Comparison of the results of monopolar and bipolar transurethral resection of prostate.

Abstract

Objective: To compare the results of using bipolar versus monopolar diathermy during TURP. Study Design: Comparative, Cross-sectional study. Setting: Department of Urology, Shahida Islam Teaching Hospital, Lodhran. Period: January 2025 to June 2025. Methods: Total 98 male patients weighing 40 to 80 grams who have an enlarged prostate and mild to severe LUTS were all included. Exclusion criteria were uremia, bleeding disorders, untreated urinary tract infections, prostate cancer (Abnormal DRE), and prior prostate surgery. Forty-nine patients had monopolar TURP treatment using 1.5% glycine as an irrigating solution in group A, and forty-nine patients received bipolar TURP treatment using normal saline as an irrigating solution in group B. Hemoglobin levels from blood samples obtained before to spinal anesthesia and six hours after surgery were subtracted to determine the drop in hemoglobin levels. By deducting the sodium level from blood samples obtained prior to spinal anesthesia and six hours after surgery, the difference in serum sodium levels was evaluated. If the postoperative serum sodium content was less than 125 mmol/l, or if the clinical symptoms were evaluated, TURP syndrome was diagnosed. Results: In our investigation, the bipolar group experienced a drop in hemoglobin (g/dl) of 0.73 ± 0.19 and a mean operative time of 32.49 ± 7.05 minutes and 1.69 ± 0.35 (g/dl) compared to 25.63 ± 5.38 minutes and 0.73 ± 0.19 (g/dl) for the monopolar group. The mean decrease in serum sodium levels (mEq/L) for the bipolar group was significantly less than that of the monopolar group (3.46 ± 0.74 vs. 1.06 ± 0.22 mEq/L). The B-TURP group did not exhibit TUR syndrome (p = 0.153), but 02 (4.08%) individuals in the M-TURP group exhibited TUR syndrome in our study. Conclusion: According to this study, TUR-P syndrome, a decline in serum sodium levels, and hemoglobin levels are less common after bipolar TURP than after monopolar TURP.