This study set out to evaluate the similarities and differences in the perioperative blood loss experienced by patients undergoing monopolar vs. bipolar transurethral resection of the prostate for benign prostatic hyperplasia.

The study was conducted at Department of Urology and Renal transplantation, DHQ Hospital Gujranwala from 11-12-2020 to 11-6-2021. Informed consent about the study was taken from the patient. Male patients ages between 55 to 75 years having were enrolled in this study. Patients with bleeding disorder (Pt, INR > 1.5 times deranged), chronic liver disease (ALT & AST>40IU/L) and with uncontrolled hypertension (≥140/90) and diabetes mellitus (240 FBS) were excluded from study.
Sample size of 80 patients (40 patients in each group) was estimated by using 95% confidence internal with 80% power of test and taking expected mean blood loss 238.5±69.43ml with bipolar TURP and 289.6±89.47ml with monopolar TURP.11 Prior to study 80 patients were divided into two equal groups by computer random number generated. Group A (unipolar diathermy) and Group B (multipolar diathermy) each had 40 individuals (bipolar diathermy). We have logged some demographic details.
The patient had a battery of tests, including a full blood count, urinalysis, and abdominal and pelvic ultrasound. Each subject in the Study had their preoperative hematocrit measured. Once 24 hours had passed since surgery, patients were checked on again to determine their hematocrit. The amount of blood lost during surgery was determined by comparing the pre- and post-op (after 24 hours) hematocrit readings. The researcher personally filled out the approved data collection form.
Hematocrit-based measurement of blood loss over the course of a full day following surgery. Patients with symptoms of micturition dysfunction and an enlarged prostate (>30 ml) on USG were classified as having benign prostatic hyperplasia. SPSS version 23 was utilized for data tabulation and analysis. Age, duration of BPH, prostate size, and blood loss were some of the quantitative data reported in the form of mean and standard deviation. Both groups' preoperative blood loss was compared using the t-test, with a p-value 0.05 considered significant. Age, duration of BPH, and prostate volume were used to separate the data. We utilized a t-test after stratifying the data, considering the results significant if the p-value was less than 0.05.

In this study perioperative blood loss was significantly higher among patients who underwent mono-polar diathermy as compared to those patients who were treated with bipolar diathermy i.e. Mono-polar 325.22 vs. Bipolar: 240.0, p-value=0.0001. Stratification of age and size of prostate showed the similar findings that bipolar TURP had significantly less perioperative blood loss.

Mean age of patients in Group-A and in Group-B was 62.42±5.27 and 62.27±4.86 years. Mean duration of BPH in Group-A and in Group-B was 3.28±1.66months and 3.70±1.84months. Mean prostate size in Group-A and in Group-B patients was 39.45±3.80 and 38.40±3.93. Mean postoperative hematocrit in Group-A and in Group-B patients was 35.77±1.65 and 35.62±1.51. Group-B patient had less perioperative blood loss as compared to Group-A patients. i.e. Group-A: 325.22 vs. Group-B: 240.0, p-value=0.0001. In all age groups patients mean perioperative blood loss was significantly lower for Group-B patients as compared to Group-A patients.  In both duration groups i.e. 1-3months and 4-6months, the difference between both groups was statistically significant and group A showed more perioperative blood loss than group B. Significant difference was seen for mean perioperative blood loss between the treatment groups in relation to prostate size.

Results of this study highlighted a significant difference in perioperative blood loss with bipolar TURP in patients with BPH.

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