Transurethral Bipolar Enucleation vs. Transurethral Monopolar Enucleation of the Prostate for the Treatment of Bladder Outlet Obstruction Due to Benign Prostatic Hyperplasia

Abstract

Objective: To compare the feasibility of bipolar transurethral enucleation (B-TUEP) and monopolar transurethral enucleation (M-TUEP) for the management of benign prostatic obstruction.

Methods: This prospective randomized study involved 160 patients: 80 patients who were subjected to B-TUEP; and 80 patients who were subjected to M-TUEP. Patients were evaluated preoperatively and for 1 year postoperatively.

Results: At the 12-month follow-up, no statistically significant intergroup differences were observed in operative time, resected tissue weight, International Prostate Symptom Score, or maximum urinary flow rate. Postoperative rates of re-catheterization for acute urinary retention, urinary incontinence, and urinary tract infections were also comparable between groups. However, the B-TUEP group exhibited significantly less intraoperative bleeding (P < .001). The M-TUEP group experienced significantly longer postoperative catheterization, and hospital stays (P < .001). Furthermore, the M-TUEP group demonstrated significantly lower mean intraoperative serum sodium levels (P < .001), with 1 patient experiencing TUR (Transurethral resection) syndrome.

Conclusion: The findings indicate comparable efficacy between M-TUEP and B-TUEP for benign prostatic hyperplasia treatment, although B-TUEP demonstrates superior safety. Monopolar transurethral enucleation of the prostate remains a safe and effective alternative in the absence of bipolar technology.

Cite this article as: Mohamed AG, Sayed O, Masoud RN, et al. Transurethral bipolar enucleation vs. transurethral monopolar enucleation of the prostate for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia. Urol Res Pract. 2026, 52, 0075 doi: 10.5152/ tud.2026.25075.