Safety and efficacy of bipolar transurethral resection of the prostate versus monopolar transurethral resection of prostate in the treatment of moderate-large volume prostatic hyperplasia: a systematic review and meta-analysis.

Bruce, Angus, Krishan, Anil, Sadiq, Salman, Ehsanullah, Syed Ali and Khashaba, Shehab (2020) Safety and efficacy of bipolar transurethral resection of the prostate versus monopolar transurethral resection of prostate in the treatment of moderate-large volume prostatic hyperplasia: a systematic review and meta-analysis. Journal of endourology. ISSN 1557-900X. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

AIMS

To compare outcomes of monopolar versus bipolar transurethral resection of the prostate (TURP) in the management of exclusively moderate-large-volume prostatic hyperplasia in terms of maximum flow rate as a surrogate for clinical efficacy, duration of catheterization, hospital stay, operative time, resection weight, Trans Urethral Resection (TUR) syndrome, acute urinary retention (AUR), clot retention and blood transfusion. Methods We conducted a search of electronic databases (PubMed, MEDLINE, EMBASE, CINAHL and CENTRAL), identifying studies comparing the outcomes of monopolar and bipolar TURP in the management of large-volume prostatic hyperplasia. The Cochrane risk-of-bias tool for randomised control trials (RCTs) and the Newcastle-Ottawa scale for observational studies were used to assess included studies. Random effects modelling was used to calculate pooled outcome data. Results Three RCTs and four observational studies were identified, enrolling 496 patients. No difference was observed in the clinical efficacy between each procedure at 3 months postoperatively (P=0.99), 6 months (P=0.46) and 12 months (P=0.29). The use of bipolar TURP was associated with significantly shorter inpatient stay (P=0.01) and a shorter duration of catheterisation (P=0.05). Monopolar TURP was associated with an increased risk of TUR syndrome (P=0.03). Operative time (P=0.58), resection weight (P=0.16), acute urinary retention (P=0.96), clot retention (P=0.79) and blood transfusion (P=0.39), were similar in both groups. Conclusion Our meta-analysis demonstrated that bipolar TURP in the treatment of moderate-large volume prostatic disease may be associated with a significantly lower rate of TUR syndrome and shortened length of hospital stay, with similar efficacy when compared with monopolar TURP. Further high quality RCTs with adequate sample sizes are required in order to compare both monopolar and bipolar TURP to open prostatectomy or laser enucleation in the treatment of exclusively large-volume prostates with stricter definition of size.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WJ Urogenital system. Urology
Divisions: Planned IP Care > Urology
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Depositing User: Jamie Edgar
Date Deposited: 24 Nov 2020 13:56
Last Modified: 24 Nov 2020 13:56
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3714

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