Comparative Safety and Short-Term Effectiveness of Monopolar Transurethral Resection Enucleation of the Prostate in Enlarged Prostate

Objective: To evaluate the short-term safety and effectiveness of monopolar transurethral resection of the prostate (M-TURP) versus monopolar transurethral enucleation of the prostate (M-TUEP) in a tertiary-care urology unit. Study Design: A descriptive study. Place and Duration of the Study: Department of Urology, Aga Khan University Hospital, Karachi, Pakistan, from July 2024 to July 2025. Methodology: Fifty men aged ≥40 years with symptomatic enlarged prostate who had undergone either M-TURP (n = 25) or M-TUEP (n = 25). Preoperative demographics, International Prostate Symptom Scores (IPSS), uroflowmetry parameters, laboratory values, and ultrasound findings were recorded. Operative variables and postoperative outcomes, including haemoglobin drop, electrolyte changes, complications, capsular perforation, irrigation duration, IPSS, maximum and average flow rates (Qmax and Qave), trial without catheter success, and quality of life, were assessed. Independent t-tests, paired t-tests, and chi-square tests were applied where appropriate. Results: Baseline characteristics were statistically similar between groups. Significant improvements were observed postoperatively in IPSS (27.18 to 4.50), Qmax (6.76 to 18.65 ml/sec), Qave (3.11 to 11.29), and postvoid residual volume (189.64 to 69.70) across the entire cohort (p <0.001). No significant differences were found between M-TURP and M-TUEP regarding haemoglobin drop, transfusion requirements (2 vs 1, p = 0.55), or electrolyte changes (137 ± 18.2 vs. 136.6 ± 4.3, p = 0.389). Capsular perforations were fewer in the TUEP group compared to the TURP group (2 vs. 9, p = 0.037). More catheters were successfully removed in the TUEP group versus the TURP group (24 vs. 17; p = 0.023), indicating better functional outcomes with TUEP. The overall complication profile also showed no statistically significant differences. Conclusion: M-TUEP is safe in short-term clinical effectiveness comparable to M-TURP. As a monopolar technique requiring no additional equipment, it offers a practical alternative in low-resource settings.