Comparison of impact of monopolar versus bipolar resection of the prostate on erectile function in patients with benign hyperplasia of the prostate

The incidence of erectile dysfunction (ED) after TURP for BPH is still debated. Current study aims at comparing the impact of monopolar and bipolar TURP on the sexual function of male patients with LUTS, using the IIEF EF-domain score (questions 1–5, 15) and to identify statistical risk factors associated with development of post-operative ED. Between April 2014 and May 2015, 102 patients underwent TURP for symptomatic BPH. Sixty on underwent TURP by the monopolar technique and 41 by the bipolar technique. Patients were assessed on the day before the surgery by IIEF and followed up 3 and 6 months postoperatively, using the same scoring system. On a 6 month follow up,13 patients (22.4%) in the monopolar group and 12 (30%) in the bipolar group, experienced clinical change in their EF score. Among risk factors studied, only diabetes, intraoperative capsular perforation and preoperative use of PDE5I had a statistically significant impact on the EF score. No statistically significant difference in IIEF score and EF domain score was observed between the patients who underwent TURP by the monopolar technique, compared to those patients in which the bipolar one was used; whether at three months (p value 0.33) or at six months (p value 0.397). No statistical difference could be detected between monopolar and bipolar TURP, regarding the risk of developing post-operative ED. However, a higher incidence of ED should be anticipated in patients with DM, intraoperative capsular perforation and preoperative use of PDE5I.