Outcome of Monopolar versus Bipolar Transurethral Resection of Prostate

Abstract

Introduction: Transurethral resection of the prostate is the gold standard surgical treatment for benign prostatic hyperplasia with the lower urinary tract symptoms. Bipolar system is a new in technology to lower the adverse effects of monopolar system. This study was designed to find out clinic-demographic data and peri-operative outcomes of the monopolar versus bipolar transurethral resection of prostate. Methods: This prospective comparative study was conducted from June 2022 to March 2023, in the Department of Urology of Bir Hospital, National Academy of Medical Sciences, Nepal. Ethical approval of research was taken from Institutional Review Board, NAMS: Ref No. 735/2079/80. Microsoft Excel was used for descriptive analysis for clinic-demographic and outcome variable data, were presented in frequencies and percentages and their relation were analyzed by chi-square test/fisher’s exact test. A p-value of <0.05 statistically significant. Result: A total 80 patients were compared, bipolar(40 cases) and monopolar(40 cases). There were no differences in the incidence of hyponatremia, clot retention and evacuation rate, re-catheterization rate, mean hemoglobin loss, and mean length of hospital stay. The longer duration of operation time (>60 min) was observed in bipolar transurethral resection ( p=0.001). The transurethral resection syndrome was found only in M-TURP. Conclusion: Both  monopolar and bipolar transurethral resection of prostate showed no statistical differences in the amount of resected prostatic tissue, the incidence of hyponatremia, length of hospital stays, blood transfusion rate, re-catheterization rate, clot retention and evacuation rate. The shorter duration of surgery and the trans-urethral resection syndrome was observed in M-TURP.