Bipolar Transurethral Resection of the Prostate (TURP) For Enlarged Prostate (BPH)

Click Here to Watch an On-Demand Webinar on BPH with Dr. Grant

Transurethral Resection of the Prostate or TURP is a surgical procedure used to shrink the prostate by physically cutting away areas of excess prostatic cell growth (hyperplasia) in order to improve urinary function in men.

There was a time not too long ago when the Trans-Urethral Resection of the Prostate was the most commonly performed operation in America besides cataract operations. This was before the advent of alpha-blockers and 5-alpha reductase inhibitors as medical therapy for benign prostatic hypertrophy (BPH). Now, patients with BPH symptoms that want to be treated, or must be treated due to a complication are usually treated by the surgeons at UrologyMax in a stepwise fashion.

Scroll down to view the operative video

First, medical therapy is introduced. The patient on his own may try herbal remedies such as saw palmetto. Symptoms do usually progress despite medical therapy, and at that point, the patient may be offered a second medication or a minimally invasive office treatment. Some patients will not get adequate relief from an office treatment, recur early, or just want a procedure with a higher success rate and faster results.

Some patients have problems associated with their BPH which require more aggressive obstruction relief such as infections, bladder stones, severe urinary retention, or even kidney failure. These patients are typically offered a TURP.

How the TURP Is Performed

The TURP itself has gone through several improvements over the years, brought on in large part by competitive pressure by lasers used for the same purpose such as the Green Light Laser, or Holmium laser (HoLEP). Now, a TURP is done via continuous flow, using bipolar electrical current. This allows the surgeon to use saline as an irrigant rather than water, and this has dramatically increased our ability to offer a bipolar TURP to patients with larger prostates allowing for longer resection times and far fewer complications. A bipolar TURP is the preferred OR procedure of the surgeons at UrologyMax, with benefits that far outweigh those provided by the various laser vaporization systems currently marketed.

This video below represents an actual TURP procedure – Warning, Content is graphic

A bipolar TURP is typically now done under general anesthesia, lasts an hour to 1.5 hours, and will involve an overnight hospital stay.

TURP Recovery & Aftercare

There is little pain with a TURP. Blood in the urine is to be absolutely expected and can occur for up to a month in a limited fashion. Although the catheter can be removed the next day, more typical is for the patient to be sent home with the urinary catheter for a few days so as to take a catheter out on a Monday to avoid problems over the weekend. Dr. Grant has his patients take out their own catheters the night before seeing him in the office so that urinary retention can be ruled out.

The main reasons one may choose a minimally invasive office procedure are that a bipolar TURP must be done under anesthesia, requires a visit to the internist, has a nearly 100% retrograde ejaculation rate, and carries with it a 1% risk of postoperative incontinence. There are the usual risks of pain, infection of course, and bleeding as mentioned.

Offsetting these risks is a higher success rate (93%) and more immediate relief. The risks of a TURP are not very high, but since they are higher than an office procedure we usually consider it the procedure to turn to when other remedies have failed. Once done, it is extremely effective and patients usually consider their problem solved. It can take up to three months for the bladder to adjust to urinating without obstruction, which leads to less warning time to get to the bathroom after a TURP, but with time this should resolve.

Due to tissue regrowth patients, on average, will enjoy 7 years of relief with a bipolar TURP.

TURP is typically used for patients suffering from more significant obstruction due to an enlarged prostate

What You Need To Know

Prior To The Procedure

  • Prepare for an overnight hospital stay
  • Do not eat after midnight before surgery
  • Follow all other pre-procedure instructions provided by our office

What To Expect

  • General anesthesia
  • 1.5 hour procedure time
  • Overnight hospital stay
  • Typically, little pain
  • Blood in urine should be expected and gradually improves over time
  • Catheterization for a few days
  • Exceptional 93% success rate
  • Up to 7 years of relief

Considerations & Complications

  • Nearly 100% retrograde ejaculation rate
  • ~1% risk of post-operative incontinence
  • Typical risks of pain, bleeding and infection
  • It may take up to 3 months for the bladder to adjust to urinating without obstruction

Clinical Trials, Research & Publications

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Frequently Asked Questions

How do I schedule an appointment at UrologyMax?

Schedule online or call 1-800-876-6299 or use our online booking. Same-day and telehealth appointments are available.

Does UrologyMax accept insurance?

UrologyMax works with most major insurance plans. Contact our billing team at 1-800-876-6299 to verify your coverage before your visit.

What should I bring to my first urology appointment?

Bring your insurance card, photo ID, medication list, prior test results, and a completed patient intake form available on our website.

Are telehealth consultations available?

Yes. UrologyMax offers telehealth consultations for many urological concerns, including ED prescriptions, follow-up visits, and second opinions.

What makes UrologyMax different from other urology practices?

UrologyMax combines advanced robotic surgery capabilities with discreet online ED medication ordering and a patient-first approach to comprehensive urological care.

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