OVERVIEW

Transurethral resection of the prostate (TURP) has been used for more than 100 years to treat the growth of the prostate. It is an endoscopic minimally invasive procedure performed very frequently, making it quite safe and effective to control obstructive urinary symptoms.

Bipolar energy is currently used to cut the prostate tissue, this modality offers greater security to the patient because it has a better coagulation profile and the absorption of liquids during the procedure is less.

The indications to perform a TURP are:

  • Obstructive prostatic growth associated with severe obstructive urinary symptoms (weak stream, nocturnal diuresis, dribbling after urination, urinary incontinence)
  • Failure in medical treatment for obstructive urinary symptoms
  • Urinary retention with the use of a bladder catheter
  • Health problems caused by the growth of the prostate: bladder stones, kidney failure, inguinal hernias, recurrent urinary tract infections

Benefits of bipolar TURP

When tissue is removed from the prostate, the urethra becomes wider and allows urine to come out more easily. This results in an improvement in urinary obstructive symptoms and improves the emptying of urine.

The procedure is endoscopic, which helps the recovery to be quick and with little pain.

Advantages of using bipolar energy in TURP

Bipolar TURP Monopolar TURP Laser vaporization
It can be done in patients with heart disease Yes Not recommended Yes
It can be done in patients taking Aspirin Yes Not recommended Yes
It can be done in patients with pacemaker Yes Not recommended Yes
Irritative urinary symptoms after the surgery Mild Mild Moderate to severe
Tissue is obtained for analysis of cancer Yes Yes No, unless a separate biopsy is done
Amount of tissue removed in less time of surgery +++ +++ ++
Control of obstructive symptoms Yes Yes Yes

Risks and complications

The possible complications that may occur when performing a TURP are the same that can occur in general with any surgical procedure and these are: hemorrhage, damage to nearby organs, reactions to anesthesia, etc. However, these complications occur infrequently and can be resolved mostly during the same surgery.

Alternatives to bipolar TURP are

Other options to treat obstructive prostatic growth are:

  • Pharmacological treatment (pills)
  • Open surgery
  • Laparoscopic surgery
  • HoLEP (Enucleation of the prostate with laser)
  • Laser vaporization of the prostate
  • Rezūm
  • Urolift

What to expect from bipolar TURP?

Day of surgery:

The day of the operation will arrive in the morning to the hospital in fasting

The surgery takes approximately 1-2 hours to be done, however, the time is variable.
Anesthesia for this procedure is spinal block (in the back) and sedation so you will not feel pain and will be relaxed during the procedure.

The pain after TURP is minimal and can be effectively controlled with intravenous analgesics.

Food: on the day of surgery you can eat in the afternoon, there are no food restrictions, however, a balanced diet is recommended.

Physical activity: the next day of surgery you can walk. It is expected to feel a bit fatigued after any surgery, this problem resolves spontaneously within a few weeks after the procedure.

Hospital stay: most patients operated of TURP remain hospitalized for 2 days.
Bladder catheter: after TURP, a bladder catheter is placed through the urethra, this facilitate the exit of the urine from the bladder and helps to irrigate the bladder with water to prevent obstruction by the clots. At 48-72 hours after surgery, this catheter is removed.
Wounds: this procedure leaves no scars on the skin because its endoscopic (through the urethra).