A short-term evaluation of the safety and the efficacy of bipolar transurethral resection of the prostate in patients with a large prostate (>90 g)

OBJECTIVE: To evaluate the efficacy and safety of bipolar transurethral resection of the prostate (TURP) in patients with a large prostate (>90 g), as a significant recent modification of TURP is the incorporation of bipolar technology, which uses the same technique as monopolar TURP but with normal saline as the irrigant. PATIENTS AND METHODS: Forty patients with a prostate of >90 g and who were considered at risk for monopolar TURP were treated by bipolar TURP. The operative duration, resection time, resected tissue weight, resection rate, resection ratio, amount of irrigation fluid used, the decrease in intraoperative haemoglobin level, haematocrit and serum sodium levels, and the blood loss were recorded. The follow-up data were analysed. RESULTS: The mean (SD) operative duration was 116.3 (25.52) min, the resection time was 106.5 (25.69) min, the resected volume was 78.9 (20.58) g, the decrease in haemoglobin levels was 1.67 (0.46) g/dL, the mean serum sodium decline was 2.60 (0.68) mmol/L, and the blood loss was 532 (101.2) mL. The blood loss/g of resected tissue was 6.85 (0.70) mL. The mean (SD) postoperative bladder irrigation time was 2.0 (0.32) days, the catheterisation time was 3.25 (0.55) days and the postoperative hospital stay was 3.25 (0.55) days. CONCLUSION: Bipolar technology makes it possible to use TURP to treat patients with very large prostates and who are at risk when treated by the standard monopolar technology, with a satisfactory safety profile and with favourable efficacy.