Wante Mahendra, Mathai Mathew John, Shetty Varun
Department of General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Aug 27;16(8):e67947. doi: 10.7759/cureus.67947. eCollection 2024 Aug.
Objective This prospective comparative study aimed to highlight and compare two types of transurethral resection of the prostate (TURP), namely M-TURP (monopolar) and B-TURP (bipolar), in the endoscopic management of benign prostatic hyperplasia (BPH). Methods and materials This research was conducted between 2022 and 2023 at a tertiary care health center. Included in the investigation were 100 consenting study participants undergoing M-TURP and B-TURP at our center. All referred patients presenting with clinical, ultrasound, or uroflowmetry features of BPH and those with failed attempts at medical management were included in the study. Patients with carcinoma of the prostate were excluded from the study. Post-operatively, the endpoints for comparison included maximal urinary flow rate (Qmax), prostate volume, duration of hospital stay, duration of catheterization, drop in serum sodium concentration, and drop in hemoglobin levels. Descriptive statistics were computed to delineate the study sample. After the completion of data collection, data analysis was performed using SPSS for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, IL, USA), and the correlations sought were achieved using the Chi-square test of significance. Results The peak incidence of BPH was seen in the sixth decade of life: the M-TURP group was 65.16 ± 7.07 years (mean ± standard deviation), while that in the B-TURP group was 62.32 ± 8.16 years (mean ± standard deviation). Nine percent of the study participants did not show any comorbidities. The most frequent symptom of BPH at presentation was a poor urinary stream (78%, n = 100), followed by nocturia (67%, n = 100). In our study, patients undergoing M-TURP had a mean serum prostate-specific antigen (PSA) level of 4.31 ± 1.03 ng/mL, while patients undergoing B-TURP had a mean serum PSA of 4.24 ± 0.99 ng/mL (p = 0.820; p > 0.05). The study found that patients undergoing M-TURP had a mean prostate size of 35.04 ± 3.57 cc, while those undergoing B-TURP had a mean prostate size of 35.72 ± 3.22 cc (p = 0.765). For the B-TURP group, the mean decrease in postoperative serum sodium concentration was 4.3 mEq/L, while for the M-TURP group, it was 6.4 mEq/L (p = 0.903). In the M-TURP group, there were three cases of transurethral resection (TUR) syndrome, while the B-TURP group had only one case. Conclusion BPH is a common problem affecting the quality of life of several male patients. Both M-TURP and B-TURP are comparable in their efficacy in treating BPH, with the exception of a higher incidence of hyponatremia and TUR syndrome in the M-TURP group.
目的 本前瞻性对照研究旨在突出并比较两种经尿道前列腺切除术（TURP），即M-TURP（单极）和B-TURP（双极），用于良性前列腺增生（BPH）的内镜治疗。方法和材料 本研究于2022年至2023年在一家三级医疗保健中心进行。纳入研究的100名同意参与的研究对象在我们中心接受了M-TURP和B-TURP。所有具有BPH临床、超声或尿流率特征且药物治疗失败的转诊患者均纳入研究。前列腺癌患者被排除在研究之外。术后，比较的终点包括最大尿流率（Qmax）、前列腺体积、住院时间、导尿时间、血清钠浓度下降以及血红蛋白水平下降。计算描述性统计量以描述研究样本。数据收集完成后，使用Windows版SPSS 16.0（2007年发布；SPSS公司，美国伊利诺伊州芝加哥）进行数据分析，并使用卡方显著性检验来寻求相关性。结果 BPH的发病高峰出现在生命的第六个十年：M-TURP组为65.16±7.07岁（均值±标准差），而B-TURP组为62.32±8.16岁（均值±标准差）。9%的研究对象未显示任何合并症。BPH最常见的症状是尿流不畅（78%，n = 100），其次是夜尿（67%，n = 100）。在我们的研究中，接受M-TURP的患者血清前列腺特异性抗原（PSA）平均水平为4.31±1.03 ng/mL，而接受B-TURP的患者血清PSA平均水平为4.24±0.99 ng/mL（p = 0.820；p>0.05）。研究发现，接受M-TURP的患者前列腺平均大小为35.04±3.57 cc，而接受B-TURP的患者前列腺平均大小为35.72±3.22 cc（p = 0.765）。对于B-TURP组，术后血清钠浓度平均下降4.3 mEq/L，而M-TURP组为6.4 mEq/L（p = 0.903）。M-TURP组有3例经尿道切除术（TUR）综合征，而B-TURP组仅有1例。结论 BPH是影响众多男性患者生活质量的常见问题。M-TURP和B-TURP在治疗BPH的疗效方面具有可比性，除了M-TURP组低钠血症和TUR综合征的发生率较高。
