Comparison of Bipolar and Monopolar Transurethral Resection of the Prostate, Functional Outcomes and Analysis of Factors Predictive of Complications: A Prospective Study

Introduction: In Morocco, RTUP-m is considered the gold standard for the surgical treatment of prostate adenomas, recommended for prostates with a volume suitable for resection in less than 60 minutes. Additionally, the challenge arises when dealing with patients on antiplatelet or anticoagulant medications due to the associated risk of bleeding, hence the significance of RTUP-b. The objective of our study is to compare the functional outcomes and immediate postoperative complications between these two techniques and to identify predictive factors for complications. Methods: This is a prospective randomized study conducted between January 2022 and September 2022. The variables age, BMI, surgical indication, transrectal prostate volume, ASA classification (American Society of Anesthesiologists), previous pharmacological treatments, IPSS score, quality of life index (QLI), maximum flow rate (Qmax) and postoperative complications were collected. The Chi2 test and Student's t-test were used for statistical analysis. Results: Sixty-nine consecutive patients were included, 38 patients in the monopolar TURP group and 31 in the bipolar TURP group. Both groups were homogeneous in their baseline characteristics. The overall pre-surgical IPSS/QLI/Qmax score was 24,03/4,73/9,47. Functional results at 1st and 3rd month are shown in Table 1. For complications, see Table 2 and 3. These differences were not statistically significant (p = 0,427): the most frequent were hematuria (9,4%) and febrile urinary tract infections (9,4%). Only one patient presented hyponatremia due to glycocol reabsorption in the monopolar group. All complications were Clavien 1 or 2. We found no significant differences between the two groups with regard to complications or their predictive factors. Conclusion: Analysis of our data over the first three months reveals no differences between the two techniques in terms of functional results and postoperative complications, and there are no predictive .........