Comparative randomized study on the efficaciousness of endoscopic bipolar prostate resection versus monopolar resection technique. 3 year follow-up

Abstract

Objective: Transurethral resection of the prostate (TURP) is the current optimal therapy for the relief of bladder outflow obstruction, with subjective and objective success rate of 85 to 90%. Aim of this study was to evaluate efficacy and safety of Plasmakinetic energy (Gyrus electro surgical system), which produces vaporization of tissue immersed in isotonic saline against standard monopolar transurethral resection of the prostate. Results: Comparative data on IPSS symptom score, IIEF-5, Qol, PSA, peak urinary flow rate and post-void residual urine volume were similar in the two groups but showed a significant improvement respect to baseline values. The postoperative haemoglobin levels, postoperative catheterization time, hospital stay and 3-year overall surgical re-treatment-free rate were significantly better in the bipolar group. Conclusions: Bipolar TURP has a comparable outcome to standard monopolar TURP at short and medium term regard to subjective and objective outcome measurements. Its impact on bladder outlet function is also similar to that of monopolar TURP. Improvement in IPSS, Qol index, IIEF-5, Q max and post-void residual urine volume were comparable in both group denoting similar efficacy of the techniques.

Bipolar Transurethral Resection Versus Monopolar Transurethral Resection for Benign Prostatic Hypertrophy: A Systematic Review and Meta-Analysis

“…8 In recent years (2009-2013), a number of new RCTs, including multicenter and international studies, have been published. [9][10][11][12][13][14][15][16][17][18][19][20][21][22] Therefore, it is necessary to conduct a new systematic review and metaanalysis of RCTs that assesses the efficacy and safety (primary outcomes) of M-TURP and B-TURP in patients with BPO.…”

Bipolar versus Monopolar Transurethral Resection of Prostate (TURP), Advantages and Disadvantages in 6-Month Follow-Up

“…In TURP, by bipolar technology, the surgeon has a clearer field (4). There are many studies that reported greater amount of blood loss during monopolar TURP in contrast with bipolar TURP (10).…”

“…However, several maleffects such as warming of deeper tissue and provocation of nerves and muscles may happen (3). In bipolar system, for the reason of putting the positive and negative electrode on the same axis of resectoscope and applying high local electrical current, accompanied with less negative effects at distance axis (4).…”

Complicaciones infecciosas después de prostatectomía abierta y resección transuretral de próstata en pacientes con hiperplasia prostática benigna

“…La Asociación Europea de Urología la recomienda cuando la próstata tiene entre 30 y 80 mL (12,20). Los resultados de las técnicas monopolar y bipolar para llevarla a cabo son muy similares, pero, al parecer, la bipolar tiene un perfil de seguridad más favorable, ausencia del síndrome de pos-RTUP, menos sangrado intraquirúrgico y posoperatorio y menor tasa de retención aguda de orina (RAO) por coágulos (17,(19)(20)(21)(22).…”