Dirk P.J. Michielsen, Danny Coomans, Benedikt Engels, Johan G. Braeckman The initial treatments are listed in Table II. Of the 70 patients, 16 (23%) patients received external beam radiation therapy. In 7 patients this was combined with hormonal treatment with luteinizing hormone-releasing hormone during 3 years. Forty- four (63%) patients had hormonal treatment for prostate cancer from the beginning (luteinizing hormone-releasing hormone in 38 patients and bilateral subcapsular orchiectomy in 6 patients). In 10 patients, active surveillance was preferred. At the time of resection, all patients had urinary retention while under hormonal treatment. PSA values are listed in Table III. Thirty-four palliative resections were carried out in 32 patients by Table II. Initial therapeutic approach to prostate cancer Variables Active surveillance Radiotherapy Radiotherapy and 3 years hormonal treatment Monopolar TURP N (%) 5 (16) 5 (16) 2 (6) Bipolar TURIS N (%) 5 (13) 4 (11) 5 (13) Total N (%) 10 (14) 9 (13) 7 (10) Hormonal treatment 20 (62) 24 (63) 44 (63) TURP – transurethral resection of prostate, TURIS – transurethral resection of prostate in saline, N – number Table III. PSA value at diagnosis, before and after endoscopic resection Variables PSA at diagnosis [ng/ml] PSA before endoscopic resection PSA after endoscopic resection Monopolar TURP (± SD) Bipolar TURIS (± SD) 70.35 (±118.43) 78.59 (±220.99) 50.72 (±73.65) 128.16 (±274.80) 93.40 (±179.72) 71.92 (±142.80) TURP – transurethral resection of prostate, TURIS – transurethral resection of prostate in saline Table IV. Characteristics of two groups Variables Age [years] Prostate [ml] Operative time [min] Resection weight [g] Resection speed [g/min] Catheterization time [days] Hospital stay [days] Monopolar TURP mean (± SD) 75.7 (±8.3) 58.6 (±16.5) 40.0 (±15.2) 16.86 (±10.6) 0.4 (±0.3) 1.6 (±0.9) 4.6 (±2.2) conventional monopolar technique. In 38 patients, 41 bipolar resections in saline were performed. Table IV compares the preoperative and perio- perative statistics. Average preoperative prostatic volume measured by transrectal ultrasound was 58.6 ±16.5 g in the conventional monopolar group and 51.0 ±16.8 g in the bipolar group. Table V shows that a vast majority of patients had spinal anaesthesia (91% in the conventional monopolar group, 78% in the bipolar group). Of all perioperative parameters, only longer resection time was statistically significant in the bipolar group (40.0 ±15.2 min vs. 49.1 ±20.5 min) (P = 0.03). However, after correction with respect to the weight of resected prostatic tissue, no statistically significant difference in resection speed between the two groups was observed (0.4 ±0.3 g/min vs. 0.4 ±0.3 g/min). Tables VI and VII show the changes in electrolytes before and after resection. No statistically significant changes were observed in haemoglobin, sodium, potassium, or chloride. Postoperatively there were no cases of TUR syndrome in either group (Table IX). The indwelling catheter was removed after 1.6 ±0.9 days in the conventional monopolar group and 2.0 ±2.5 days in the bipolar group (p = 0.342) (Table IV). Seven palliative resections (9.3%) were complicated with postoperative clot retention, 2 in the conventional monopolar group and 5 in the bipolar resection group (p = 0.565) (Table IX). Palliative endoscopic resection was successful in 77% of the patients. Urinary retention occurred after 5 conventional monopolar resections (15%) and 11 bipolar resections (27%) (p = 0.292). A long- term indwelling catheter was necessary for 16 patients (23%) (Table IX). Patients were discharged from the hospital after respectively 4.6 ±2.2 days in the conventional and 5.8 ±4.6 days in the bipolar group (Table IV). Postoperative pathological evaluation was available in 66 (94.4%) patients. In 6 procedures there was only benign prostate tissue in the resected parts. Cancer was found in 65 procedures (62 patients) (Table VIII), well-differentiated in 3% p-value 95% confidence interval 0.941 0.517 0.032 0.858 0.992 0.342 0.179 (–3.930, 4.230) (–33.976, 18.776) (0.785, 17.374) (–5.361, 4.476) (–0.159, 0.157) (–0.464, 1.321) (–0.543, 2.855) Bipolar TURIS mean (± SD) 75.6 (±8.8) 51.0 (±16.8) 49.1 (±20.5) 17.30 (±10.3) 0.4 (±0.3) 2.0 (±2.5) 5.8 (±4.6) TURP – transurethral resection of prostate, TURIS – transurethral resection of prostate in saline, SD – standard deviation 782 Arch Med Sci 5, October / 2010