A multicentre single-blind randomized controlled trial comparing bipolar and monopolar transurethral resection of the prostate
Introduction: Monopolar transurethral resection of the prostate
(TURP) is the gold standard surgical therapy for men with lower urinary
tract symptoms due to benign prostatic hyperplasia. Although
generally considered safer, TURP experience is limited in Canada.
Methods: Forty-three patients from 5 Canadian centres were randomized
to TURP with either bipolar or monopolar platforms.
Patients underwent baseline determinations of American Urological
Association (AUA) symptom score, peak urinary flow rate, postvoid
residual bladder volume and transrectal ultrasound prostate
volume. Primary outcome measures were improvement in AUA
symptom score, quality of life assessment and bother assessment.
Secondary outcomes included procedural times, duration of catheterization,
length of hospitalization, complications and the degree
of thermal artifact in tissue specimens. Patients were followed for
Results: Twenty-two patients were treated with bipolar and 21 with
monopolar TURP. Preoperative demographics were not statistically
different between groups. Postoperative data collection times were
equivalent in AUA symptom, quality of life, bother and sexual
function assessments. No differences were observed in the procedure
time (60.7 min, bipolar vs. 47.4, monopolar) or the duration
of urethral catheterization (1.5 days, bipolar vs. 1.1, monopolar).
More patients in the bipolar group were discharged on the same
day of surgery. There were no differences in the degree of tissue
thermal artifact or complication rate.
Conclusion: This trial suggests equivalent short-term outcomes for
men undergoing monopolar or bipolar TURP.
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