Comparative Analysis of Bleeding Risk and Operation Time Between Conventional TURP and Bipolar Transurethral Resection of the Prostate at Zheen Hospital, 2024

Abstract

Background: Benign prostatic hyperplasia (BPH) remains one of the most prevalent urological conditions affecting aging males worldwide. While conventional monopolar transurethral resection of the prostate (M-TURP) has been the gold standard surgical treatment for decades, bipolar transurethral resection of the prostate (B-TURP) has emerged as a promising alternative with potential advantages in perioperative outcomes.

Objective: This study aimed to compare bleeding risk and operation time between conventional M-TURP and B-TURP procedures performed at Zheen Hospital, Iraq, during 2024.

Methods: A prospective comparative study was conducted involving 120 patients with symptomatic BPH who underwent surgical intervention between January and September 2024. Patients were allocated into two groups: Group A (n=60) underwent conventional M-TURP, and Group B (n=60) underwent B-TURP. Primary outcome measures included intraoperative blood loss, postoperative bleeding complications, and total operation time.

Results: The mean operation time was significantly shorter in the B-TURP group (48.3±12.7 minutes) compared to the M-TURP group (62.5±15.3 minutes, p<0.001). Intraoperative bleeding, assessed by mean hemoglobin drop, was significantly lower in B-TURP patients (1.2±0.6 g/dL) versus M-TURP patients (2.4±0.9 g/dL, p<0.001). The transfusion rate was 3.3% (2/60) in the B-TURP group compared to 15% (9/60) in the M-TURP group (p=0.023).

Conclusion: Bipolar TURP demonstrated superior perioperative safety profile compared to conventional monopolar TURP, with significantly reduced bleeding risk, shorter operation time, and lower transfusion requirements.