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Yashoda Hospitals » Surgery Care » Bipolar/Monopolar TURP

Monopolar and Bipolar TURP in Hyderabad

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What is Monopolar / Bipolar TURP?

Bipolar/Monopolar TURP(Transurethral Resection of the Prostate) involves removing parts of the enlarged prostate gland through the penis to improve the flow of urine in men. It is a minimally invasive endoscopic surgery.

The surgery requires only a few hours of recovery time as it is done without an incision. It provides relief from urine retention and reduces the risk of untreated urinary infections, injuries to the urinary bladder and renal failure.

How is Monopolar and Bipolar TURP surgery performed: Before, During and After

Before Monopolar/Bipolar TURP

The patient will have to undergo ECG and blood tests a few weeks before surgery to see whether he is fit for the test.Just before surgery, he will be given a general or a spinal anaesthetic to prevent him from feeling pain during surgery.

During Monopolar/Bipolar TURP

During a TURP procedure, a thin metal tube containing a camera, light and loop of wire called a resectoscope is inserted into the urethra, which is the organ that carries urine out of the body. An electric current is used to heat the wire loop to cut out parts of the enlarged prostate. Afterwards, a thin, flexible tube and catheter are used to pump fluid into the bladder and the clean pieces of the prostate that have been cut. This takes about an hour.

After TURP Surgery and Precautions

The patient is required to stay in the hospital post-surgery. The stay duration can range from a few hours to 2 days. The catheter is left in place for 1 to 7 days after the surgery until the patient is able to urinate normally. It is adviced to abstain from sex, heavy lifting and exercising for 3 to 4 weeks.

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Cost of Monopolar/Bipolar TURP

The cost of TURP generally varies depending on other medical conditions and the type of hospital facility availed. Estimated costs are listed below:

Description Cost
Cost of TURP across India Approximately Rs. 1,17,500
Cost of TRP Surgery in Hyderabad Rs. 1,15,000 to Rs. 1,60,000

 

Bipolar and Monopolar TURP : Key Details

Procedure Monopolar TURP Bipolar TURP
Hospitalisation Few hours to 2 days Few hours to 2 days
Anaesthesia type Minor Minor
Type of surgery General/spinal anaesthesia General/spinal anaesthesia
Recovery Time 3-4 weeks 3-4 weeks
Duration of procedure 1 hour 1 hour

 

Risks and complications of Monopolar/Bipolar TURP surgery

Serious complications of TURP include

  • Retrograde ejaculation- losing the ability to ejaculate semen during intercourse despite experiencing an orgasm.
  • Urinary Incontinence- losing control of the bladder.
  • Erectile dysfunction due to reduced flow of blood to the penis.
  • Urinary infections.
  • Difficulty in urination.
  • Experiencing problems in emptying the bladder completely as the muscles that control the bladder can get temporarily damaged.
  • Bleeding during and after surgery which may require a blood transfusion.

Who needs a Bipolar and Monopolar TURP surgery?

Men with the following symptoms require Bipolar/Monopolar TURP

  • Weak and irregular urine flow
  • Straining for urination
  • Frequent need to urinate
  • Urge to urinate frequently during the night
  • Sudden urge to urinate
  • Bladder not emptying completely

These symptoms occur due to an obstructive condition called benign prostatic hyperplasia or BPH that is common in men over 50.

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Frequently Asked Questions

Monopolar TURP is an older method of TURP surgery, whereas Bipolar TURP is a new method.

In Monopolar TURP, tissue is cut with a wire loop that has an electrical current flowing in one direction. The site of surgery is irrigated with non-conducting fluid.

In Bipolar TURP surgery, a bipolar generator is used to cut the prostate with active and return electrodes present inside the instrument. The principal advantage of Bipolar TURP is the lower risk of TUR syndrome due to the systemic uptake of normal saline, which causes electrolyte disturbances.

According to a Gold-standard study, there was no difference between TURP and laser procedures in terms of hospital stay or complications. In fact, patients in the TURP group got back to their normal urinary flow rate faster. TURP is also more cost-effective and takes less time to perform than laser procedures.

TURP can last up to 10 years. The prostate gland does get large again and begins to press the urethra. The patient may have to get TURP done again to reduce symptoms of prostate enlargement, i.e. slow urination, urge incontinence, urinary incontinence, trouble clearing the bladder and pain.

Yes, TURP can be done twice. It has been seen that  repetitive surgery is required in  8.3% of the cases. After the TURP procedure, the prostate usually grows larger again within 10 years. This requires another TURP surgery to relieve the patient from  urination and incontinence problems, and pain.

The most common complication of  TURP surgery is retrograde ejaculation. Because of this complication, the ejaculated sperm goes into the bladder instead of coming out of the penis during intercourse.

In addition, up to 10% of male patients who undergo TURP surgery suffer from erectile dysfunction.

No, it is a minor procedure. TURP is a minimally invasive surgery, or an endoscopic surgery, which requires no incisions.

Retrograde ejaculation is a common complication of TURP that affects about 75% of patients. Since the semen doesn’t come out of the penis during intercourse, it can lead to infertility.

It happens due to decreased blood flow to the penis after the surgery. The muscles and nerves near the neck of the urethra are damaged during the surgery, which causes retrograde ejaculation. Both erectile dysfunction and retrograde ejaculation are more common in men over 50 years of age.