Comparative Study to Evaluate Efficacy of Bipolar Electrosurgical Unit Versus Monopolar Electrosurgical Unit in Transurethral Resection of Prostate
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
Introduction: Transurethral resection of the prostate (TURP) is the gold standard in the management of benign prostatic hyperplasia. Electrocautery devices that have been used during TURP procedures have monopolar design and cannot be used with electrolyte rich irrigation fluid. Now use of bipolar TURP has challenged monopolar TURP. Bipolar cautery allows TURP to be performed in a normal saline environment, which addresses a fundamental concern of conventional monopolar TURP. As a result, the risks of dilutional hyponatremia and transurethral resection (TUR) syndrome are eliminated, allowing for longer and safer resection. Study aimed to compare the safety and efficacy of bipolar Electrocautery unit using saline as irrigant against monopolar Electrocautery unit using glycine as irrigant. Material and methods: A total of 100 patients who underwent Monoploar TURP (group A: 50 patients) or Bipolar TURP (group B: 50 patients) were analyzed in dept of surgery, Muzaffarnagar Medical College And Hospital from May 2015 to December 2016. Variables analyzed were, hemoglobin, serum sodium, serum potassium, IPSS, Qmax, QoL Intraoperative resection time, amount of irrigant, resection volume were recorded. Postoperative hemoglobin, Na+ , K+ were assessed within 6 hour of surgery. Patients were followed after 6 weeks to assess the IPSS, Qmax, Qol. Results: The mean Hemoglobin, S. Na+ and K+ level were comparable between both groups. The mean resection time [56.24min and 59.2min] and resected weight [22.68 gm and 21.09 gm] in monopolar and bipolar TURP was not statically significant. For both groups amount of irrigant fluid used was same. The statically significant decline in hemoglobin was seen in monopolar group (1.25g%, p< 0.0001) as compared to the bipolar group (0.64g%,p<0.01) but, no patient required blood transfusion. When in follow up Patients of both the group after 6 weeks showed comparable alleviation in all IPSS, Qmax, QoL. Conclusion: Bipolar Electrocautery is comparable in terms both safety and efficacy to monopolar Electrocautery
Authors and Affiliations
Singla Mamta, Gupta K Akhil, Zea M. Iqbal, Garg Sahaj, Mishra R K, Jain Shaleen
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