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• W2090151316 abstract "No AccessJournal of UrologyNew Technology and Techniques1 Apr 2015Bipolar Versus Monopolar Transurethral Resection of the Prostate: A Prospective Randomized Trial Focusing on Bleeding Complications P. Stucki, L. Marini, A. Mattei, K. Xafis, M. Boldini, and H. Danuser P. StuckiP. Stucki Equal study contribution. More articles by this author , L. MariniL. Marini Equal study contribution. More articles by this author , A. MatteiA. Mattei More articles by this author , K. XafisK. Xafis More articles by this author , M. BoldiniM. Boldini More articles by this author , and H. DanuserH. Danuser More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.08.137AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compare monopolar vs bipolar transurethral resection of the prostate in patients with benign prostatic hyperplasia, focusing on functional outcomes as well as rates of bleeding complications and the transurethral resection syndrome. Materials and Methods: A total of 137 patients with benign prostatic hyperplasia (mean age 67 years, range 47 to 91) were prospectively randomly assigned to undergo monopolar (67) or bipolar (70) transurethral resection of the prostate. Patient characteristics of the 2 groups were similar. Hemoglobin (as a marker of blood loss) was measured preoperatively and perioperatively. I-PSS, I-PSS-QoL score, maximal flow rate and post-void residual urine volume were assessed preoperatively and 3 and 12 months postoperatively. Duration of surgery, indwelling catheter use and hospitalization were also documented, as were postoperative clot retention requiring removal by catheterization or surgery, and rates of bladder neck and/or urethral strictures. Results: No significant perioperative differences were found in duration of surgery, catheterization or hospitalization, or in blood loss or rates of blood transfusion and transurethral resection syndrome. Postoperatively there were no significant differences in I-PSS or I-PSS-QoL scores, or rates of rehospitalization, clot retention, blood transfusions, reoperation or urethral strictures. However, bladder neck stricture occurred significantly more often in the bipolar group (8.5% vs 0%, p = 0.02). The 3 and 12-month followup showed significant and equal improvement in micturition in the 2 groups. Conclusions: Bipolar and monopolar transurethral resection of the prostate are effective and safe techniques for the surgical treatment of benign prostatic hyperplasia. The only significant difference between them was a significantly higher rate of bladder neck strictures with bipolar resection of the prostate. References 1 : Natural history of benign prostatic hyperplasia. Urology2001; 58: 5. Google Scholar 2 : Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol1989; 141: 243. Link, Google Scholar 3 : Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol2008; 180: 246. Link, Google Scholar 4 : Techniques and long-term results of surgical procedures for BPH. Eur Urol2006; 49: 970. Google Scholar 5 : Reoperation, myocardial infarction and mortality after urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of transurethral resection of prostate for bladder outlet obstruction. Eur Urol2005; 47: 499. Google Scholar 6 : Bipolar transurethral resection of the prostate: the ‘golden standard’ reclaims its leading position. Curr Opin Urol2009; 19: 26. Google Scholar 7 : Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol2009; 56: 798. Google Scholar 8 : New bipolar resection device for transurethral resection of the prostate: first ex-vivo and in-vivo evaluation. J Endourol2005; 19: 1203. Google Scholar 9 : Bipolar versus monopolar transurethral resection of prostate: pathologic study in canines. Urology2007; 70: 180. Google Scholar 10 : Transurethral resection syndrome: effect of the clinical practice of a new method for monitoring fluid absorption. J Clin Anesth1998; 10: 360. Google Scholar 11 : A multicentre single-blind randomized controlled trial comparing bipolar and monopolar transurethral resection of the prostate. Can Urol Assoc J2011; 5: 385. Google Scholar 12 : Bipolar transurethral resection of the prostate: technical modifications and early clinical experience. Minim Invasive Ther Allied Technol2007; 16: 11. Google Scholar 13 : Bipolar transurethral resection of prostate: a new reference standard?. Curr Opin Urol2008; 18: 50. Google Scholar 14 : Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol2010; 58: 384. Google Scholar 15 : Gyrus bipolar versus standard monopolar transurethral resection of the prostate: a randomized prospective trial. Urology2006; 67: 69. Google Scholar 16 : Complications of transurethral resection of the prostate (TURP): incidence, management, and prevention. Eur Urol2006; 50: 969. Google Scholar 17 : A hybrid technique using bipolar energy in transurethral prostate surgery: a prospective, randomized comparison. J Urol2005; 174: 1339. Link, Google Scholar 18 : Urethral strictures and bipolar transurethral resection in saline of the prostate: fact or fiction?. J Endourol2010; 24: 1333. Google Scholar 19 : Die transurethrale elektroresektion der prostata. Akt Urol2002; 33: 469. Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4April 2015Page: 1371-1376 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsrandomized controlled trialtransurethral resection of prostatetreatment outcomehemorrhageMetricsAuthor Information P. Stucki Equal study contribution. More articles by this author L. Marini Equal study contribution. More articles by this author A. Mattei More articles by this author K. Xafis More articles by this author M. Boldini More articles by this author H. Danuser More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2090151316 title "Bipolar Versus Monopolar Transurethral Resection of the Prostate: A Prospective Randomized Trial Focusing on Bleeding Complications" @default.
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