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Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36-month outcomes

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Abstract

Objectives

Monopolar transurethral resection of the prostate (TURP) is the gold standard surgical treatment for bothersome moderate to severe lower urinary tract symptoms (LUTS) secondary to benign prostate obstruction. The aim of the study is to compare monopolar versus bipolar TURP focusing on operative and functional outcomes, and evaluating complications with a long-term follow-up.

Methods

From January 2007 to July 2014, a total of 497 patients were randomized and prospectively scheduled to undergo bipolar (251) or monopolar (246) TURP. International prostate symptom score (IPSS), IPSS-Quality of life (QoL), post-void residual and maximum flow rate were assessed preoperatively and postoperatively at 3, 12, 24 and 36 months. Operative time, length of catheterization and hospitalization were all recorded. Complications were classified and reported.

Results

All patients completed the 36-month follow-up visit. Perioperative results showed no statistical significance between the two groups in terms of catheterization days, post-void residual, IPSS, IPSS-QoL score. The hospitalization length was found statistically significant in favor of the bipolar group. The 3-, 12-, 24- and 36-month follow-up showed significant and equal improvements in LUTS related to BPO in the two treatment groups. Regarding TURP complications, significant differences were observed in relation to urethral strictures, blood transfusion and TUR syndrome in favor of the bipolar group.

Conclusions

Monopolar and bipolar TURP are safe and effective techniques for BPH management. Bipolar TURP in our prospective study reported the same efficacy of monopolar prostate resection, with a significant reduction of related complications.

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Acknowledgements

The authors declare that the development of the manuscript was not supported by honorarium, grant, or any other sources of support, including sponsorship or any material sources of support.

Author contributions

ALP; GP; AF; YAS; SAR carried out the data collection, and drafted the manuscript. SAR; ALP;GP; AF; AM; EI performed the statistical analysis. VP, EC, ALP; GP; AC conceived of the study, and participated in its design and coordination and helped to draft the manuscript.

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Author notes

    Authors and Affiliations

    1. Urology Unit, Department of Special Surgery, Mutah University, Karak, Jordan

      Samer Fathi Al-Rawashdah

    2. Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy

      Samer Fathi Al-Rawashdah, Antonio Luigi Pastore, Yazan Al Salhi, Andrea Fuschi, Giovanni Palleschi & Antonio Carbone

    3. Uroresearch, No Profit Research Association, Latina, Italy

      Antonio Luigi Pastore, Giovanni Palleschi & Antonio Carbone

    4. Pathology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy

      Vincenzo Petrozza

    5. Department of Urology, Sapienza University of Rome, Rome, Italy

      Angela Maurizi

    6. Department of Urology and Andrology, University of Perugia, Perugia, Italy

      Ester Illiano & Elisabetta Costantini

    Authors
    1. Samer Fathi Al-Rawashdah
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    Correspondence to Antonio Luigi Pastore.

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    Competing interest

    All authors declare no competing interests.

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    The authors declare that they have no conflict of interest.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    S. F. Al-Rawashdah and A. L. Pastore equally contributed to the drafting of the manuscript, so they both have to be considered as first authors.

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    Cite this article

    Al-Rawashdah, S.F., Pastore, A.L., Salhi, Y.A. et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36-month outcomes. World J Urol 35, 1595–1601 (2017). https://doi.org/10.1007/s00345-017-2023-7

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    • DOI: https://doi.org/10.1007/s00345-017-2023-7

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