Bipolar versus monopolar technique for palliative transurethral prostate resection in patients with prostate cancer, and the fact that in palliative resections one does not need to go as close to the surgical capsule of the prostate because the creation of a voiding channel is sufficient. Surprisingly, there was a 12% clot retention rate in the bipolar resection group. However, this is not a statistically significant difference from the conventional monopolar group. Recent experimental work by Qu et al. reported significantly better haemostasis with the bipolar technique of the Gyrus PlasmaKinetic system (Gyrus Medical Ltd, UK) in an isolated normal saline perfused porcine kidney [34]. The coagulation depth with bipolar technology is sufficient to seal blood vessels of 125 µm diameter, which is not possible with monopolar devices. Such vessels are only present in 0.1% of benign prostate hyperplastic tissue. In the majority (79%) of patients undergoing palliative endoscopic resection, the tumour was pathologically upgraded. Potential explanations for this phenomenon are grade progression with time, effects of hormonal deprivation, and achievement of a hormone refractory state. Civantos et al. pointed out that prolonged hormonal deprivation induces histological changes in prostate cancer that may be incorrectly interpreted as high-grade disease [35]. In conclusions, urethral obstruction by prostate cancer is initially treated by hormonal deprivation and drained by a suprapubic or urethral catheter. Endoscopic resection is a valuable therapeutic option when hormonal manipulation fails or when there is hormone refractory disease. Effective relief of the obstruction is possible with an acceptable rate of procedure-related side effects. In this specific setting, bipolar technology offers no substantial benefit over conventional monopolar technology. R e f e r e n c e s 1. 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