Neyer Michael, Reissigl Andreas, Schwab Christoph, Pointner Joseph, Abt Dominik, Bachmayer Christian, Schmid Hans-Peter, Engeler Daniel S
State Hospital Bregenz, Bregenz, Austria. michael.neyer @ aon.at
Urol Int. 2013;90(1):62-7. doi: 10.1159/000343688. Epub 2012 Nov 8.
To compare bipolar and monopolar transurethral resection of the prostate (TURP) in a comparative prospective study at two urology centers.
Of 212 patients with symptomatic benign prostatic hyperplasia entered prospectively into the study, 111 underwent bipolar and 101 monopolar TURP. Patients were treated in two consecutive series with each surgical method at both centers. Improvement in peak flow rate, postvoid residual, International Prostate Symptom Score, and quality of life score postoperatively and at 3, 12, 24 and 36 months, as well as long-term adverse events were compared. Regarding safety, duration of surgery, postoperative catheterization and hospitalization time, amount of fluid absorption, frequency of transurethral resection (TUR) syndrome, and risk of hemorrhage were evaluated.
Patient characteristics of the two series were comparable. The risk of developing TUR syndrome (p = 0.32) and bleeding tendency (p = 0.52) did not differ significantly between groups. Significant differences were seen for duration of surgery and resection speed. All functional parameters improved significantly during follow-up, with no relevant differences between surgical groups.
Since no major differences in efficacy and safety were seen between the surgical groups, we feel that the monopolar technique still has a valuable place in TURP.
在两家泌尿外科中心进行的一项比较性前瞻性研究中，比较双极和单极经尿道前列腺切除术（TURP）。
前瞻性纳入该研究的212例有症状的良性前列腺增生患者中，111例行双极TURP，101例行单极TURP。两个中心均采用两种手术方法对患者进行连续两组治疗。比较术后以及术后3个月、12个月、24个月和36个月时的最大尿流率、残余尿量、国际前列腺症状评分和生活质量评分的改善情况，以及长期不良事件。在安全性方面，评估手术持续时间、术后导尿和住院时间、液体吸收量、经尿道电切（TUR）综合征发生率以及出血风险。
两组患者特征具有可比性。两组发生TUR综合征的风险（p = 0.32）和出血倾向（p = 0.52）无显著差异。手术持续时间和切除速度存在显著差异。随访期间所有功能参数均显著改善，手术组之间无相关差异。
由于手术组之间在疗效和安全性方面未见重大差异，我们认为单极技术在TURP中仍占有重要地位。
