Clinical Outcomes of Monopolar Versus Bipolar Transurethral Resection of the Prostate for Benign Prostatic Enlargement: A Prospective Comparative Study.

Benign prostatic enlargement (BPE) is a common cause of lower urinary tract symptoms (LUTS) in older men, and transurethral resection of the prostate (TURP) remains an established surgical treatment when conservative management is inadequate. However, uncertainty persists regarding whether bipolar TURP offers meaningful perioperative safety advantages without compromising functional efficacy. This prospective, non-randomized comparative study evaluated monopolar and saline bipolar TURP in 100 patients, including 50 (50%) patients in the monopolar group and 50 (50%) patients in the bipolar group. Preoperative and one-month postoperative assessments included International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate, hemoglobin, packed cell volume (PCV), serum sodium, resection time, and early postoperative complications. Both techniques produced substantial and broadly comparable functional improvement. Maximum urinary flow rate increased from 9.76 to 17.74 mL/s after monopolar TURP and from 9.55 to 17.54 mL/s after bipolar TURP. International Prostate Symptom Score decreased by 10.50 and 9.54 points, while quality-of-life score improved by 2.08 and 2.04 points, respectively. Bipolar TURP required a longer mean resection time than monopolar TURP (44.92 versus 41.74 minutes; p=0.001). Postoperative serum sodium declined more markedly after monopolar TURP, and transurethral resection syndrome occurred in 2 (4%) patients in the monopolar group and 0 (0%) patients in the bipolar group. Hemoglobin and packed cell volume reductions were modest in both groups. Overall, bipolar TURP preserved short-term functional efficacy while offering a more favorable electrolyte and fluid-related safety profile.