Korean J Urol.  2011 Apr;52(4):269-273.

Comparison of Effectiveness of Monopolar and Bipolar Transurethral Resection of the Prostate and Open Prostatectomy in Large Benign Prostatic Hyperplasia

• Kwon JS
• Lee JW
• Lee SW
• Choi HY
• Moon HS

Abstract

PURPOSE
Transurethral resection of the prostate (TURP) is still considered the gold standard in the treatment of benign prostatic hyperplasia (BPH). However, open prostatectomy is indicated for prostate glands over 75 ml. There have been few reports concerning the use of TURP for large prostate glands over 100 ml. Herein we compared the effectiveness of monopolar TURP, bipolar TURP, and open prostatectomy in prostate glands larger than 100 ml.
MATERIALS AND METHODS
We reviewed the data of 48 patients with prostate glands larger than 100 ml. A total of 19, 17, and 12 patients underwent monopolar TURP (group A), bipolar TURP (group B), or open prostatectomy (group C), respectively. Preoperative International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), prostate volume, resected tissue volume, resection velocity, and operative time were documented. Postoperative hemoglobin, serum sodium change, hospital stay, and postoperative 6-month IPSS and Qmax were evaluated.
RESULTS
The prostate volumes did not differ significantly among the three groups. Operative time was similar in the two TURP groups, but open prostatectomy required a longer operative time. There was no significant difference in the resected prostate tissue or resection velocity between the two TURP groups. There was a marked decrease in postoperative serum sodium in the monopolar group compared with the other two groups. Among the groups, bipolar TURP required a shorter hospitalization. Postoperative IPSS, quality of life (QoL), and Qmax improved significantly in all groups.
CONCLUSIONS
Even for large prostate glands, the results of this study suggest that bipolar TURP is an effective and safe operation owing to the significant improvements in voiding symptoms, shorter hospitalization, and fewer complications such as transurethral resection syndrome.

Keyword

Complications; Prostatic hyperplasia; Transurethral resection of prostate

MeSH Terms

Hemoglobins
Hospitalization
Humans
Length of Stay
Operative Time
Prostate
Prostatectomy
Prostatic Hyperplasia
Quality of Life
Sodium
Transurethral Resection of Prostate
Hemoglobins
Sodium

Figure

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  FIG. 1 Perioperative change in serum sodium level among the groups.

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