ORIGINAL ARTICLE Short-stay transurethral prostate surgery: A randomized controlled trial comparing transurethral resection in saline bipolar transurethral vaporization of the prostate with monopolar transurethral resection Chi-hang Yee, 1 Joseph Hon-ming Wong, 2 Peter Ka-fung Chiu, 1 Chi-kwok Chan, 1 Wai-man Lee, 1 James Hok-leung Tsu, 3 Jeremy Yuen-chun Teoh 3 & Chi-fai Ng 1 1 Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 2 Alice Ho Miu Ling Nethersole Hospital, Hong Kong 3 Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong Keywords Benign Prostatic Hyerplasia (BPH); lower urinary tract symptoms; TURP Correspondence Chi-hang Yee, Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. Tel: +852 26322625 Fax: +852 26377974 Email: yeechihang@surgery.cuhk.edu.hk Received: 23 February 2015; revised 28 April 2015; accepted 30 April 2015 DOI:10.1111/ases.12197 Abstract Objectives: The aim of the present study was to establish the safety and efficacy profile of transurethral resection in saline (TURis) bipolar vaporization of the prostate relative to monopolar transurethral resection of prostate (TURP) and to test the hospital stay efficiency after TURis vaporization. Materials and Methods: in this multicenter, double-blinded, prospective, ran- domized controlled trial, men aged 50–75 years old were randomized into two arms: TURis bipolar vaporization and monopolar TURP. Intraoperative details, perioperative parameters, and postoperative functional outcomes were assessed after intervention. Follow-up with symptom score assessment, prostate volume measurement, and uroflowmetry were performed at 3 and 6 months. Results: Eighty-four patients (mean age, 65.0 ± 5.6 years) were randomized into each study arm. TURis bipolar vaporization had a longer operative time than monopolar TURP (51.6 ± 24.5 vs 38.5 ± 20.3 min, P < 0.001). Post- operatively, the TURis group had a shorter catheter time (33.6 ± 23.7 vs 40.8 ± 29.4 h, P = 0.013) and a shorter length of hospital stay (43.14 ± 18.79 vs 52.33 ± 30.58 h, P = 0.013). The postoperative dysuria score was higher in the TURis vaporization arm. There was no statistically significant difference between the two arms in terms of hemoglobin change and postoperative complication. No significant difference was observed in quality of life score at 3 and 6 months. Conclusions: TURis bipolar vaporization of the prostate is a safe and compa- rable alternative to monopolar TURP. It leads to a reduction in both catheter time and length of hospital stay. Introduction Lower urinary tract symptoms are common (1,2). Cur- rently, monopolar transurethral resection of the prostate (TURP) is considered the surgical gold standard for the management of symptomatic benign prostatic enlarge- ment in prostates between 30 and 80 mL (3). However, monopolar TURP has some drawbacks, and bipolar TURP is one of the major advances that have tried to address the flaws of monopolar TURP. A modification of the bipolar TURP technique is transurethral resection in saline (TURis) bipolar electro- vaporization. The employment of a “button” electrode instead of a resection-based technique has been reported to reduce the bleeding rate (4). Furthermore, a ran- domized controlled trial showed that a hybrid bipolar Asian J Endosc Surg ISSN 1758-5902 Asian J Endosc Surg 8 (2015) 316–322 © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd. 316