Comparing urethral stricture rates following bipolar and monopolar transurethral resection of the prostate: a retrospective study

Abstract

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.