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Bipolar vs Monopolar TURP Safety — FRCA Final MCQ

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ModerateGeneral AnaesthesiaBipolar vs Monopolar TURP SafetyFRCA Final

A 68-year-old man (ASA III) has a transurethral resection of bladder tumour (TURBT) under spinal anaesthesia. The surgeon is using bipolar resectoscope with saline irrigation. Compared to monopolar TURP with glycine irrigation, what is the main advantage of bipolar technology?

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Correct answer: D — Deeper tissue resection

Bipolar resectoscope technology uses 0.9% normal saline as the irrigating fluid instead of glycine 1.5% (used with monopolar). Since saline is isotonic, absorption of irrigation fluid does NOT cause dilutional hyponatraemia or TURP syndrome. This is the principal advantage. Additionally, saline is non-toxic (unlike glycine which causes visual disturbances and encephalopathy). This has made TURBT and TURP significantly safer, particularly for larger glands requiring longer resection times.

Reference: BAUS – 2019 – TURBT/TURP guidelines; RCOA – 2023 – Urological anaesthesia