Monopolar Transurethral Resection of the Prostate versus Bipolar Resection for Mild to Moderate Benign Prostatic Enlargement: A Randomized Controlled Study

Objective: To compare the safety and efficacy of monopolar transurethral resection of the prostate (M-TURP) versus bipolar transurethral resection of the prostate (B-TURP) in patients with benign prostatic hyperplasia (BPH) and prostate volumes between 30 and 80 ml scheduled for endoscopic resection. Methods: In this prospective, randomized, parallel-group study, 120 patients with prostate volumes >30 ml and ≤80 ml were enrolled. Participants were randomly assigned into two equal groups: Group A (control) underwent M-TURP, while Group B (study) received B-TURP. All patients underwent clinical evaluation, including preoperative transrectal ultrasound for prostate volume measurement, with intraoperative documentation of resection time, total operative duration, and weight of resected tissue. Results: Quality of life (QoL) scores at 1 and 6 months postoperatively were significantly improved in Group B compared with Group A (P = 0.006 and 0.003, respectively). Maximum urinary flow rate (Qmax) at 1 and 6 months was significantly higher in Group B (P = 0.002 and <0.001). International Prostate Symptom Score (IPSS) and post-void residual urine (PVRU) at 1 and 6 months were significantly lower in Group B (P < 0.05). Postoperative hemoglobin decline was also significantly less in Group B compared with Group A (P < 0.001). Conclusions: B-TURP provided superior safety and faster recovery compared with M-TURP for prostates 30–80 mL, while maintaining equivalent efficacy.