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

Alexander, Cameron E.; Scullion, Malo M.F.; Omar, Muhammad Imran; Yuan, Yuhong; Mamoulakis, Charalampos; N’Dow, James; Chen, Changhao; Lam, Thomas

doi:10.1002/14651858.cd009629.pub4

Cited by 41 publications

(22 citation statements)

References 160 publications

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“…In a Cochrane review of 59 randomized trials that compared monopolar and bipolar TURP, it was stated that incidence of TURP syndrome is more in monopolar TURP group as compared to bipolar TURP group. 9 Patients who were operated by bipolar TURP stayed in hospital for a mean duration of 2.07 days in compared to patients operated by monopolar TURP which stayed for duration of 3.5 days in hospital. The difference in post op hospital stay is statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Maurya

Kumar

2021

Asian J Med Sci

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Background: Transurethral resection of prostate is considered as gold standard surgical procedure for treatment of benign enlargement of prostate. It can be performed in two forms- monopolar transurethral resection and bipolar transurethral resection. Aims and Objective: This study was conducted to know which energy source among monopolar and bipolar energy leads to more post-operative morbidity after performing transurethral resection of prostate. Materials and Methods: In this study, total eighty (80) cases were included. They were suffering from lower urinary tract symptoms which were diagnosed to be due to benign enlargement of prostate after careful clinical and radiological examination. In forty cases, transurethral resection of prostate was performed by using monopolar energy source and in another forty cases, resection of prostate by transurethral route was done using bipolar energy source. Results: In our study, we found that development of TURP syndrome was more in monopolar TURP group in which pre-operative weight of prostate was more than 50 grams in comparison to bipolar TURP group in which there was no incidence of development of TURP syndrome in same class. Further, post-operative hospital stay and post-operative urethral catheter in situ was less in bipolar TURP group in terms of days as compared to monopolar TURP group. Conclusion: Our study concludes that Bipolar TURP is better in terms of development of less post-operative morbidity as compared to monopolar TURP. Bipolar TURP must be used extensively in teaching hospitals where students take more time than a seasoned surgeon to perform a surgical procedure and bipolar TURP will come handy in that situation.

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Section: Discussionmentioning

confidence: 99%

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Maurya

Kumar

2021

Asian J Med Sci

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“…10 A recent Cochrane review of 59 randomized controlled trial comparing monopolar TURP to B-TURP, concluded that both currents result in comparable improvement of the urological symptoms; however, B-TURP is associated with lower risk of TUR syndrome and blood transfusion. 11 In this setting, we evaluated the use of B-TURP in the management of prostates more than 100 g in size showing that it is a safe and efficient technology even for large prostates.…”

Section: Discussionmentioning

confidence: 99%

Bipolar transurethral resection of large prostate >100 gm: single center experience

et al. 2021

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Background: Benign prostatic hyperplasia (BPH) is a common urological finding in aged men. It may be associated with deterioration of the patient’s quality of life as it may cause lower urinary tract symptoms (LUTS), urinary retention, and deterioration of the renal function. The gold standard treatment option is transurethral resection of prostate (TURP) in patients with prostate up to 80g in size. However, in larger prostates (>80 g), laser or bipolar enucleation of the prostate is considered the treatment of choice. In this setting, we decided to report a single center experience with bipolar TURP for large prostates (>100 g).Methods: The database of our center was retrospectively reviewed to identify all the patients undergoing bipolar TURP for large prostates (>100 g) between January 2018 and January 2019. The following data was collected, age, prostate size in grams, urinalysis and culture. Moreover, the operative time, resected tissue weight, complications, hospitalization, and catheterization times were also collected Furthermore, urinary tract ultrasound (including the assessment of post voiding residual urine [PVR]), uroflowmetry (including the peak urinary flow [Qmax]), and IPSS were assessed preoperatively, at one, and 12 months postoperatively.Results: Eight were retrieved from the database and were included in the current study. The median prostate size was 115 grams. All cases were completed by B-TURP without the need for conversion to open prostatectomy and the operative time ranged from 65 to 90 minutes. All the patients showed significant improvement of the IPSS, Qmax, and PVR at one and 12 months follow up. Only three patients in the current series (37.5%) suffered from complications. Conclusions: B-TURP can be used safely for the management of large prostates (>100 g); however, further studies are required to confirm these results.

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“… Surgery should be offered as a primary modality for patients presenting with complications arising secondary to BPH such as renal insufficiency, refractory urinary retention, recurrent urinary tract infections, recurrent bladder stones, and gross hematuria (GR strong) Surgery shall be offered as an alternative to patients presenting with moderate-to-severe LUTS who failed to respond to medical management and who are not tolerant or compliant to medical management (GR optional) Open prostatectomy shall be offered for treatment of moderate-to-severe LUTS in men with prostate size >80–100 ml if endoscopic enucleation techniques are not available or are deemed unsuitable for the patient[ 23 24 ] (GR selective) Transurethral resection of prostate (TURP) should be offered to treat moderate-to-severe LUTS in men with prostate size 30–80 ml[ 25 ] (GR strong) Transurethral incision of prostate should be offered to treat LUTS in men with prostate size <30 ml, in absence of a median lobe[ 26 ] (GR strong) Bipolar TURP may be offered to treat moderate-to-severe LUTS in men with prostate size 30–80 ml based on equipment availability, surgeon's experience, and patient's choice[ 27 ] (GR optional) Holmium laser enucleation of prostate (HOLEP) should be offered to treat moderate-to-severe LUTS in men as size-independent modality as an alternative to TURP. HOLEP is especially beneficial offered to treat moderate-to-severe LUTS in men with prostate size >80 ml.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Bipolar TURP may be offered to treat moderate-to-severe LUTS in men with prostate size 30–80 ml based on equipment availability, surgeon's experience, and patient's choice[ 27 ] (GR optional)…”

Section: Surgical Treatmentmentioning

confidence: 99%

The Urological Society of India guidelines on management of benign prostatic hyperplasia/benign prostatic obstruction (Executive summary)

2021

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

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

Cited by 41 publications

References 160 publications

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Bipolar TURP decreases post-operative morbidity – A prospective study in a tertiary care hospital from north India

Bipolar transurethral resection of large prostate >100 gm: single center experience

The Urological Society of India guidelines on management of benign prostatic hyperplasia/benign prostatic obstruction (Executive summary)

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