Transurethral resection of the prostate (TURP) using bipolar electrocautery and 0.9% saline is a new technology in the field of surgery for benign prostatic hyperplasia (BPH). This randomized prospective study was conducted to compare the efficacy and safety of the Gyrus™ Plasmasect loop bipolar TURP and the conventional monopolar TURP for the treatment of BPH.

This study included 50 patients who were randomized 1:1 to undergo bipolar or monopolar TURP from August 2003 to October 2004. Preoperatively, the patients were assessed by the symptom score, uroflow and transrectal ultrasonography, and the two groups were comparable with regards to these measures and the mean group age. The perioperative and postoperative parameters we studied included the operative time, the resected prostate volume and the change in serum Na and Hb. Postoperatively, the patients were assessed for the symptom score and uroflow at both 1 and 6 months.

Postoperative improvements in the symptom score and the Qmax were significant for both groups and the improvements were similar for the two groups. There was no difference in the operative time and resected prostate volume. The serum Na dropped by 4.2mEq/l in the monopolar group, whereas it fell only 1.1mEq/l in the bipolar group (p<0.001). Significant smaller reduction in serum Hb, a shorter postoperative catheterization time and a shorter hospital stay were noted for the bipolar group.

Bipolar TURP using the Gyrus™ system is as effective as conventional monopolar TURP and it has additional advantages too. Thus, bipolar TURP may be a good alternative to conventional TURP. However, more follow-up is necessary to assess its long-term efficacy.