Transurethral Bipolar Enucleation vs. Monopolar Enucleation in Benign Prostatic Hyperplasia: Comparative Analysis of Enucleation Techniques
Abstract
Background: Benign prostatic hyperplasia (BPH) remains one of the most common causes of bladder outlet obstruction in ageing men. Among electrosurgical methods, transurethral bipolar enucleation of the prostate (BTUEP/BipolEP/TUEB) and monopolar transurethral enucleation of the prostate (M-TUEP/mTUEP) use similar mechanical principles but differ in current delivery, irrigation environment, hemostatic profile, and electrolyte safety. Aim: The present paper aims to compare bipolar and monopolar prostate enucleation for BPH with respect to perioperative efficiency, safety, early and intermediate functional outcomes, and practical applicability in resource-variable settings. Materials and Methods: This paper is a structured comparative review based on guideline statements, technical descriptions, and comparative clinical literature addressing transurethral prostate enucleation with bipolar and monopolar energy for symptomatic BPH. Extracted outcome domains included operative time, resected tissue weight, symptom scores, peak urinary flow, catheterization duration, length of stay, bleeding, electrolyte changes, irrigation-related risk, and postoperative complications such as acute retention, urinary tract infection, and incontinence. Results: The most consistent finding across the comparative literature is that bipolar and monopolar transurethral enucleation provide broadly comparable efficacy in terms of adenoma clearance and postoperative symptom relief, but bipolar technology…
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