Akpala Anna, Warda Ahmed, Batson-Patel Serene, Bhattacharyya Saloni, Damola Adebiyi, Farag Ahmed, Manandhar Amar
Urology, Queen Elizabeth Hospital Birmingham, Birmingham, GBR.
Urology, Northampton General Hospital, Northampton, GBR.
Cureus. 2024 Nov 12;16(11):e73548. doi: 10.7759/cureus.73548. eCollection 2024 Nov.
Aim The aim is to compare the incidence of urethral strictures and other complications following monopolar and bipolar transurethral resection of the prostate (TURP). Method We conducted a retrospective study to compare patients who underwent bipolar TURP with those who underwent monopolar TURP between 2017 and 2023. The collected data included demographics, age, history of urethral stricture, prostate size, operation duration, and postoperative complications, such as blood transfusion, transurethral resection (TUR) syndrome, and other relevant data points. Results The COVID-19 pandemic significantly affected the number of surgeries performed. A total of 572 patients who underwent TURP at our center during this period were identified, 302 of whom underwent monopolar TURP, and 270 underwent bipolar TURP. Bladder neck stenosis was more frequently identified in the monopolar group compared to the bipolar group (1.99% (6) vs. 0.7% (2)). In the monopolar group, 6.62% (20) of the patients had strictures compared to 4.07% (11) in the bipolar group; however, this difference is not statistically significant. The bipolar group had a higher incidence of urinary incontinence (5.6% (15) vs. 3.3% (10)), whereas the monopolar group had higher readmission rates (18.8% (57) vs. 13.7% (37)) and a higher frequency of delayed trial without catheter (TWOC) (84% (254) vs. 75.9% (205)). Conclusion We believe that our findings contribute towards resolving the debate between stricture complication rates in monopolar versus bipolar TURP. Our analysis revealed no statistically significant differences in stricture rates between the two groups. However, we noted differences in other complications, such as higher rates of urinary incontinence in the bipolar group, whereas the monopolar group had increased rates of readmission and bladder neck stenosis.
目的 目的是比较单极和双极经尿道前列腺切除术（TURP）后尿道狭窄及其他并发症的发生率。方法 我们进行了一项回顾性研究，比较2017年至2023年间接受双极TURP的患者与接受单极TURP的患者。收集的数据包括人口统计学、年龄、尿道狭窄病史、前列腺大小、手术时间以及术后并发症，如输血、经尿道切除（TUR）综合征和其他相关数据点。结果 新冠疫情显著影响了手术例数。在此期间，我们中心共有572例接受TURP的患者，其中302例接受单极TURP，270例接受双极TURP。与双极组相比，单极组膀胱颈狭窄的发生率更高（1.99%（6例）对0.7%（2例））。在单极组中，6.62%（20例）的患者发生狭窄，双极组为4.07%（11例）；然而，这种差异无统计学意义。双极组尿失禁的发生率更高（5.6%（15例）对3.3%（10例）），而单极组再入院率更高（18.8%（57例）对13.7%（37例）），且无导尿管试验延迟（TWOC）的频率更高（84%（254例）对75.9%（205例））。结论 我们认为我们的研究结果有助于解决单极与双极TURP狭窄并发症发生率之间的争论。我们的分析显示两组之间狭窄率无统计学显著差异。然而，我们注意到其他并发症存在差异，如双极组尿失禁发生率较高，而单极组再入院率和膀胱颈狭窄发生率增加。
