Bipolar TURP
Saline-based bipolar prostatic resection eliminating TUR syndrome entirely — equivalent outcomes to standard TURP with a superior safety profile for high-risk and anticoagulated patients.
What is Bipolar TURP?
Bipolar TURP uses bipolar electrical energy and normal saline irrigation instead of monopolar current and hypotonic glycine solution. Because current flows between two electrodes on the resection loop itself rather than through the patient, isotonic saline is used safely — completely eliminating TUR syndrome. Surgical outcomes in flow improvement and symptom relief are equivalent to monopolar TURP with a superior safety profile, particularly for patients with cardiac or renal comorbidities, those on anticoagulation, and patients with pacemakers in whom monopolar diathermy is contraindicated by international cardiac device guidelines.
How the Procedure Works
Bipolar Scope Insertion
Bipolar resectoscope introduced transurethrally; normal saline used as irrigation throughout; bladder and prostate inspected before resection begins.
Landmark Identification
Verumontanum, bladder neck, and ureteric orifices are identified; bipolar loop activated and tested before commencing systematic resection.
Systematic Resection
Lateral lobes and median lobe resected systematically; bipolar current returns through the adjacent loop electrode — not through the patient's body.
Chip Evacuation
Prostatic chips evacuated using Ellik evacuator; resected field inspected for completeness; all tissue collected for histological submission.
Haemostasis & Catheter
Bleeding vessels coagulated using bipolar diathermy; three-way catheter with continuous bladder irrigation placed; irrigation often discontinued earlier than monopolar.
Outcomes
Who Needs This Treatment?
- →Men with cardiac or renal comorbidities at higher risk of TUR syndrome from monopolar TURP fluid absorption.
- →Patients with cardiac pacemakers or implanted defibrillators for whom monopolar diathermy is contraindicated.
- →Those with large prostates requiring prolonged resection time beyond the 60–90 minute safe limit of monopolar.
- →Patients on anticoagulation where superior haemostasis reduces risk of post-operative haematuria and clot retention.
- →Elderly patients with reduced physiological reserve who benefit from the lower systemic risk of bipolar technique.
- →Men undergoing TURP in institutions where bipolar technology has become the established standard of care.
"Bipolar TURP has become our preferred resection technique. The safety of saline irrigation means we can operate confidently in patients with significant cardiac or renal comorbidities who would previously have been very high-risk TURP candidates."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
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