Objectives: To compare bipolar and monopolar transurethral resection of the prostate (TURP) in a comparative prospective study at two urology centers. Methods: Of 212 patients with symptomatic benign prostatic hyperplasia entered prospectively into the study, 111 underwent bipolar and 101 monopolar TURP. Patients were treated in two consecutive series with each surgical method at both centers. Improvement in peak flow rate, postvoid residual, International Prostate Symptom Score, and quality of life score postoperatively and at 3, 12, 24 and 36 months, as well as long-term adverse events were compared. Regarding safety, duration of surgery, postoperative catheterization and hospitalization time, amount of fluid absorption, frequency of transurethral resection (TUR) syndrome, and risk of hemorrhage were evaluated. Results: Patient characteristics of the two series were comparable. The risk of developing TUR syndrome (p = 0.32) and bleeding tendency (p = 0.52) did not differ significantly between groups. Significant differences were seen for duration of surgery and resection speed. All functional parameters improved significantly during follow- up, with no relevant differences between surgical groups. Conclusions: Since no major differences in efficacy and safety were seen between the surgical groups, we feel that the monopolar technique still has a valuable place in TURP.

1.
Madersbacher S, Marberger M: Is transurethral resection of the prostate still justified? BJU Int 1999;83:227–237.
2.
Mebust WK, Holtgrewe HL, Cockett AT, Peters PC: Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol 1989;141:243–247.
3.
Engeler DS, Schwab C, Neyer M, Grün T, Reissigl A, Schmid HP: Bipolar versus monopolar TURP: a prospective controlled study at two urology centers. Prostate Cancer Prostatic Dis 2010;13:285–291.
4.
Eaton AC, Francis RN: The provision of transurethral prostatectomy on a day-case basis using bipolar plasma kinetic technology. BJU Int 2002;89:534–537.
5.
Patel A, Adshead JM: First clinical experience with new transurethral bipolar prostate electrosurgery resection system: controlled tissue ablation (coblation technology). J Endourol 2004;18:959–964.
6.
Ghanem AN, Ward JP: Osmotic and metabolic sequelae of volumetric overload in relation to the TUR syndrome. BJU Int 1990;66:71–78.
7.
Hahn RG: Early detection of the TUR syndrome by marking the irrigating fluid with 1% ethanol. Acta Anaesthesiol Scand 1989;33:146–151.
8.
Goel CM, Badenoch DF, Fowler CG, Blandy JP, Tiptaft RC: Transurethral resection syndrome. A prospective study. Eur Urol 1992;21:15–17.
9.
Michielsen DP, Debacker T, De Boe V, et al: Bipolar transurethral resection in saline – an alternative surgical treatment for bladder outlet obstruction? J Urol 2007;178:2035–2039.
10.
Ho HS, Cheng CW: Bipolar transurethral resection of prostate: a new reference standard? Curr Opin Urol 2008;18:50–55.
11.
Autorino R, Damiano R, Di Lorenzo G, et al: Four-year outcome of a prospective randomized trial comparing bipolar plasmakinetic and monopolar transurethral resection of the prostate. Eur Urol 2009;55:922–929.
12.
Rassweiler J, Schulze M, Stock C, Teber D, de la Rosette J: Bipolar transurethral resection of the prostate – technical modifications and early clinical experience. Minim Invasive Ther Allied Technol 2007;16:11–21.
13.
Seckiner I, Yesilli C, Akduman B, Altan K, Mungan NA: A prospective randomized study for comparing bipolar plasmakinetic resection of the prostate with standard TURP. Urol Int 2006;76:139–143.
14.
Singh H, Desai MR, Shrivastav P, Vani K: Bipolar versus monopolar transurethral resection of the prostate: randomized controlled study. J Endourol 2005;19:333–338.
15.
Chen Q, Zhang L, Fan QL, Zhou J, Peng YB, Wang Z: Bipolar transurethral resection in saline vs traditional monopolar resection of the prostate: results of a randomized trial with a 2-year follow-up. BJU Int 2010;106:1339–1343.
16.
Mamoulakis C, Ubbink DT, de la Rosette J: Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol 2009;56:798–809.
17.
Yang S, Lin WC, Chang HK, et al: Gyrus Plasmasect: is it better than monopolar transurethral resection of prostate? Urol Int 2004;73:258–261.
18.
Yoon CJ, Kim JY, Moon KH, Jung HC, Park TC: Transurethral resection of the prostate with a bipolar tissue management system compared to conventional monopolar resectoscope: one-year outcome. Yonsei Med J 2006;47:715–720.
19.
Iori F, Franco G, Leonardo C, et al: Bipolar transurethral resection of prostate: clinical and urodynamic evaluation. Urology 2008;71:252–255.
20.
Tefekli A, Muslumanoglu AY, Baykal M, Binbay M, Tas A, Altunrende F: A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. J Urol 2005;174:1339–1343.
21.
Fung BT, Li SK, Yu CF, Lau BE, Hou SS: Prospective randomized controlled trial comparing plasmakinetic vaporesection and conventional transurethral resection of the prostate. Asian J Surg 2005;28:24–28.
22.
Mamoulakis C, Skolarikos A, Schulze M, et al: Results from an international multicentre double-blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate. BJU Int 2012;109:240–248.
23.
Wendt-Nordahl G, Häcker A, Fastenmeier K, Knoll T, Reich O, Alken P, Michel MS: New bipolar resection device for transurethral resection of the prostate: first ex-vivo and in-vivo evaluation. J Endourol 2005;19:1203–1209.
24.
Rose A, Suttor S, Goebell PJ, Rossi R, Rubben H: Transurethral resection of bladder tumors and prostate enlargement in physiological saline solution (TURIS). A prospective study (in German). Urologe A 2007;46:1148–1150.
25.
Ho HS, Yip SK, Lim KB, Fook S, Foo KT, Cheng CW: A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Eur Urol 2007;52:517–522.
26.
de Sio M, Autorino R, Quarto G, et al: Gyrus bipolar versus standard monopolar transurethral resection of the prostate: a randomized prospective trial. Urology 2006;67:69–72.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.