Retreatment rates have not influenced the continued adoption of new endoscopic and minimally invasive treatments.

Socioeconomic factors involved in acceptance and use of laser technology have not been described.

Younger men are more likely to undergo treatment for BPH than older men.

The advent of the bipolar resection system increased the overall percentage of endoscopic procedures done as transurethral resections of the prostate (TURPs).

With the widespread use of medical therapy for BPH, there has been a trend toward less use of surgical management.

Comparisons across surgical techniques are often unfair because new technologies are frequently compared with a historic, and often inferior, data set.

Reports of long-term treatment efficacy are highly influenced by a loss of patients to follow-up and, possibly, reporting of responder data only.

Intent to treat analyses are commonly reported.

In a randomized controlled trial (RCT), comparison with TURP assumes that the surgeon performing the TURP has been sufficiently trained and can produce predictable results.

Subjective symptoms (such as dysuria) can be influenced by observer reporting.

ampicillin.

acyclovir.

trimethoprim.

fluoroquinolone.

ceftriaxone.

anterior portion of the prostate.

bladder neck.

prostate floor.

apical portion of the prostate.

median lobe, if present.

intraoperative ureteral injury.

irrigating fluid placed at a less than ideal height above the patient.

absorption of non–sodium-containing irrigating fluid, leading to an acute dilutional hyponatremia.

absorption of fluid during procedures such as holmium laser enucleation of the prostate (HoLEP) and bipolar TURP.

a serum sodium of greater than 130 mEq/L.

Late complications such as bladder neck contracture and need for retreatment of BPH do not appear to be much different from those found with conventional TURP.

All of the above.

Improved visualization during bipolar TURP may also lead to a decrease in capsular perforations and operating time.

In a meta-analysis of patients undergoing bipolar TURP, authors concluded that by treating 50 patients with bipolar TURP, one case of TUR syndrome could be prevented.

A relative risk of 0.53 for blood transfusion with bipolar resection was found in meta-analysis.

Was first described in 2005

There is a large startup cost associated with the procedure due to the required purchase of new generators and equipment.

Frequently leads to lower hemostasis related complications (transfusion, clot retention) compared to monopolar TURP

It leads entirely to tissue vaporization.

Is available only as a monopolar technology

have comparable results in both the low energy and high energy platforms.

improve AUA Symptom Score (AUASS) by approximately 60% at 1 year.

increase density of nerve endings in the prostate.

induce changes in prostate volume of greater than 50%.

frequently cause erectile dysfunction.

frequently show statistically significant decreases in AUASS.

have never shown a statistically significant improvement in objective measures such as peak urinary flow.

are poorly tolerated by the patient.

have significant side effects and should not be performed as part of research.

have never been performed.

Blood transfusion

Incontinence

Urethral stricture

Erectile dysfunction

Urinary tract infection

is required to be done in a hospital-based operating room with overnight admission.

has an equivalent need for retreatment for lower urinary tract symptoms (LUTS) due to BPH compared to TURP.

should only be performed on prostates less than 50 mL in size.

is not recommended in patients with metallic pelvic prostheses.

now universally regulates temperature based on impedance.

It commonly results in TUR syndrome.

It causes retrograde ejaculation in 80% of cases.

It is generally only used in prostates larger than 60 mL.

It may have a lower rate of ejaculatory dysfunction in patients when done unilaterally.

It results in removal of a large volume of prostate adenoma.

Eye protection is required only when a video camera is not used during the case.

Signs denoting that a laser is in use need only be displayed on the most commonly used door for that operating room.

All windows or wall openings from the operating room (OR) must be covered.

All laser energy is readily absorbed by air/irrigating fluid, making it safe to use in the OR.

Eye protection is required for the surgeon only.

has been shown to be superior to TURP in recent meta-analyses.

requires the use of a morcellator.

preceded HoLEP chronologically and conceptually.

follows anatomic planes to remove the prostate in lobes.

uses a thulium laser.

Transient urinary retention is seen in more than 50% of patients.

Overall complication rates increase significantly with increasing prostate size.

When observed, urinary incontinence is generally permanent.

Bladder neck contracture may be more common in smaller prostate glands.

A morcellator-related bladder injury has never been reported.