Evaluation of sexual function following bipolar vaporization versus monopolar transurethral resection of the prostate

Abstract

Background: Little light has been shed on erectile functions following bipolar vaporization of the prostate. Patients and Methods: A prospective study was conducted that included 100 cases with a history of endoscopic prostatic surgery. Cases were allocated into two groups: group I included 50 patients who were subjected to the conventional monopolar transurethral resection of the prostate (TURP), and group II included 50 patients who were subjected to bipolar vaporization of the prostate. All patient were assessed 3 and 6months after the operation.Severity of benign prostatic hypertrophy symptoms and erectile function were reassessed using International Prostate Symptom Score and International Index of Erectile Function-5 (IIEF-5), respectively. Results: Although all patients in both groups demonstrated significantly lower IIEF-5 scores 3months postoperatively (P<0.0001), the percentage of IIEF-5 score reduction was insignificantly different between both groups. No significant differences were found at the 6-month follow-up. The erectile fraction (EF) in group II (bipolar vaporization group) was slightly better, yet insignificantly different from group I. The incidence of complications (TURP syndrome, bladder perforation, intraoperative bleeding, postoperative bleeding, and postoperative urinary tract infection) in group I (monopolar TURP) was significantly higher than the incidence in group II (bipolar vaporization). Among the study variables, it seems that diabetes mellitus and hypertension and development of postoperative complications (especially intraoperative bleeding, capsular perforation, and urinary tract infection) were significantly associated with development of postoperative erectile dysfunction (ED). Conclusion: No significant difference was found regarding sexual function following monopolar TURP and the bipolar vaporization of the prostate. However, the bipolar TURP is safer with less complications.