Background: Transurethral resection of the prostate (TURP) is still considered the gold standard in the treatment of benign prostatic hyperplasia (BPH). However, open prostatectomy is indicated for prostate glands over 80 ml. There have been few reports concerning the use of TURP for large prostate glands over 100 ml.
Objective: To prospectively compare the effectiveness and safety of bipolar TURP and open prostatectomy in prostate glands ranging from 80-120 ml.
Patients and Methods: We reviewed the data of 60 patients with prostate glands ranging from 80-120 ml. which were randomized 30 patients underwent bipolar TURP (group A), and another 30 underwent open prostatectomy (group B). Preoperative International Prostate Symptom Score (IPSS), flow rate (Qmax), prostate volume, resected tissue volume, and operative time were documented. Postoperative hemoglobin, serum sodium change, hospital stay, duration of catheter indwelling and postoperative 6-month IPSS and Qmax were evaluated.
Results: The Bipolar TURP (B-TURP) and open prostatectomy (OP) emphasized similar mean operating durations as well as the mean hemoglobin drop, catheterization period and hospital stay were significantly improved for bipolar group. During the follow up period, no statistically significant difference was determined in terms of IPSS, Qmax, QOL, PVRU between the two series.
Conclusion: Bipolar TURP represented a promising endoscopic approach in very large BPH cases compared with standard open prostatectomy as patients benefited from significantly satisfactory follow up symptom scores and voiding parameters.