Bipolar Transurethral Resection of the Prostate—A New Approach

Abstract

Benign prostatic hyperplasia (BPH) is a common problem among older men. Transurethral resection of the prostate (TURP) is a common surgical procedure for treatment of BPH. Typically, TURP is performed using monopolar electric current and a wire electrode; however, the irrigating solution used during this procedure has the potential to cause transurethral resection (TUR) syndrome. A new technology uses bipolar electrosurgery, which creates less risk of electrical shock, and saline irrigation, which eliminates the risk for TUR syndrome.

Bipolar versus monopolar TURP: a prospective controlled study at two urology centers

“…1,9,10,14 The differences between the two groups with regard to IPSS and Q-max-as the most important subjective and objective measures of the outcome of surgery-were not statistically significant. There were also no significant differences for QoL scores related to micturition.…”

“…By 2007, the median number of years of experience in urology was 10 years (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Patients in both study arms were treated by the same surgeons.…”

“…The absence of reverse current is intended to decrease the risk of burns and subsequent stricture formation. 8,9 Studies already published have described advantages of bipolar resection with regard to the frequency of the TUR syndrome, 1,2,10-13 intraoperative absorption of fluid, risk of hemorrhage, 14 duration of postoperative indwelling catheter irrigation, duration of catheterization and duration of hospitalization. 2,9,11,15 The duration of surgery, improvement in Q-max, residual urine volume, IPSS and QoL score have, however, been reported as similar to the monopolar approach.…”

“…2,9,11,15 The duration of surgery, improvement in Q-max, residual urine volume, IPSS and QoL score have, however, been reported as similar to the monopolar approach. 12,14 …”

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

“…The bipolar electrosurgical equipment simultaneously vaporizes tissue during resection, which controls bleeding as it effectively and accurately seals all bleeding points 8101415. The plasmakinetic system, however, uses a smaller loop compared with the conventional TURP, which requires more strokes for every unit volume of prostate resected 916–18. This explains the insignificant operative time difference between the two groups despite the advantage of better hemostasis 91718…”