Comparison between monopolar and bipolar transurethral resection of the prostate for benign prostatic hyperplasia – A randomized controlled study

Abstract

Introduction: Benign prostate hyperplasia (BPH) is characterized by an unregulated proliferation of smooth muscle, glandular epithelium and connective tissue within the prostate. In Surgical intervention Monopolar TURP and Bipolar TURP are safe, standard and effective techniques. Both are widely used in the surgical treatment for BPH. B-TURP is the new benchmark modality which has decreased incidence of hyponatremia and bleeding. Objectives: To compare the clinical outcomes of the two procedures with respect to Efficacy of the procedures in relation to resected prostatic tissue, Resection time, IPSS, Qmax, Fall in Serum Sodium in the post-operative period and post-op complications. Material and Methods: The present study was conducted in the Department of Surgery, Rohilkhand Medical College and Hospital, Bareilly with the objective to compare the clinical efficacy and safety of M-TURP and B-TURP. 118 patients were randomly divided into two groups. Randomization was done using the software available at http://www.randomizer.org/. There were 59 patients in each group. Results: The mean change in hemoglobin and serum sodium was significantly (p<0.05) more in the M-TURP group. The resection time with significantly less in M-TURP and the mean post-operative Q-max (ml/sec) was 17.42±1.23 and 17.97±0.94 in M-TURP and B-TURP respectively with significant difference (p=0.008). The mean Post void residual urine was significantly higher in M-TURP (76.61ml) than in B-TURP (67.56 ml) group (p<0.05) post-operatively. Conclusion: Overall, the results of M-TURP and B-TURP are generally similar. Hemoglobin and serum sodium decreased more post-operatively in M-TURP. The complication rate was low in both the groups but TUR syndrome occurred only in M-TURP patients. Both methods can be used safely in BPH surgery, but B-TURP is safer in long duration surgery. QOL was statistically similar in M-TURP and B-TURP and significantly improved in both the groups.