Bipolar Transurethral Resection of the Prostate (Bipolar TURP) is a minimally invasive procedure designed to remove the prostate tissue blocking urine flow and improve bladder emptying.
This article explains what Bipolar TURP is, why it is performed, who may benefit from it, how the procedure is carried out, its benefits, recovery process, potential risks, and how it compares with conventional TURP.
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What Is Bipolar TURP?
Bipolar Transurethral Resection of the Prostate (Bipolar TURP) is a surgical procedure used to treat urinary symptoms caused by Benign Prostatic Hyperplasia (BPH), a non-cancerous enlargement of the prostate gland. As the prostate enlarges, it can press against the urethra, restricting the flow of urine and making it difficult to empty the bladder.
During the procedure, a surgeon inserts a specialised instrument called a resectoscope through the urethra to access the prostate. Using a small wire loop that delivers bipolar electrical energy, the enlarged prostate tissue is carefully removed, creating a wider channel for urine to pass through. At the same time, the electrical energy seals blood vessels, helping to minimise bleeding during surgery.
Unlike conventional monopolar TURP, Bipolar uses normal saline as the irrigation fluid instead of non-conductive solutions. This significantly reduces the risk of Transurethral Resection (TUR) syndrome, a rare but potentially serious complication caused by the absorption of electrolyte-free irrigation fluid. The use of saline also provides a safer operating environment while maintaining excellent visibility throughout the procedure.
Why Is Bipolar TURP Performed?
Bipolar TURP is performed to relieve bladder outlet obstruction caused by Benign Prostatic Hyperplasia (BPH). As the prostate enlarges, it can compress the urethra and restrict the normal flow of urine. This obstruction may gradually worsen over time, making it difficult to empty the bladder and affecting everyday activities.
Although medications are often the first line of treatment for BPH, they may not provide adequate relief for every patient. In some cases, symptoms continue to progress, or complications develop despite medical therapy. Bipolar TURP is recommended to remove the excess prostate tissue causing the blockage, helping restore normal urine flow and reduce urinary symptoms.
The procedure may also be considered when an enlarged prostate leads to complications such as:
- Recurrent urinary retention
- Frequent urinary tract infections (UTIs)
- Bladder stones
- Recurrent blood in the urine (haematuria)
- Bladder damage or reduced kidney function caused by long-term urinary obstruction
By relieving the obstruction, Bipolar TURP can improve bladder emptying, reduce urinary symptoms, and help prevent further complications associated with untreated BPH.
Who Is a Candidate for Bipolar TURP?
Bipolar TURP is typically recommended for men with moderate to severe urinary symptoms caused by BPH that have not improved with medication or lifestyle changes. It is one of the standard surgical treatments for relieving bladder outlet obstruction and restoring normal urine flow.
Your urologist may recommend Bipolar TURP if you have:
- Frequent or urgent urination
- Difficulty starting urination
- A weak or interrupted urine stream
- A feeling of incomplete bladder emptying
- Recurrent urinary retention requiring catheterisation
- Repeated urinary tract infections
- Bladder stones or persistent blood in the urine caused by an enlarged prostate
Although Bipolar TURP is commonly performed for prostates measuring approximately 30–80 mL, the most appropriate treatment depends on several factors, including prostate size, symptom severity, overall health, and your surgeon’s assessment.
Benefits of Bipolar TURP
Bipolar TURP is recognised as an effective and reliable procedure for relieving urinary obstruction caused by an enlarged prostate. Removing excess tissue improves urine flow, reduces bothersome urinary symptoms, and enhances overall quality of life.
Compared with conventional monopolar TURP, Bipolar TURP offers several advantages:
- Effective long-term relief of urinary symptoms
- Improved urine flow and bladder emptying
- Better bleeding control during surgery
- Reduced risk of TUR syndrome due to saline irrigation
- Lower likelihood of requiring a blood transfusion
- Short hospital stay in many patients
- No external surgical incisions
Clinical studies have shown that Bipolar TURP provides symptom relief comparable to monopolar TURP while offering improved perioperative safety, making it a preferred technique in many modern urology centres.
How Is Bipolar TURP Performed?
Bipolar TURP is usually performed under general or spinal anaesthesia and typically takes 60 to 90 minutes, depending on the size of the prostate and the complexity of the procedure. Since the surgery is performed through the urethra, no external incisions are required.
During the procedure, the surgeon inserts a resectoscope through the penis and into the urethra until it reaches the prostate. The resectoscope is equipped with a camera and a small wire loop that delivers bipolar electrical energy. This allows the surgeon to carefully remove the enlarged prostate tissue blocking the flow of urine while simultaneously sealing blood vessels to help minimise bleeding.
Throughout the procedure, normal saline is continuously used to irrigate the surgical area. This helps maintain a clear view for the surgeon and reduces the risk of TUR syndrome, a recognised advantage of bipolar technology over conventional monopolar TURP.
Once enough prostate tissue has been removed, the tissue fragments are flushed into the bladder and removed. A urinary catheter is then placed to drain urine and irrigate the bladder during the initial healing period. The catheter is usually removed within 24 to 48 hours, depending on your recovery and your urologist’s assessment.
Recovery After Bipolar TURP
Recovery after Bipolar TURP is generally smooth, with most men noticing a gradual improvement in urinary symptoms over the following weeks. The length of recovery varies from person to person, but following your urologist’s post-operative advice can help promote healing and reduce the risk of complications.
During recovery, you can generally expect:
- Hospital stay: Most patients stay in the hospital for one to two days, depending on their recovery and overall health.
- Urinary catheter: A catheter is usually left in place for 24 to 48 hours to drain urine and allow the bladder to heal.
- Temporary urinary symptoms: Mild burning during urination, urinary frequency, urgency, and small amounts of blood in the urine are common during the early recovery period and usually improve within a few weeks.
- Activity restrictions: Avoid heavy lifting, strenuous exercise, and activities that place pressure on the pelvic area for four to six weeks, or as advised by your urologist.
- Hydration: Drinking plenty of water can help flush the bladder and support healing.
- Return to normal activities: Most men can resume light daily activities within one to two weeks, while complete recovery may take four to six weeks.
Contact your healthcare provider promptly if you develop a fever, severe bleeding, increasing pain, or difficulty passing urine after the procedure, as these may require medical evaluation.
Know more about Benign Prostatic Hyperplasia
Risks and Possible Complications of Bipolar TURP
Bipolar TURP is generally considered a safe and effective procedure, but like any surgery, it carries some potential risks. Most side effects are temporary and improve as the body heals, while serious complications are uncommon.
Possible risks include:
- Blood in the urine during the early recovery period
- Urinary tract infection (UTI)
- Temporary difficulty urinating
- Retrograde ejaculation, where semen enters the bladder during ejaculation
- Urethral stricture or bladder neck narrowing due to scar tissue (uncommon)
- Temporary urinary incontinence, which usually improves with recovery
- Need for additional treatment if prostate tissue regrows over time
Your urologist will discuss these risks before surgery and guide recognising symptoms that require medical attention after the procedure.
Conclusion
Bipolar TURP is a well-established and minimally invasive treatment for men with bothersome urinary symptoms caused by an enlarged prostate. It offers effective symptom relief, improved urine flow, and a favourable safety profile, making it a preferred surgical option in many cases. If medications are no longer providing adequate relief, consult a urologist to determine whether Bipolar TURP is the right treatment for your condition.
FAQs
What is the difference between TURP and Bipolar TURP?
Bipolar TURP uses bipolar electrical energy and normal saline irrigation, reducing the risk of TUR syndrome and improving bleeding control. Both procedures effectively treat an enlarged prostate.
Is TURP a major surgery?
No. TURP is a minimally invasive procedure performed through the urethra without any external incisions.
What is the recovery time for TURP prostate surgery?
Most men resume light activities within 1–2 weeks, while full recovery usually takes 4–6 weeks.
What is the Bipolar TURP technique?
Bipolar TURP removes enlarged prostate tissue using bipolar electrical energy through a resectoscope inserted into the urethra. The procedure uses normal saline irrigation for added safety.