Evaluation of sexual function following bipolar vaporization versus monopolar transurethral resection of the prostate

Document Type : Original Article

Authors

1 urology and andrology department, faculty od medicine, Benha university

2 urology and andrology department, faculty of medicine,Benha university

3 urology and andrology department, faculty of medicine, Benha university

4 Urology and andrology department, faculty of medicine, Benha University

Abstract

Background: Little light has been shed on erectile functions following bipolar vaporization of the prostate.
Patients and Methods: A prospective study was conducted that included 100 cases with a history of endoscopic prostatic
surgery. Cases were allocated into two groups: group I included 50 patients who were subjected to the conventional monopolar
transurethral resection of the prostate (TURP), and group II included 50 patients who were subjected to bipolar vaporization
of the prostate. All patient were assessed 3 and 6months after the operation.Severity of benign prostatic hypertrophy
symptoms and erectile function were reassessed using International Prostate Symptom Score and International Index of
Erectile Function-5 (IIEF-5), respectively.
Results: Although all patients in both groups demonstrated significantly lower IIEF-5 scores 3months postoperatively
(P<0.0001), the percentage of IIEF-5 score reduction was insignificantly different between both groups. No significant
differences were found at the 6-month follow-up. The erectile fraction (EF) in group II (bipolar vaporization group)
was slightly better, yet insignificantly different from group I. The incidence of complications (TURP syndrome, bladder
perforation, intraoperative bleeding, postoperative bleeding, and postoperative urinary tract infection) in group I (monopolar
TURP) was significantly higher than the incidence in group II (bipolar vaporization). Among the study variables, it seems
that diabetes mellitus and hypertension and development of postoperative complications (especially intraoperative bleeding,
capsular perforation, and urinary tract infection) were significantly associated with development of postoperative erectile
dysfunction (ED).
Conclusion: No significant difference was found regarding sexual function following monopolar TURP and the bipolar
vaporization of the prostate. However, the bipolar TURP is safer with less complications.

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