Sucheta Panigrahi1, Acharya Suryakanta Pattajoshi2, Sanjay Kumar Mahapatra3, P. Raja Kumar Subudhi4, Biswajit Sahu5
BACKGROUND
In this study we wanted to compare the clinical outcomes in terms of symptom
improvement and perioperative results of monopolar and bipolar trans urethral
resection of prostrate (TURP) for benign prostatic hyperplasia (BPH) and evaluate
the advantages of bipolar transurethral resection over the monopolar resection.
METHODS
A total of 150 patients who underwent trans urethral resection of prostate (TURP)
surgical procedure, (n = 75 for monopolar TURP) and (n = 75 for bipolar TURP)
for BPH enrolled between December 2018 to November 2020 at the Department
of Urology in VSSIMSAR, Burla, Odisha.
RESULTS
Significant differences were found in operating time in minutes (45.11 ± 4.029 vs
41.99 ± 5.020, P < 0.025) between monopolar and bipolar TURP. The mean
sodium falls in post-operative period in bipolar and monopolar TURP was 7 Meq
and 3 Meq respectively which was statistically significant (P - value less than 0.05).
Bipolar TURP is equally effective as monopolar in reducing the international
prostate symptom score (IPSS), improvement in quality of life, maximum urinary
flow rate. Trans urethral resection (TUR) syndrome was reported in two patients
who had undergone monopolar resection without any incidence in bipolar group.
3 patients in monopolar group developed clot retention compared to 1 in bipolar
group in post-operative period. Fall in haemoglobin (Hb) and packed cell volume
(PCV) was more with monopolar group but insignificant.
CONCLUSIONS
Bipolar TURP is safe and equally effective as monopolar TURP with advantage of
shorter operative time and absence of dilutional hyponatremia and TUR syndrome,
but needs large randomized trials with long follow up to confirm its efficacy and
safety.
