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Bipolar transurethral resection of prostate: a new reference standard?

Ho, Henry SS; Cheng, Christopher WS

doi: 10.1097/MOU.0b013e3282f194db
Benign prostatic hyperplasia: Edited by Jean de la Rosette

Purpose of review Transurethral resection of prostate is the gold standard for the surgical management of benign prostate hyperplasia. Bipolar devices allow transurethral resection of prostate with saline irrigation, which lessens water intoxication and negates the need for diathermy pad and unwanted stimulation of the obturator nerves and cardiac devices. Several randomized clinical trials compare the various bipolar devices with conventional monopolar ones. For this review, we search all peer-reviewed published literature databases and present the evidence from them to substantiate its advantages and disadvantages.

Recent findings Of the various types of bipolar devices, Gyrus has the longest clinical experience. Bipolar transurethral resection of prostate overcomes the shortcomings of bipolar transurethral prostate vaporization, which includes the absence of histology, postop irritative urinary symptoms and nondurable clinical outcomes. With bipolar transurethral resection of prostate, there is lesser bleeding which leads to shorter resection time and lower fluid absorption. This also enables shorter cathterization time and hospital stay. Transurethral resection syndrome has not been observed.

Summary Bipolar transurethral resection of prostate has demonstrated similar clinical efficacy as monopolar transurethral resection of prostate with shorter catheterization and hospital stay. It eliminates the occurrence of transurethral resection syndrome and minimizes bleeding risk. Long term outcomes from these randomized clinical trials will determine the durability of its clinical efficacy and incidence of urethral strictures.

Department of Urology, Singapore General Hospital, Outram Road, Singapore

Correspondence to Christopher W.S. Cheng, MD, Head of Department, Senior consultant, Department of Urology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore Tel: +65 6 3214693; fax: +65 6 2273787; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.