Samer Fathi Al-Rawashdah1,2, Antonio Luigi Pastore3,4, Yazan Al Salhi2, Andrea Fuschi2, Vincenzo Petrozza5, Angela Maurizi6, Ester Illiano7, Elisabetta Costantini7, Giovanni Palleschi2,8, Antonio Carbone2,8. 1. Urology Unit, Department of Special Surgery, Mutah University, Karak, Jordan. 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. 3. 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. antopast@hotmail.com. 4. Uroresearch, No Profit Research Association, Latina, Italy. antopast@hotmail.com. 5. Pathology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy. 6. Department of Urology, Sapienza University of Rome, Rome, Italy. 7. Department of Urology and Andrology, University of Perugia, Perugia, Italy. 8. Uroresearch, No Profit Research Association, Latina, Italy.
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) ormonopolar (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.
RCT Entities:
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.
Authors: Francesco Iori; Giorgio Franco; Costantino Leonardo; Cesare Laurenti; Andrea Tubaro; Francesco D-Amico; Danilo Dini; Cosimo De Nunzio Journal: Urology Date: 2008-02 Impact factor: 2.649
Authors: Sascha A Ahyai; Peter Gilling; Steven A Kaplan; Rainer M Kuntz; Stephan Madersbacher; Francesco Montorsi; Mark J Speakman; Christian G Stief Journal: Eur Urol Date: 2010-06-11 Impact factor: 20.096