Comparative Study of Monopolar versus Bipolar Transurethral Resection of Benign Prostate for Safety and Complications (Related to Technique) under Regional Anaesthesia

Background: Benign Prostatic Hyperplasia (BPH) is one of the most common causes of lower urinary tract symptoms in elderly men. Management of BPH includes conservative or watchful waiting, medical therapies, and surgical interventions. Monopolar transurethral resection of prostate (TURP) is considered as the surgical gold standard for BPH.TURP syndrome is a rare but most dreaded complication of TURP. The aim of the present study is to compare the safety profile of these two techniques of TURP- monopolar and bipolar in terms of incidence of TUR syndrome and other complications. Study Design: Prospective observational comparative study. Method: 23 patients in each group, total 46 patients, divided into two groups – Group M (monopolar TURP) and Group B (bipolar TURP) who underwent TURP under regional anaesthesia. Duration of surgery, blood loss, intraop complications like TUR syndrome, post-op serum electrolyte and haemoglobin level (immediate post op & 24 hrs after surgery) were analyzed. Results: The change in hemoglobin values from pre-op to immediate postoperatively was significantly more in the monopolar group(0.81+/-0.16) compared to the bipolar group(0.40+/-0.17) with a p value<0.001.Also, the change in serum sodium values was significantly more in the monopolar group(4.13+/- 1.14) compared to the bipolar group(0.83+/-0.89) with a p value<0.001. No case of TUR syndrome was recorded. The duration of surgery (62.04+/-4.07 minutes) and amount of irrigation fluid used (4.63+/-0.48 liters) was significantly lesser in the bipolar group as compared to monopolar group (66.39+/-3.38 minutes) & (5.08+/-0.45 liters) respectively p value < 0.001. Conclusion: We conclude that Bipolar TURP is better in terms of safety and complication rates compared to monopolar TURP.