Bipolar Plasma TURP for Enlarged Prostate
A procedure that removes excess prostate tissue through the urethra to improve urinary flow in men with an enlarged prostate.
Bipolar plasma TURP may be considered when urinary symptoms continue despite medication or when complications such as urinary retention, recurrent urinary tract infections or bladder stones occur.
A Surgical Procedure for Urinary Symptoms Caused by an Enlarged Prostate
Bipolar plasma transurethral resection of the prostate (TURP) is a surgical procedure used to treat urinary symptoms caused by benign prostatic hyperplasia (BPH), also known as an enlarged prostate.
Bipolar plasma TURP removes the part of the prostate causing the blockage through the natural urinary passage without external incisions.
What Is an Enlarged Prostate?
The prostate is a small gland located below the bladder and surrounding the urethra, the tube that carries urine out of the body.
The prostate commonly increases in size with age. This non-cancerous enlargement is known as benign prostatic hyperplasia (BPH).
Not all men with an enlarged prostate develop symptoms, and prostate size does not always reflect symptom severity.
Common symptoms include:
- A weak or interrupted urine stream
- Difficulty starting urination
- Straining to pass urine
- A sensation of incomplete bladder emptying
- Frequent urination during the day or night
- Sudden urgency to urinate
- Stopping and starting during urination
- Urinary leakage associated with urgency
Some men may develop complications, including:
- Urinary retention
- Recurrent urinary tract infections
- Bladder stones
- Blood in the urine
- Kidney problems caused by bladder outlet obstruction
When Might Bipolar Plasma TURP Be Recommended?
Many men with mild symptoms can be managed with lifestyle changes, monitoring or medication.
Surgery may be considered when symptoms interfere with daily activities, sleep or quality of life, or when complications occur.
Bipolar plasma TURP may be recommended if:
- Medication no longer provides sufficient symptom relief
- Side effects from medication are difficult to tolerate
- You experience repeated episodes of urinary retention
- You require a catheter because you cannot empty your bladder
- You develop recurrent urinary tract infections
- You develop bladder stones related to prostate enlargement
- You have persistent bleeding associated with prostate enlargement
- Kidney function is affected by bladder outlet obstruction
The decision to proceed with surgery depends on factors such as symptom severity, prostate size, bladder function, overall health and personal treatment priorities.
How Does Bipolar Plasma TURP Treat an Enlarged Prostate?
Bipolar plasma TURP is performed using a specialised instrument called a resectoscope, which is inserted through the urethra.
The resectoscope contains a small wire loop connected to a bipolar energy source. When activated, the loop generates a plasma field that allows excess prostate tissue to be removed while controlling bleeding during the procedure.
As the obstructing tissue is removed, the urinary channel becomes wider, which can improve the flow of urine from the bladder.
Unlike open surgery, bipolar plasma TURP is performed entirely through the natural urinary passage and does not require external incisions.
Normal saline is used to irrigate the bladder during the procedure. The tissue removed during surgery is routinely sent for laboratory analysis.
What Are the Features of Bipolar Plasma TURP?
Bipolar plasma TURP has several characteristics that may influence treatment decisions.
These include:
- Removal of excess prostate tissue through the urethra without external incisions
- Use of saline irrigation during surgery
- Collection of tissue samples for laboratory analysis
- A short hospital stay for most patients
- Relief of urinary retention caused by bladder outlet obstruction
- Suitability for many men with moderate-sized prostates
Bipolar plasma TURP is one of several surgical options for urinary symptoms caused by an enlarged prostate. The most appropriate treatment depends on factors such as prostate size, bladder function, symptom severity and individual treatment priorities.
What Tests May Be Needed Before Surgery?
Before recommending surgery, your urologist will confirm that prostate enlargement is the main cause of your symptoms and assess whether other conditions may be contributing.
Your assessment may include:
- Discussion of symptoms and medical history
- Physical examination, including a digital rectal examination
- Urine tests
- Blood tests, including kidney function and prostate-specific antigen (PSA) when appropriate
- Measurement of urinary flow rate
- Ultrasound assessment of bladder emptying
- Flexible cystoscopy in selected cases
- Urodynamic testing when the diagnosis is uncertain
You should inform your doctor about any medications you take, particularly blood-thinning medication.
What Happens During Bipolar Plasma TURP?
Bipolar plasma TURP is usually performed under general or spinal anaesthesia.
During the procedure:
- A resectoscope is inserted through the urethra.
- Excess prostate tissue causing the obstruction is removed.
- Bleeding points are controlled during surgery.
- Tissue samples are collected for laboratory analysis.
- A temporary urinary catheter is inserted.
No external incisions are required.
The procedure usually takes between 45 and 90 minutes, depending on the size and shape of the prostate.
What Can I Expect After Surgery?
Most patients remain in hospital for one or two days.
The catheter is usually removed within 24 to 48 hours.
After catheter removal, it is common to experience:
- Mild burning or discomfort when passing urine
- Increased urinary frequency or urgency
- Small amounts of blood in the urine
- Passing small blood clots or tissue fragments
- Temporary changes in urinary control
These symptoms usually improve gradually over several weeks.
Drinking adequate fluids, avoiding constipation and limiting heavy lifting can help reduce strain during recovery.
Many men return to office-based work within one to two weeks, although strenuous exercise and heavy physical activity should be avoided for approximately four to six weeks.
What Improvements Can I Expect After Bipolar Plasma TURP?
Many men experience improvement in urinary flow and bladder emptying after recovery.
Potential benefits include:
- A stronger urine stream
- Reduced urinary frequency and urgency
- Fewer night-time trips to the toilet
- Reduced sensation of incomplete bladder emptying
- Lower risk of future urinary retention
The rate and degree of improvement vary between individuals.
Some men notice changes soon after catheter removal, while others continue to improve over several weeks or months as the bladder adapts.
Men who have had long-standing symptoms or reduced bladder function may experience a slower recovery.
What Are the Possible Risks and Side Effects?
As with any surgical procedure, bipolar plasma TURP carries potential risks and side effects.
Potential complications include:
- Bleeding requiring additional treatment
- Urinary tract infection
- Temporary difficulty passing urine after catheter removal
- Scar tissue formation in the urethra or bladder neck
- Temporary urinary leakage
- Persistent urgency or frequency
- Erectile dysfunction, which is uncommon
- Retrograde ejaculation, where semen passes backwards into the bladder during orgasm
- Need for further treatment in the future
Your doctor will discuss the potential benefits and risks based on your individual circumstances.
How Does Bipolar Plasma TURP Compare With Other Enlarged Prostate Treatments?
Several treatment options are available for urinary symptoms caused by an enlarged prostate.
The most suitable treatment depends on prostate size, symptom severity, bladder function, overall health and personal preferences.
| Treatment | Removes Tissue | Suitable Prostate Size | Hospital Stay | Typical Catheter Duration | Preserves Ejaculation |
|---|---|---|---|---|---|
| Medication | No | Mild to moderate symptoms | None | None | Usually |
| Rezūm™ water vapour therapy | No | Selected small to moderate prostates | Day procedure | 3–7 days | Often |
| Bipolar plasma TURP | Yes | Moderate-sized prostates | 1–2 days | 1–2 days | Usually no |
| Aquablation® | Yes | Selected prostates | 1–2 days | 1–2 days | Often |
| HoLEP | Yes | Small to very large prostates | 1–2 days | 1–2 days | Usually no |
Your urologist can help you understand the potential benefits and trade-offs of each approach.
Frequently Asked Questions
Will I still need prostate medication after surgery?
Some men are able to reduce or stop their prostate medication after surgery. This varies depending on symptom improvement and other medical conditions.
Will bipolar plasma TURP affect sexual function?
Most men maintain erectile function after surgery. However, retrograde ejaculation is common.
Can I have bipolar plasma TURP if I already have a catheter?
Yes. Bipolar plasma TURP is commonly performed in men who are unable to empty their bladder because of prostate enlargement.
Can the tissue removed during surgery be tested?
Yes. Tissue removed during the procedure is routinely sent for laboratory analysis.
Can symptoms return after bipolar plasma TURP?
Many men continue to experience symptom improvement for years after surgery, although some may require further treatment over time.
How long does it take to recover from bipolar plasma TURP?
Most men return to office-based work within one to two weeks. Recovery varies between individuals, and strenuous exercise or heavy lifting should be avoided for approximately four to six weeks.
Will I need a catheter after bipolar plasma TURP?
Yes. A temporary urinary catheter is usually required after surgery and is commonly removed within 24 to 48 hours.
What is the difference between bipolar TURP and HoLEP?
Both procedures remove prostate tissue to improve urinary flow. The choice between bipolar TURP and HoLEP depends on factors such as prostate size, anatomy, available technology and treatment goals.
When Should I Seek Medical Attention After Surgery?
Contact your healthcare team promptly if you experience:
- Inability to pass urine
- Heavy bleeding or large blood clots
- Fever or chills
- Severe pain that is not improving
- Increasing difficulty passing urine
Early assessment can help identify and manage potential complications promptly.
Are Urinary Symptoms Affecting Your Daily Life?
Symptoms such as a weak urine stream, frequent urination, difficulty emptying the bladder or urinary retention can affect sleep, daily activities and quality of life.
If symptoms are affecting your sleep, daily activities or quality of life, an assessment can help determine whether an enlarged prostate is contributing to your symptoms and whether treatment may be beneficial.
Several treatment options are available, including lifestyle measures, medication and surgical procedures such as bipolar plasma TURP. The most appropriate approach depends on factors including symptom severity, prostate size, bladder function and your treatment priorities.