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TURP from monopolar to bipolar..TURP syndrome vanish

Monopolar TURP

The conventional gold standard for TURP was the monopolar electrode resectoscope. With the monopolar electrode, layers of prostatic tissue are resected with a cutting current transmitted through a single-limb electrode which exits the patient by way of a grounding pad.
A non-electrolyte bladder-irrigating solution is required to avoid dispersion of the electrical current as well as tissue damage at the site of prostatic resection. TURP syndrome is a potentially serious complication which can occur when a nonelectrolyte, hypoosmolar bladder-irrigating solution is used.

Bipolar TURP

Bipolar TURP electrode technology incorporates a continuous loop electrode to resect prostatic tissue of BPH. This surgical tool is designed to contain the inflow and outflow of current via the resectoscope for prostatic tissue resection. By being completely self-contained within the bipolar unit, the current is prevented from passing through the patient.

The advantage of this system is that for the bladder-irrigating solution, an electrolyte-containing solution such as normal saline can be used.

Although intravascular absorption of normal saline can occur via resected prostatic veins opened during prostatic resection, hypoosmolality and hyponatremia associated with TURP syndrome are prevented. Nevertheless, the risk of volume overload as a consequence of the bladder-irrigating solution can still occur with the bipolar TURP technique.

In a review of 16 studies conducted over a 10-year period, Issa compared the safety properties of monopolar and bipolar TURP . He found a statistically significant decrease in overall complication rate,
transfusion rate, and TURP syndrome with bipolar TURP.(1)

1-Issa MM. Technological advances in transurethral resection of the prostate: bipolar versus monopolar TURP.
J Endourol. 2008; 22(8):1587-95.

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