Bipolar transurethral resection in saline system versus traditional monopolar resection system in treating large-volume benign prostatic hyperplasia.

OBJECTIVES: We report our prospective clinical result of transurethral resection in saline (TURIS) versus monopolar transurethral resection of the prostate (TURP) system in treating large-volume benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Patients with BPH (volume >50 ml) were enrolled in the study. An intravenous device was used for serum sodium and hemoglobin tests to monitor the alteration. All acute complications were noted. Patients were followed up for at least 6 months. RESULTS: Forty patients were randomized into two groups. Follow-up data were compared with baseline. The decline in serum sodium postoperatively was smaller in the TURIS group (6.9 +/- 0.7 vs. 14.8 +/- 1.8 mM, p = 0.001). Hemoglobin only dropped by 1.4 g/dl in the TURIS group, whereas it dropped by 2.5 g/dl in the TURP group (p = 0.001). The TURIS system showed a better resection rate (0.64 vs. 0.52 g/min, p = 0.001). Total acute complication rate was 8 of 19 (42%) in the TURP arm and 4 of 21 (19%) in the TURIS arm. The catheter was removed sooner (2.5 vs. 3.4 days) and hospitalization time was less (3.0 vs. 4.2 days) in the TURIS group. The mean improvement in the International Prostate Symptom Score and maximum urinary flow rate at 6 months was comparable in the two groups. CONCLUSION: The TURIS system demonstrated superior safety in treating large-volume BPH and had a similar efficacy to TURP in short term.