of LUTS secondary to BPO.

Data collection and analysis: Two independent review authors screened the literature, extracted data, and assessed eligible RCTs for risk of bias. Statistical analyses were undertaken according to the statistical guidelines presented in the Cochrane Handbook for Systematic Reviews of Interventions. The quality of evidence (QoE) was rated according to the GRADE approach.

Main results: A total of 59 RCTs with 8924 participants were included. The mean age of included participants ranged from 59.0 to 74.1 years. Mean prostate volume ranged from 39 mL to 82.6 mL. Primary outcomes BTURP probably results in little to no difference in urological symptoms, as measured by the International Prostate Symptom Score (IPSS) at 12 months on a scale of 0 to 35, with higher scores reflecting worse symptoms (mean difference (MD) -0.24, 95% confidence interval (CI) -0.39 to -0.09; participants = 2531; RCTs = 16; I² = 0%; moderate certainty of evidence (CoE), downgraded for study limitations), compared to MTURP. BTURP probably results in little to no difference in bother, as measured by health-related quality of life (HRQoL) score at 12 months on a scale of 0 to 6, with higher scores reflecting greater bother (MD -0.12, 95% CI -0.25 to 0.02; participants = 2004; RCTs = 11; I² = 53%; moderate CoE, downgraded for study limitations), compared to MTURP. BTURP probably reduces transurethral resection (TUR) syndrome events slightly (risk ratio (RR) 0.17, 95% CI 0.09 to 0.30; participants = 6745; RCTs = 44; I² = 0%; moderate CoE, downgraded for study limitations), compared to MTURP. This corresponds to 20 fewer TUR syndrome events per 1000 participants (95% CI 22 fewer to 17 fewer). Secondary outcomes BTURP may carry a similar risk of urinary incontinence at 12 months (RR 0.20, 95% CI 0.01 to 4.06; participants = 751; RCTs = 4; I² = 0%; low CoE, downgraded for study limitations and imprecision), compared to MTURP. This corresponds to four fewer events of urinary incontinence per 1000 participants (95% CI five fewer to 16 more). BTURP probably slightly reduces blood transfusions (RR 0.42, 95% CI 0.30 to 0.59; participants = 5727; RCTs = 38; I² = 0%; moderate CoE, downgraded for study limitations), compared to MTURP. This corresponds to 28 fewer events of blood transfusion per 1000 participants (95% CI 34 fewer to 20 fewer). BTURP may result in similar rates of re-TURP (RR 1.02, 95% CI 0.44 to 2.40; participants = 652; RCTs = 6; I² = 0%; low CoE, downgraded for study limitations and imprecision). This corresponds to one more re-TURP per 1000 participants (95% CI 19 fewer to 48 more). Erectile function as measured by the International Index of Erectile Function score (IIEF-5) at 12 months on a scale from 5 to 25, with higher scores reflecting better erectile function, appears to be similar (MD 0.88, 95% CI -0.56 to 2.32; RCTs = 3; I² = 68%; moderate CoE, downgraded for study limitations) for the two approaches.

Authors' conclusions: BTURP and MTURP probably improve urological symptoms, both to a similar degree. BTURP probably reduces both TUR syndrome and postoperative blood transfusion slightly compared to MTURP. The impact of both procedures on erectile function is probably similar. The moderate certainty of evidence available for the primary outcomes of this review suggests that there is no need for further RCTs comparing BTURP and MTURP.

PubMed Disclaimer

Conflict of interest statement

Cameron Edwin Alexander: none known.

Malo MF Scullion: none known.

Muhammad Imran Omar: none known.

Yuhong Yuan: none known.

Charalampos Mamoulakis: none known.

James MO N'Dow: none known.

Changhao Chen: none known.

Thomas BL Lam: none known.

Figures

1
1
Flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Funnel plot of comparison: 1 BTURP versus MTURP, outcome: 1.1 Urological symptoms (IPSS at 12 months).
5
5
Funnel plot of comparison: 1 B‐TURP versus M‐TURP, outcome: 1.2 Bother (HRQoL at 12 months).
6
6
Funnel plot of comparison: 1 B‐TURP versus M‐TURP, outcome: 1.3 TUR syndrome.
7
7
Funnel plot of comparison: 1 BTURP versus MTURP, outcome: 1.5 Blood transfusion.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009629.pub3

References

References to studies included in this review

Abascal Junquera 2006 {published data only}
    1. Abascal Junquera JM, Cecchini Rosell L, Salvador Lacambra C, Martos Calvo R, Celma Domenech A, Morote Robles J. Bipolar versus monopolar transurethral resection of the prostate: perioperative analysis of the results. Actas Urologicas Españolas 2006;30(7):661‐6. [PUBMED: 17058610] - PubMed
Acuña Lopez 2010 {published data only}
    1. Acuña‐López JA, Hernández‐Torres AU, Gómez‐Guerra LS, Martínez‐Montelongo R, Lozano‐Salinas JF. Bipolar versus monopolar transurethral resection of the prostate: intraoperative and postoperative result analysis. Revista Mexicana de Urología 2010;70(3):146‐51. [http://revistamexicanadeurologia.com/Revistas/2010/English/May‐Jun/Bipol...
Ahmad 2016 {published data only}
    1. Ahmad M, Khan H, Aminullah, Masood I, Masood W, Malik A. Comparison of bipolar and monopolar cautery use in TURP for treatment of enlarged prostate. Journal of Ayub Medical College Abbottabad 2016;28(4):758‐61. - PubMed
Akçayöz 2006 {published data only}
    1. Akçayöz M, Kaygisiz O, Akdemir O, Aki FT, Adsan O, Cetinkaya M. Comparison of transurethral resection and plasmakinetic transurethral resection applications with regard to fluid absorption amounts in benign prostate hyperplasia. Urologia Internationalis 2006;77(2):143‐7. [PUBMED: 16888420] - PubMed
Akman 2013 {published data only}
    1. Akman T, Binbay M, Tekinarslan E, Tepeler A, Akcay M, Ozgor F, Ugurlu M, Muslumanoglu A. Effects of bipolar and monopolar transurethral resection of the prostate on urinary and erectile function: a prospective randomized comparative study. British Journal of Urology International 2013;111(1):129‐36. [PUBMED: 22672229] - PubMed
    1. Akman T, Binbay M, Tekinarslan E, Tepeler A, Akçay M, Özgör F, et al. Effects of bipolar and monopolar transurethral resection of the prostate on urinary and erectile functions: a prospective randomized comparative study. Journal of Endourology 2012;26(Suppl 1):A269‐270. - PubMed
Al‐Rawashdah 2017 {published data only}
    1. Al‐Rawashdah SF, Pastore AL, Salhi YA, Fuschi A, Petrozza V, Maurizi A, et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of the prostate in benign prostatic obstruction: 36‐month outcomes. World Journal of Urology 2017;35(10):1595‐601. - PubMed
    1. Palleschi G, Pastore AL, Al Salhi Y, Fuschi A, Velotti G, Leto A, et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate on a large cohort of patients with benign prostatic obstruction: long term outcomes. Journal of Urology. Conference: 112th Annual Meeting of American Urological Association, AUA 2017. United States. 197 (4 Suppl 1) (pp e448), 2017. [Conference Abstract] April 2017;197:e448.
    1. Pastore AL, Palleschi G, Al Rawashdah S, Fuschi A, Velotti G, Leto A, et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate on a large cohort of patients with benign prostatic obstruction: long term outcomes. European Urology, Supplements. Conference: 32nd Annual European Association of Urology Congress, EAU 2017. United Kingdom. 16 (3) (pp e517‐e518), 2017. [Conference Abstract] March 2017;16(3):e517‐e518.
    1. Pastore AL, Palleschi G, Illiano E, Constantini E, Al Rawshdah S, Al Salji Y, et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: long term outcomes. Neurourology and Urodynamics. Conference: 47th Annual Meeting of the International Conference Society, ICS 2017. Italy. 36 (pp S476‐S477), 2017. [Conference Abstract] July 2017;36:S476‐S477.
Bahadzor 2006 {published data only}
    1. Bahadzor B, Fadzli I, Nazri J, Zulkifli Z, Taufik M. Prospective randomized clinical trial comparing the use of plasmakinetic resection of prostate versus conventional transurethral resection of prostate In the treatment of benign prostatic hyperplasia. International Journal of Urology 2006;13(Suppl.1):A21‐2.
Bertolotto 2007 {published data only}
    1. Bertolotto F, Naselli A, Vigliercio G, Raggio M, Puppo P. Prospective randomized study confronting monopolar versus bipolar TURP. 6 months follow up outcome. European Urology Supplements 2007;6(2):137.
    1. Bertolotto F, Raggio M, Vigliercio G, Germinale F, Introini C. Monopolar vs. bipolar TUR: results of a randomised prospective study. European Urology Supplements 2006;5(2):311.
Bhansali 2009 {published data only}
    1. Bhansali M, Patankar S, Dobhada S, Khaladkar S. Management of large (>60 g) prostate gland: PlasmaKinetic Superpulse (bipolar) versus conventional (monopolar) transurethral resection of the prostate. Journal of Endourology 2009;23(1):141‐5. [PUBMED: 19178175] - PubMed
Chen 2009 {published data only}
    1. Chen Q, Zhang L, Liu YJ, Lu JD, Wang GM. Bipolar transurethral resection in saline system versus traditional monopolar resection system in treating large‐volume benign prostatic hyperplasia. Urologia Internationalis 2009;83(1):55‐9. [PUBMED: 19641360] - PubMed
Chen 2010 {published data only}
    1. Chen Q, Zhang L, Fan QL, Zhou J, Peng YB, Wang Z. Bipolar transurethral resection in saline vs traditional monopolar resection of the prostate: results of a randomized trial with a 2‐year follow‐up. British Journal of Urology International 2010;106(9):1339‐43. [PUBMED: 20477825] - PubMed
Choi 2006 {published data only}
    1. Choi SH, Lee JH, Seo JH, Yoon CJ, Moon KH, Park YI, Cho SR. The comparison of PK tissue management system TURP with conventional monopolar TURP. European Urology Supplements 2006;5(2):271.
D'Elia 2004 {published data only}
    1. D’Elia G, Mastrangeli B. A randomized prospective trial of bipolar versus standard monopolar transurethral resection of the prostate. European Urology Supplements 2004;3(2):235.
Demirdag 2016 {published data only}
    1. Demirdag C, Citgez S, Tunc B, Simsekoglu F, Can G, Onal B. The clinical effect of bipolar and monopolar transurethral resection of the prostate more than 60 milliliters. Urology 2016;98:132‐7. - PubMed
De Sio 2006 {published data only}
    1. Autorino R, Damiano R, Lorenzo G, Quarto G, Perdonà S, D'Armiento M, et al. Four‐year outcome of a prospective randomised trial comparing bipolar plasmakinetic and monopolar transurethral resection of the prostate. European Urology 2009;55(4):922‐9. [PUBMED: 19185975] - PubMed
    1. Autorino R, Sio M, D'Armiento M. Bipolar plasmakinetic technology for the treatment of symptomatic benign prostatic hyperplasia: evidence beyond marketing hype?. British Journal of Urology International 2007a;100(5):983‐5. [PUBMED: 17578467] - PubMed
    1. Autorino R, Sio M, Quarto G, Giugliano F, Mordente S, Neri F, et al. Bipolar plasmakinetic vs standard trans‐urethral resection of the prostate: long term follow‐up from a single institution. Journal of Endourology 2007;21(Suppl 1):A97.
    1. Sio M, Autorino R, Quarto G, Cosentino L, Pane U, Mordente S, et al. Gyrus™ bipolar versus standard monopolar transurethral resection of the prostate: a randomized prospective trial. Journal of Endourology 2005;19(Suppl 1):A43.
    1. Sio M, Autorino R, Quarto G, Damiano R, Perdonà S, Lorenzo G, Mordente S, D'Armiento M. Gyrus bipolar versus standard monopolar transurethral resection of the prostate: a randomized prospective trial. Urology 2006;67(1):69‐72. [PUBMED: 16413335] - PubMed
Eaton 2004 {published data only}
    1. Eaton A, Francis R, Duncan N, Silva B. A randomized prospective study comparing the performance of the 4mm plasma kinetic loop against standard monopolar TURP in prostates 4‐=100 gm size. European Urology Supplements 2004;3(2):145.
    1. Eaton AC, Duncan NH. Gyrus plasmakinetic bipolar loop resection compared to conventional monopolar TURP in prostates > 40 gms. Journal of Endourology 2003;17(7):A8.
Egui Rojo 2017 {published data only}
    1. Egui Rojo MA, Redon Galvez L, Alvarez Ardura M, Otaola Arca H, Paez Borda A. Monopolar versus bipolar transurethral resection of the prostate: evaluation of the impact on sexual function. Journal of Sexual Medicine 2017;14:e107‐e197. - PubMed
El‐Assmy 2018 {published data only}
    1. El‐Assmy A, ElShal AM, Mekkawy R, El‐Kappany H, Ibrahiem EHI. Erectile and ejaculatory function changes following bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study. International Urology and Nephrology 2018;50(9):1569‐76. - PubMed
Erturhan 2007 {published data only}
    1. Erturhan S, Erbagci A, Seckiner I, Yagci F, Ustun A. Plasmakinetic resection of the prostate versus standard transurethral resection of the prostate: a prospective randomized trial with 1‐year follow‐up. Prostate Cancer and Prostatic Diseases 2007;10(1):97‐100. [PUBMED: 16926854 ] - PubMed
Fagerström 2011 {published data only}
    1. Fagerström T, Nyman CR, Hahn RG. Bipolar transurethral resection of the prostate causes less bleeding than the monopolar technique: a single‐centre randomized trial of 202 patients. British Journal of Urology International 2010;105(11):1560‐4. [PUBMED: 19912211] - PubMed
    1. Fagerström T, Nyman CR, Hahn RG. Complications and clinical outcome 18 months after bipolar and monopolar transurethral resection of the prostate. Journal of Endourology 2011;25(6):1043‐9. [PUBMED: 21568691] - PubMed
Geavlete 2011 {published data only}
    1. Geavlete B, Georgescu D, Multescu R, Stanescu F, Jecu M, Geavlete P. Bipolar plasma vaporization vs monopolar and bipolar TURP ‐ A prospective, randomized, long‐term comparison. Urology 2011;78(4):930‐5. [PUBMED: 21802121] - PubMed
    1. Geavlete B, Multescu R, Georgescu D, Stanescu F, Jecu M, Moldoveanu C, et al. Three‐year prospective, randomized comparison of the bipolar plasma vaporization of the prostate, monopolar and bipolar resection in medium size BPH patients. European Urology Supplements 2013;12(4):e1276.
    1. Geavlete B, Multescu R, Georgescu D, Stanescu F, Jecu M, Moldoveanu C, et al. Three‐year prospective, randomized comparison of the bipolar plasma vaporization of the prostate, monopolar and bipolar resection in medium size BPH patients. Journal of Urology 2013;189(Suppl 4):e806‐7.
    1. Geavlete B, Multescu R, Georgescu D, Stanescu F, Moldoveanu C, Jecu M, et al. Bipolar plasma vaporization versus monopolar and bipolar resection – Which is “the better choice” in cases of average size BPH?. European Urology Supplements 2012a;11(4):99.
    1. Geavlete B, Multescu R, Moldoveanu C, Jecu M, Georgescu D, Geavlete P. Bipolar plasma vaporization versus monopolar and bipolar resection ‐ Which is ''the better choice'' in cases of average size BPH?. Journal of Endourology 2012;26:A46.
Ghozzi 2014 {published data only}
    1. Ghozzi S, Ghorbel J, Ben Ali M, Dridi M, Maarouf J, Khiari R, et al. Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study [Article in French]. Progrès en Urologie 2014;24(2):121‐6. [PUBMED: 24485082] - PubMed
    1. Khiari R, Ben Rais N, Rebai H, Mansouri O, Zwari MB, Cherif M, et al. Bipolar resection versus standard transurethral resection of the prostate: a prospective randomized study with 2‐year follow‐up. 3rd International Meeting Challenges in Endourology & Functional Urology, Paris. 2013. [http://www.challenges‐endourology.com/2013/posters/PP‐06.pdf]
    1. Oussama M, Ghorbel J, Hedi R, Zouari M, Kilani T, Maaroufi J, et al. Bipolar resection versus standard transurethral resection of the prostate: a prospective randomized study with 2‐year follow‐up. European Urology Supplemnets 2013;12(1):e520.
Giulianelli 2013 {published data only}
    1. Giulianelli R, Albanesi L, Attisani F, Gentile BC, Vincenti G, Pisanti F, et al. Comparative randomized study on the efficaciousness of endoscopic bipolar prostate resection versus monopolar resection technique. 3 year follow‐up. Archivio Italiano di Urologia e Andrologia 2013;85(2):86‐91. [PUBMED: 23820656] - PubMed
    1. Giulianelli R, Gentile BC, Bmnori S, Vincent G, Akpan Patrick G. The comparative randomized study on the efficaciousness of endoscopic Gyrus prostate resection versus traditional. European Urology Supplements 2005;4(3):148.
Goh 2009 {published data only}
    1. Goh M, Gulur DM, Aning J, Okeke A, Gilbert H, Kinder R, et al. Bipolar versus monopolar transurethral Resection of the prostate (TURP) for benign prostatic obstruction: a randomised prospective trial comparing treatment efficacy and the incidence of transurethral resection (TUR) syndrome. Journal of Urology 2010;183:e739. [EMBASE: 225347]
    1. Goh MHC, Gulur DM, Okeke AA, Gilbert HW, Kinder RB, Timoney AG. Bipolar versus monopolar transurethral resection of the prostate for benign prostatic obstruction: a randomised prospective trial with one year follow up. British Journal of Urology International 2009;103(Suppl 4):17.
    1. Gulur DM, Goh MHC, Anning JJ, Okeke AA, Gilbert HW, Kinder RB, et al. Comparison between bipolar versus monopolar transurethral resection of the prostate: a randomized prospective trial. European Urology Supplements 2010;9(2):279.
    1. Gulur DM, Goh MHC, Okeke AA, Gilbert HW, Kinder RB, Timoney AG. A randomised controlled trial of the incidence of TUR syndrome in bipolar versus monopolar transurethral resection of the prostate for benign prostatic obstruction. British Journal of Urology International 2009;103(Suppl 4):16‐7.
    1. Gulur DM, Goh MHC, Okeke AA, Gilbert HW, Kinder RB, Timoney AG. Transurethral resection of the prostate for benign prostatic obstruction: a comparison of the Olympus bipolar and monopolar resectoscopes from the operation surgeon’s perspective. British Journal of Urology International 2010a;106(Suppl 1):21‐2.
He 2010 {published data only}
    1. He JW, Xie J, Chen GY, Guan DH, LIN YW. Therapeutic efficacy of bipolar plasmakinetic resection compared with transurethral resection on benign prostate hyperplasia [Article in Chinese]. Chinese Journal of Endourology (electronic version) 2010;4(4):302‐4.
Ho 2007 {published data only}
    1. Hakenberg OW. Editorial comment on: A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. European Urology 2007;52(2):523. [PUBMED: 17416452] - PubMed
    1. Ho H, Yip S, Foo KT, Cheng C. A prospective randomized controlled trial comparing bipolar transurethral resection in saline (TURIS) system and conventional monopolar transurethral resection of prostate in men with benign prostate hyperplasia: a 1 year's clinical efficacy and safety. Journal of Endourology 2005;19(Suppl 1):A47.
    1. Ho H, Yip S, Lim K, Foo K, Cheng C. A prospective randomized controlled trial comparing bipolar transurethral resection in saline (TURIS) system and conventional monopolar transurethral resection of prostate in men with benign prostate hyperplasia: a 1 year's clinical efficacy and safety. The Journal of Urology 2006;175(4):461.
    1. Ho H, Yip S, Lim KB, Foo KT, Cheng C. A prospective randomized controlled trial comparing bipolar transurethral resection in saline (TURIS) system and conventional monopolar transurethral resection of prostate in men with benign prostate hyperplasia: 1 years's clinical efficacy and safety. European Urology Supplements 2006;5(2):308.
    1. Ho HS, Yip SK, Lim KB, Fook S, Foo KT, Cheng CW. A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. European Urology 2007;52(2):517‐22. [PUBMED: 17416453] - PubMed
Huang 2012 {published data only}
    1. Degirmenci T, Kozacioglu Z. Re: Huang et al: Bipolar transurethral resection of the prostate causes deeper coagulation depth and less bleeding than monopolar transurethral prostatectomy (Urology 2012;80:1116‐20). Urology 2013;81(2):471‐2. [PUBMED: 23374838] - PubMed
    1. Huang X, Wang L, Wang XH, Shi HB, Zhang XJ, Yu ZY. Bipolar transurethral resection of the prostate causes deeper coagulation depth and less bleeding than monopolar transurethral prostatectomy. Urology 2012;80(5):1116‐20. [PUBMED: 22990062] - PubMed
    1. Mamoulakis C, Ubbink DT, Sofras F, N'Dow JM, Rosette JJ. Re: Huang et al: Bipolar transurethral resection of the prostate causes deeper coagulation depth and less bleeding than monopolar transurethral prostatectomy (Urology 2012;80:1116‐20). Urology 2013d;81(5):1113‐5. [PUBMED: 23608435] - PubMed
    1. Mandal S, Singh V, Sankhwar S. Re: Huang et al: Bipolar transurethral resection of the prostate causes deeper coagulation depth and less bleeding than monopolar transurethral prostatectomy (Urology 2012;80:1116‐20). Urology 2013;81(2):468. [PUBMED: 23374832] - PubMed
Iori 2008 {published data only}
    1. Autorino R, Sio M. Re: Iori F, Franco G, Leonardo C, et al. Bipolar transurethral resection of the prostate: clinical and urodynamic evaluation (Urology 2008;71:252‐5). Urology 2008;72(2):462‐3. [PUBMED: 18561987] - PubMed
    1. DeNunzio C, Leonardo C. Re: Iori et al: Bipolar transurethral resection of the prostate: clinical and urodynamic evaluation. (Urology 2008;71:252‐5). Urology 2008;72(5):1188‐9. [PUBMED: 18984146] - PubMed
    1. Iori F, Franco G, Leonardo C, Laurenti C, Tubaro A, D‐Amico F, et al. Bipolar transurethral resection of prostate: clinical and urodynamic evaluation. Urology 2008;71(2):252‐5. [PUBMED: 18308095] - PubMed
Kadyan 2014 {published data only}
    1. Kadyan B, Kankalia SP, Sabale VP, Satav V, Bhirud P, Garg S. A prospective randomized study comparing safety and efficacy of bipolar resection versus standard transurethral resection of prostate. Indian Journal of Urology 2014;30:s155. [EMBASE: 71491390]
Kim 2006 {published data only}
    1. Kim JY, Moon KH, Yoon CJ, Park TC. Bipolar transurethral resection of the prostate: a comparative study with monopolar transurethral resection [Article in Korean]. Korean Journal of Urology 2006;47(5):493‐7.
Komura 2015 {published data only}
    1. Komura K, Inamoto T, Takai T, Uchimoto T, Saito K, Tanda N, et al. Could transurethral resection of the prostate using the TURis system take over conventional monopolar transurethral resection of the prostate? A randomized controlled trial and midterm results. Urology 2014;84(2):405‐11. [PUBMED: 24958486] - PubMed
    1. Komura K, Inamoto T, Takai T, Uchimoto T, Saito K, Tanda N, et al. Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis: results from a randomized trial. BJU International 2015;115(4):644‐52. [PUBMED: 24909399] - PubMed
Kong 2009 {published data only}
    1. Kong CH, Ibrahim MF, Zainuddin ZM. A prospective, randomized clinical trial comparing bipolar plasma kinetic resection of the prostate versus conventional monopolar transurethral resection of the prostate in the treatment of benign prostatic hyperplasia. Annals of Saudi Medicine 2009;29(6):429‐32. [PUBMED: 19847078] - PMC - PubMed
Kumar 2013 {published data only}
    1. Kumar A, Vasudeva P, Kumar N, Nanda B, Jha SK, Mohanty N. A prospective randomized comparative study of monopolar and bipolar transurethral resection of the prostate and photoselective vaporization of the prostate in patients who present with benign prostatic obstruction: a single center experience. Journal of Endourology 2013;27(10):1245‐53. [PUBMED: 23746047] - PubMed
    1. Kumar N, Kumar A, Vasudeva P, Nanda B, Kumar R, Jha SK. Monopolar TURP vs. bipolar TURP vs. photoselective vaporization prostate: prospective randomized comparison in patient with lower urinary tract symptom secondary to benign prostatic obstruction. Indian Journal of Urology 2014;30:s46. [EMBASE: 71490887]
    1. Kumar N, Vasudeva P, Kumar A, Singh H. Prospective randomized comparison of monopolar TURP, bipolar TURP and photoselective vaporization of the prostate in patients with benign prostatic obstruction. LUTS 2018;10:17‐20. - PubMed
Lin 2006 {published data only}
    1. Lin MS, Wu JC, Hsieh HL, Lin TC, Chen CC, Lin E. Comparison between monopolar and bipolar TURP in treating benign prostatic hyperplasia: 1‐year report. Mid‐Taiwan Journal of Medicine 2006;11:143‐8.
Mamoulakis 2013 {published data only}
    1. Bachmann A, Muir GH, Wyler SF, Rieken M. Surgical benign prostatic hyperplasia trials: the future is now!. European Urology 2013;63(4):677‐9. [PUBMED: 23158588] - PubMed
    1. Cetti RJ, Hicks JA, Venn SN, Carter PG, Britton JP. Results from an international multi‐centre double‐blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate. British Journal of Urology International 2012;109(11):E38; author reply E38‐40. [PUBMED: 22564326] - PubMed
    1. Hindley R. Bipolar vs monopolar transurethral resection of the prostate: evaluation of impact on overall sexual function in an international randomized controlled setting. British Journal of Urology International 2013;112(1):7‐9. [PUBMED: 23759006] - PubMed
    1. Ho CC, Eng HS, Das S. Results from an international multi‐centre double‐blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate. British Journal of Urology International 2012;109(7):E22; author reply E22‐4. [PUBMED: 22414177] - PubMed
    1. Kaplan SA. Re: Bipolar vs monopolar transurethral resection of the prostate: evaluation of the impact on overall sexual function in an international randomized controlled trial setting. Editorial comment. Journal of Urology 2014;191(6):1826‐7. - PubMed
Mei 2010 {published data only}
    1. Mei HB, Wang F, Chang JP, Zhang ZL, Shi M, Ye SB, et al. Comparison of clinical effect of transurethral resection and bipolar plasma kinetic resection of benign prostatic hyperplasia [Article in Chinese]. Chinese Journal of Endourology (electronic version) 2010;4(3):1‐5.
Méndez‐Probst 2011 {published data only}
    1. Hueber PA, Al‐Asker A, Zorn KC. Monopolar vs. bipolar TURP: assessing their clinical advantages. Canadian Urological Association Journal 2011;5(6):390‐1. [PUBMED: 22154631] - PMC - PubMed
    1. Méndez‐Probst CE, Nott L, Pautler SE, Razvi H. A multi‐centre single‐blind randomized controlled trial comparing bipolar and monopolar transurethral resection of the prostate. Canadian Urological Association Journal 2011;5(6):385‐9. [PUBMED: 22154630] - PMC - PubMed
Michielsen 2007 {published data only}
    1. Alexander C, Omar MI. Re: Urethral strictures and bipolar transurethral resection in saline of the prostate: fact or fiction? (From: Michielsen DP, Coomans D. Journal of Endourology 2010;24:1333‐7). Journal of Endourology 2013 Feb 21 [Epub ahead of print];30(7):832. [PUBMED: 23272942] - PubMed
    1. Ho H, Lim KB. Re: Bipolar transurethral resection in saline ‐ an alternative surgical treatment for bladder outlet obstruction? Michielsen DP, Debacker T, De Boe B, Van Lersberghe C, Kaufman L, Braeckman JG, et al. Journal of Urology 2007;178:2035‐9. Journal of Urology 2008;179(6):2482‐3; author reply 2483. [PUBMED: 18436257] - PubMed
    1. Michielsen DP, Coomans D. Urethral strictures and bipolar transurethral resection in saline of the prostate: fact or fiction?. Journal of Endourology 2010;24(8):1333‐7. [PUBMED: 20583960] - PubMed
    1. Michielsen DP, Coomans D, Braeckman JG, Umbrain V. Bipolar transurethral resection in saline: the solution to avoid hyponatraemia and transurethral resection syndrome. Scandinavian Journal of Urology and Nephrology 2010b;44(4):228‐35. [PUBMED: 20345336] - PubMed
    1. Michielsen DP, Debacker T, Boe V, Lersberghe C, Kaufman L, Braeckman JG, et al. Bipolar transurethral resection in saline ‐ an alternative surgical treatment for bladder outlet obstruction?. Journal of Urology 2007;178(5):2035‐9. [PUBMED: 17869297] - PubMed
Nasution 2017 {published data only}
    1. Nasution P, Nur Budaya T, Duarsa G, Prasetyawan W, Laksono K, Wijaya C, et al. Comparative study of monopolar versus bipolar transurethral resection of the prostate versus thulium laser vaporesection of the prostate (ThuVaRP) in patients with benign prostatic hyperplasia and urinary retention: randomized multicenter study. Journal of Clinical Urology. Conference: 2017 Annual Scientific Meeting of the British Association of Urological Surgeons, BAUS 2017. United Kingdom. June 2017; Vol. 10 (2 Suppl 1):69.
Nuhoğlu 2006 {published data only}
    1. Nuhoğlu B, Ayyildiz A, Karagüzel E, Cebeci O, Germiyanoğlu C. Plasmakinetic prostate resection in the treatment of benign prostate hyperplasia: results of 1‐year follow up. International Journal of Urology 2006;13(1):21‐4. [PUBMED: 16448427] - PubMed
Patankar 2006 {published data only}
    1. Patankar S. Comparison between plasmakinetic resection of prostate and monopolar TURP: a prospective randomized trial with 5‐year follow‐up. Journal of Urology 2012;187(4 Suppl 1):e878‐9.
    1. Patankar S, Jamkar A, Dobhada S, Gorde V. PlasmaKinetic Superpulse transurethral resection versus conventional transurethral resection of prostate. Journal of Endourology 2006;20(3):215‐9. [PUBMED: 16548733] - PubMed
    1. Patankar S, Rasal D, Shah R, Oza N. Comparison between plasmakinetic resection of prostate and monopolar TURP: a prospective randomized trial with 5‐year follow‐up. Urology 2011;78(Suppl 3A):S13‐4.
    1. Patankar SB, Dobhada SH. Superpulse bipolar prostate resection v/s conventional TURP: a randomized prospective trial with 3 months follow up ‐ an Indian experience. Journal of Endourology 2004;18(Suppl 1):A77.
Qian 2014 {published data only}
    1. Qian P, Li Mingtao. Study of transurethral bipolar plasma kinetic resection operation for treatment of benign prostatic hyperplasia patients and its effect on sexual function. Chinese Journal of Andrology 2014;28(6):52‐4.
Rojo 2018 {published data only}
    1. Rojo MAE, Galvez LR, Ardura MA, Arca HO, Borda AP. Comparison of monopolar versus bipolar transurethral resection of the prostate: evaluation of the impact on sexual function. Andrologia 2018;212:1‐7. - PubMed
Rose 2007 {published data only}
    1. Rose A, Suttor S, Goebell PJ, Rossi R, Rübben H. Transurethral resection of bladder tumors and prostate enlargement in physiological saline solution (TURIS). A prospective study. Urologe A 2007;46(9):1148‐50. [PUBMED: 17619851] - PubMed
Seckiner 2006 {published data only}
    1. Seckiner I, Yesilli C, Akduman B, Altan K, Mungan NA. A prospective randomized study for comparing bipolar plasmakinetic resection of the prostate with standard TURP. Urologia Internationalis 2006;76(2):139‐43. [PUBMED: 16493215] - PubMed
    1. Seckiner I, Yesilli C, Akduman B, Altan K, Mungan NA. TURP vs plasmakinetic resection of the prostate: results of a prospective randomized study. European Urology Supplements 2005;4(3):148.
Shaik 2017 {published data only}
    1. Shaik JA, Devraj R, Vidyasager, Ram Reddy CH. Bipolar versus monopolar transurethral resection of the prostate for benign prostatic obstruction: a randomized prospective study. Indian Journal of Urology 2017;33:(Suppl 1).
Singh 2005 {published data only}
    1. Singh H, Desai MR, Shrivastav P, Vani K. Bipolar versus monopolar transurethral resection of prostate: randomized controlled study. Journal of Endourology 2005;19(3):333‐8. [PUBMED: 15865523] - PubMed
Singhania 2010 {published data only}
    1. Singhania P, Nandini D, Sarita F, Hemant P, Hemalata I. Transurethral resection of prostate: a comparison of standard monopolar versus bipolar saline resection. International Brazilian Journal of Urology 2010;36(2):183‐9. [PUBMED: 20450503] - PubMed
Stucki 2014 {published data only}
    1. Stucki P, Marini L, Mattei A, Xafis K, Boldini M, Danuser H. Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized trial focusing on bleeding complications. Journal of Urology 2014 Nov 20;193(4):pii: S0022‐5347(14)04936‐2. doi: 10.1016/j.juro.2014.08.137. [Epub ahead of print]. [PUBMED: 25464004] - PubMed
    1. Stucki P, Mattei A, Marini L, Xafis K, Danuser H. Bipolar versus monopolar transurethral resection of the prostate: a prospective randomized trial focusing on bleeding complications. Journal of Urology 2013;189(Suppl 4):e817. - PubMed
Symons 2002 {published data only}
    1. Symons S, Browning A, Chahal R. A comparative study of the Gyrus plasmakinetic electrosurgical system versus conventional loop electroresection (TURP) for the treatment of bladder outflow obstruction ‐ six month data. European Urology Supplements 2002;1(1):169.
Terrone 2006 {published data only}
    1. Poggio M, Scoffone C, Cecilia C, Scarpa RM. Bipolar versus monopolar TURP: a randomized study. Journal of Endourology 2006;20(Suppl 1):A87.
    1. Terrone C, Scoffone C, Cracco C, Poggio M, Tarabuzzi R, Morra I, et al. Bipolar versus monopolar TURP: a randomized study. European Urology Supplements 2006;5(2):235.
Wang 2007 {published data only}
    1. Wang D, Lu J, Xia S, Zhu J, Sun X, Zhang Q, Wen W. A comparative study of transurethral plasma kinetic resection versus transurethral resection of the prostate for benign prostatic hyperplasia [Article in Chinese]. Journal of Clinical Urology 2007;22(7):520‐2.
Wu 2005 {published data only}
    1. Wu WJ, Wang XH, Wang HP, Zou WB, Liang XY, Cai ZG, et al. Therapeutic efficacy of bipolar plasmakinetic technique compared with transurethral resection on benign prostate hyperplasia. National Medical Journal of China 2005;85(47):3365‐7. - PubMed
Xie 2012 {published data only}
    1. Xie CY, Zhu GB, Wang XH, Liu XB. Five‐year follow‐up results of a randomized controlled trial comparing bipolar plasmakinetic and monopolar transurethral resection of the prostate. Yonsei Medical Journal 2012;53(4):734‐41. [PUBMED: 22665339] - PMC - PubMed
Xin 2007 {published data only}
    1. Xin G, Xingqiao W, Jianguang Q, Yubin C. A prospective randomized study comparing gyrus bipolar and standard monopolar transurethral resection of the prostate. Journal of Endourology 2007;21(Suppl 1):A102.
Xin 2009 {published data only}
    1. Xin L, Zhu J, Yao B. Transurethral prostate ion bipolar electrosurgical excision efficacy. Medical Journal of Communications 2009;23(6):685‐7.
Xue 2008 {published data only}
    1. Xue S, Ma HQ, Ge JP, Wei W, Zhou WQ, Zhou SG, et al. A comparative study of two different surgical procedures for benign prostatic hyperplasia [Article in Chinese]. Journal of Postgraduate Medicine 2008;21(3):283‐6.
Yang 2004 {published data only}
    1. Yang S, Lin WC, Chang HK, Hsu JM, Lin WR, Chow YC, et al. Gyrus plasmasect: is it better than monopolar transurethral resection of prostate?. Urologia Internationalis 2004;73(3):258‐61. [PUBMED: 15539847] - PubMed
Yousef 2010 {published data only}
    1. Yousef AA, Suliman GA, Elashry OM, Elsharaby MD, Elgamasy Ael‐N. A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia. BioMed Central Anesthesiology 2010 May 28;10(7):doi:10.1186/1471‐2253‐10‐7. [PUBMED: 20509864] - PMC - PubMed

References to studies excluded from this review

Demir 2015 {published data only}
    1. Demir A, Karadag MA, Cecen K, Uslu M, Arslan OE. Monopolar versus plasmakinetic energy effect on prostatic tissue damage in terms of PSA levels: a prospective randomised trial. Urologia Internationalis 2015;95:265‐8. - PubMed
El Saied Hafez 2013 {published data only}
    1. Saied Hafez MH, Din Abd El Hamid MH, Abd El Raouf S, Soaida SM, Marie MM. Bipolar versus monopolar transurethral prostate resection: comparison of hemodynamic and biochemical changes. Egyptian Journal of Anaesthesiology 2014;30(1):47‐52. [EMBASE: 2014067679]
Engeler 2010 {published data only}
    1. Engeler DS, Schwab C, Neyer M, Grün T, Reissigl A, Schmid HP. Bipolar versus monopolar TURP: a prospective controlled study at two urology centers. Prostate Cancer and Prostatic Diseases 2010;13(3):285‐91. [PUBMED: 20142841] - PubMed
Fung 2005 {published data only}
    1. Fung BT, Li SK, Yu CF, Lau BE, Hou SS. Prospective randomized controlled trial comparing plasmakinetic vaporesection and conventional transurethral resection of the prostate. Asian Journal of Surgery 2005;28(1):24‐8. [PUBMED: 15691793] - PubMed
Inzuna 2017 {published data only}
    1. Inzunza G, Rada G, Majerson A. Bipolar or monopolar transurethral resection for benign prostatic hyperplasia?. [Review]. Medwave 2018;18(1):e7134. - PubMed
Kwon 2011 {published data only}
    1. Kwon JS, Lee JW, Lee SW, Choi HY, Moon HS. Comparison of effectiveness of monopolar and bipolar transurethral resection of the prostate and open prostatectomy in large benign prostatic hyperplasia. Korean Journal of Urology 2011;52(4):269‐73. [PUBMED: 21556214] - PMC - PubMed
Liangyu 2006 {published data only}
    1. Liangyu X, Dirong C, Xiaogang L, Jianye D. A comparative study on erectile dysfunction after transurethral plasma kinetic resection of prostate or TURP for BPH [Article in Chinese]. Chinese Journal of Andrology 2006;20(11):34‐6.
Lv 2012 {published data only}
    1. Lv L, Wang L, Fan M, Ju W, Pang Z, Zhu Z, et al. Two‐year outcome of high‐risk benign prostate hyperplasia patients treated with transurethral prostate resection by plasmakinetic or conventional procedure. Urology 2012;80(2):389‐94. [PUBMED: 22698467] - PubMed
    1. Rodriguez AR. Editorial comment. Urology 2012;80(2):394‐5; author reply 395. [PUBMED: 22698468] - PubMed
Michielsen 2010b {published data only}
    1. Michielsen DP, Coomans D, Peeters I, Braeckman JG. Conventional monopolar resection or bipolar resection in saline for the management of large (>60 g) benign prostatic hyperplasia: an evaluation of morbidity. Minimally Invasive Therapy and Allied Technologies 2010;19(4):207‐13. [PUBMED: 20642387] - PubMed
Michielsen 2011 {published data only}
    1. Michielsen DP, Coomans D, Lersberghe C, Braeckman JG. Comparison of the haemostatic properties of conventional monopolar and bipolar transurethral resection of the prostate in patients on oral anticoagulants. Archives of Medical Science 2011;7(5):856‐63. [PUBMED: 22291832] - PMC - PubMed
Muslumanoglu 2012 {published data only}
    1. Muslumanoglu AY, Yuruk E, Binbay M, Akman T. Transurethral resection of prostate with plasmakinetic energy: 100 months results of a prospective randomized trial. British Journal of Urology International 2012;10(4):546‐9. [PUBMED: 22115409] - PubMed
    1. Muslumanoglu AY, Yuruk E, Binbay M, Akman T. Transurethral resection of prostate with plasmakinetic energy: 100 months results of a prospective randomized trial. European Urology Supplements 2011;10(9):583. - PubMed
Neyer 2011 {published data only}
    1. Neyer M, Engeler D, Schwab C, Pointner J, Grun T, Schmid HP, et al. A prospective controlled study comparing bipolar versus monopolar transurethral resection of the prostate. Journal of Urology 2010;183(4):e738‐9.
    1. Neyer M, Reissigl A, Schwab C, Bachmayer C, Abt D, Schmid HP, Engeler D. A prospective controlled study comparing bipolar versus monopolar transurethral resection of the prostate: long‐term outcome. European Urology Supplements 2011;10(2):62.
    1. Neyer M, Reissigl A, Schwab C, Pointner J, Abt D, Bachmayer C, et al. Bipolar versus monopolar transurethral resection of the prostate: results of a comparative, prospective bicenter study ‐ perioperative outcome and long‐term efficacy. Urologia Internationalis 2013;90(1):62‐7. [PUBMED: 23147406] - PubMed
Tefekli 2005 {published data only}
    1. Ho H, Yip S, Foo KT. Re: A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. Journal of Urology 2006a;175(5):1965; author reply 1965‐6. [PUBMED: 16600811] - PubMed
    1. Tefekli A, Muslumanoglu AY, Baykal M, Binbay M, Tas A, Altunrende F. A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. Journal of Urology 2005;174(4 Pt 1):1339‐43. [PUBMED: 16145415] - PubMed
Treharne 2018 {published data only}
    1. Treharne C, Crowe L, Booth D, Ihara Z. Economic value of the transurethral resection in saline system for treatment of benign prostatic hyperplasia in England and Wales: systematic review, meta‐analysis, and cost‐consequence model. European Urology Focus 2018;4(2):270‐9. - PubMed
Valdivia Uría 2005 {published data only}
    1. Valdivia Uría JG, Regojo Zapata O, Sánchez Zalabardo JM, Elizalde Benito A, Navarro Gil J, Hijazo Conejos I. Transurethral resection with saline solution: a technological achievement not yet assimilated by the urological community [Article in Spanish]. Archivos Españoles de Urología 2005;58(4):335‐45. [PUBMED: 15989098] - PubMed
Vasudeva 2019 {published data only}
    1. Vasudeva P, Kumar N, Kumar A, Kumar G, Patel M, Gupta P. Impact of monopolar TURP, bipolar TURP and photoselective vaporization of prostate for enlarged prostate on erectile function. Luts 2019;11(1):24‐9. - PubMed
Yoon 2006 {published data only}
    1. Yoon CJ, Kim JY, Moon KH, Jung HC, Park TC. Transurethral resection of the prostate with a bipolar tissue management system compared to conventional monopolar resectoscope: one‐year outcome. Yonsei Medical Journal 2005;47(5):715‐20. [PUBMED: 17066516] - PMC - PubMed
Zhang 2013 {published data only}
    1. Zhang HM, Zheng JH, Xu YF, Peng B, Yan Y, Gao QR. Improvement of erectile function in patients with benign prostatic hyperplasia undergoing transurethral plasmakinetic resection of the prostate. International Journal of Urology 2013;20(7):724‐8. [PUBMED: 23305506] - PubMed

Additional references

Abrams 2002
    1. Abrams P, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub‐committee of the International Continence Society. Neurourology and Urodynamics 2002;21(2):167‐78. - PubMed
Abrams 2009
    1. Abrams P, Chapple C, Khoury S, Roehrborn C, Rosette J. Evaluation and treatment of lower urinary tract symptoms in older men. Journal of Urology 2009;181(4):1779‐87. [PUBMED: 19233402] - PubMed
Agarwal 2014
    1. Agarwal A, et al. What is the most bothersome lower urinary tract symptom? Individual and population‐level perspectives for both men and women. European Urology 2014;65(6):1211‐7. - PMC - PubMed
Ahyai 2010
    1. Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, et al. Meta‐analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. European Urology 2010;58(3):384‐97. [PUBMED: 20825758] - PubMed
AUA 2018
    1. Foster HE, Barry MJ, Gandh MCi, Kaplan SA, Kohler T, Lerner LB, et al. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (2018). American Urological Association Guidelines Retrieved from http://www.auanet.org/guidelines/surgical‐management‐of‐lower‐urinary‐tr... June 2018):612‐9. - PubMed
Burke 2010
    1. Burke N, Whelan JP, Goeree L, Hopkins RB, Campbell K, Goeree R, et al. Systematic review and meta‐analysis of transurethral resection of the prostate versus minimally invasive procedures for the treatment of benign prostatic obstruction. Urology 2010;75(5):1015‐22. [PUBMED: 19854492] - PubMed
CG97 LUTS: NICE guideline, 2010
    1. Lower Urinary Tract Symptoms: Full Guideline [CG97]. London: National Institute for Health and Clinical Excellence, 2010. - PubMed
Corbett 2014
    1. Corbett MS, Higgins JPT, Woolacott NF. Assessing baseline imbalance in randomised trials: implications for the Cochrane risk of bias tool. Research Synthesis Methods 2015;5:79‐85. - PubMed
Cornu 2015
    1. Cornu JN, Ahyai S, Bachmann A, Rosette J, Gilling P, Gratzke C, et al. A systematic review and meta‐analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. European Urology 2015;67(6):1066‐96. [PUBMED: 24972732] - PubMed
EAU 2018
    1. Gravas S, Cornu JN, Drake MJ, Gacci M, Gratzke C, Herrmann TRW, et al. Treatment of non‐neurogenic male LUTS. European Association of Urology Guidelines 2018; Vol. Retreived from http://uroweb.org/guideline/treatment‐of‐non‐neurogenic‐male‐luts/, issue accessed June 2018.
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. British Medical Journal 1997;315(7109):629‐34. [PUBMED: 9310563] - PMC - PubMed
Faul 2008
    1. Faul P, Schlenker B, Gratzke C, Stief CG, Reich O, Hahn RG. Clinical and technical aspects of bipolar transurethral prostate resection. Scandinavian Journal of Urology and Nephrology 2008;42(4):318‐23. [PUBMED: 18622807] - PubMed
Guyatt 2008
    1. Guyatt GH, Oxman AD, Kunz R, Vist GE, Falck‐Ytter Y, Schünemann HJ, GRADE Working Group. What is "quality of evidence" and why is it important to clinicians?. British Medical Journal 2008;336(7651):995‐8. [PUBMED: 18456631] - PMC - PubMed
Guyatt 2011a
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction ‐ GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64(4):383‐94. [PUBMED: 21195583] - PubMed
Guyatt 2011b
    1. Guyatt GH, Oxman AD, Kunz R, Atkins D, Brozek J, Vist G, et al. GRADE guidelines: 2. Framing the question and deciding on important outcomes. Journal of Clinical Epidemiology 2011;64(4):395‐400. [PUBMED: 21194891] - PubMed
Guyatt 2011c
    1. Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso‐Coello P, et al. GRADE guidelines: 4. Rating the quality of evidence ‐ study limitations (risk of bias). Journal of Clinical Epidemiology 2011;64(4):407‐15. [PUBMED: 21247734] - PubMed
Guyatt 2011d
    1. Guyatt GH, Oxman AD, Montori V, Vist G, Kunz R, Brozek J, et al. GRADE guidelines: 5. Rating the quality of evidence ‐ publication bias. Journal of Clinical Epidemiology 2011;64(12):1277‐82. [PUBMED: 21802904] - PubMed
Guyatt 2011e
    1. Guyatt G, Oxman AD, Kunz R, Brozek J, Alonso‐Coello P, Rind D, et al. GRADE guidelines 6. Rating the quality of evidence ‐ imprecision. Journal of Clinical Epidemiology 2011;64(12):1283‐93. [PUBMED: 21839614] - PubMed
Guyatt 2011f
    1. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 7. Rating the quality of evidence ‐ inconsistency. Journal of Clinical Epidemiology 2011;64(12):1294‐302. [PUBMED: 21803546] - PubMed
Guyatt 2011g
    1. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M, et al. GRADE guidelines: 8. Rating the quality of evidence ‐ indirectness. Journal of Clinical Epidemiology 2011;64(12):1303‐10. [PUBMED: 21802903] - PubMed
Guyatt 2011h
    1. Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso‐Coello P, et al. GRADE guidelines: 9. Rating up the quality of evidence. Journal of Clinical Epidemiology 2011;64(12):1311‐6. [PUBMED: 21802902] - PubMed
Hahn 1993
    1. Hahn RG. Ethanol monitoring of extravascular absorption of irrigation fluid. British Journal of Urology 1993;72:766‐9. - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. British Medical Journal 2003;327(7414):557‐60. [PUBMED: 12958120] - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.handbook.cochrane.org.
Hozo 2005
    1. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Medical Research Methodology 2005;5(13):doi: https://doi.org/10.1186/1471‐2288‐5‐13. - PMC - PubMed
Isaacs 1989
    1. Isaacs JT, Coffey DS. Etiology and disease process of benign prostatic hyperplasia. Prostate Suppl 1989;2:33‐50. - PubMed
Issa 2008
    1. Issa MM. Technological advances in transurethral resection of the prostate: bipolar versus monopolar TURP. Journal of Endourology 2008;22(8):1587‐95. [PUBMED: 18721041] - PubMed
Kirby 2010
    1. Kirby RS, Kirby M, Fitzpatrick JM. Benign prostatic hyperplasia: counting the cost of its management. British Journal of Urology International 2010;105(7):901‐2. [PUBMED: 20356323] - PubMed
Kupelian 2006
    1. Kupelian V, et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Archives of Internal Medicine 2006;166(21):2381‐7. - PubMed
Lepor 1993
    1. Lepor H. The role of alpha blockage in the treatment of BPH. In: Lepor H, Lawson R editor(s). Prostatic Diseases. Philadelphia: WB Saunders, 1993:170‐81.
Liberati 2009
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta‐analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009;6(7):doi: https://doi.org/10.1136/bmj.b2700. - PMC - PubMed
Lourenco 2008
    1. Lourenco T, Pickard R, Vale L, Grant A, Fraser C, MacLennan G, et al. Alternative approaches to endoscopic ablation for benign enlargement of the prostate: systematic review of randomised controlled trials. British Medical Journal 2008;337:a449. [PUBMED: 18595932] - PMC - PubMed
Mamoulakis 2009
    1. Mamoulakis C, Trompetter M, Rosette J. Bipolar transurethral resection of the prostate: the 'golden standard' reclaims its leading position. Current Opinion in Urology 2009;19(1):26‐32. [PUBMED: 19057207] - PubMed
Mamoulakis 2009a
    1. Mamoulakis C, Ubbink DT, Rosette JJ. Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta‐analysis of randomized controlled trials. European Urology 2009;56(5):798‐809. [PUBMED: 19595501] - PubMed
Mamoulakis 2010
    1. Mamoulakis C, Rosette JJ, Ubbink DT. Re: Burke et al: Systematic review and meta‐analysis of transurethral resection of the prostate versus minimally invasive procedures for the treatment of benign prostatic obstruction (Urology 2010;75:1015‐22). Urology 2010; Vol. 75, issue 5:1235‐6; author reply 1236‐7. [PUBMED: 20451750] - PubMed
Mebust 1989
    1. Mebust WK, Holtgrewe HL, Cockett ATK, et al. Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of thirteen participating institutions evaluating 3,885 patients. Journal of Urology 1989;141:243‐7. - PubMed
Omar 2014
    1. Omar MI, Lam TBL, Cameron A, Graham J, Mamoulakis C, Imamura M, et al. Systematic review and meta‐analysis of the clinical effectiveness of bipolar compared to monopolar transurethral resection of the prostate. British Journal of Urology International 2014;113(1):24‐35. [PUBMED: 24053602] - PubMed
Rassweiler 2007
    1. Rassweiler J, Schulze M, Stock C, Teber D, Rosette J. Bipolar transurethral resection of the prostate − technical modifications and early clinical experience. Minimally Invasive Therapy and Allied Technologies 2007;16(1):11‐21. [PUBMED: 17365673] - PubMed
Reich 2006
    1. Reich O, Gratzke C, Stief CG. Techniques and long‐term results of surgical procedures for BPH. European Urology 2006;49(6):970‐8; discussion 978. [PUBMED: 16481092] - PubMed
Reich 2008
    1. Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. Journal of Urology 2008;180(1):246‐9. [PUBMED: 18499179] - PubMed
Rosen 2003
    1. Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM‐7). European Urology 2003;44:637‐49. - PubMed
Speakman 2015
    1. Speakman M, Kirby R, Doyle S, Ioannou C. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) ‐ focus on the UK. BJU International 2015;115:508‐19. - PubMed
Starkman 2007
    1. Starkman JS, Santucci RA. Comparison of bipolar transurethral resection of the prostate with standard transurethral prostatectomy: shorter stay, earlier catheter removal and fewer complications. British Journal of Urology International 2005;95(1):69‐71. [PUBMED: 15638897] - PubMed
Sterne 2011
    1. Sterne JAC, Sutton AJ, Ionnadis JPA, Terrin N, Jones DR, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta‐analyses of randomised controlled trials. BMJ 2011;342:doi: https://doi.org/10.1136/bmj.d4002. - PubMed
van Exel 2006
    1. Exel NJ, Koopmanschap MA, McDonnel J, Chapple CR, Berges R, Rutten FF. Medical consumption and costs during a one‐year follow‐up of patients with LUTS suggestive of BPH in six European countries: report of the TRIUMPH study. European Urology 2006;49:92‐102. - PubMed
Wendt‐Nordhal 2004
    1. Wendt‐Nordahl G, Hacker A, Reich O, Djaven B, Alken P, Michel MS. The Vista system: a new bipolar resection device for endourological procedures: comparison with conventional resectoscope. European Urology 2004;46:586‐90. - PubMed

References to other published versions of this review

Mamoulakis 2014
    1. Mamoulakis C, Sofras F, Rosette J, Omar MI, Lam TBL, N'Dow JMO, Ubbink DT. Bipolar versus monopolar transurethral resection of the prostate for lower urinary tract symptoms secondary to benign prostatic obstruction. Cochrane Database of Systematic Reviews 2014. - PMC - PubMed

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