Benign Prostatic Hyperplasia (BPH) is a common condition in older men, characterized by the enlargement of the prostate gland, which can lead to various urinary issues. Two effective endoscopic treatments for BPH are the Traditional Transurethral Resection of the Prostate (TUR-P) and Plasmakinetic TUR-P techniques. Both procedures aim to alleviate symptoms by removing excess prostate tissue, but they differ in their methods and associated risks.

These FAQs (frequently asked questions) and answers provide a comprehensive overview of the endoscopic treatment of BPH using the Plasmakinetic We have been using both of these methods successfully for a long time.

FAQs and answers about traditional TUR-P and plasmakinekic TUR-P techniques

The working method and indications of both methods are similar. I have summarized the frequently asked questions and answers below:

1. What is BPH?

Answer: Benign Prostatic Hyperplasia, a condition in which the prostate gland enlarges, potentially causing urinary problems like difficulty in starting urination, a weak urine stream, and frequent urination, especially at night.

2. What is TUR-P?

Answer: TUR-P (Transurethral Resection of the Prostate) is a surgical procedure used to treat BPH. It involves the removal of prostate tissue using a resectoscope inserted through the urethra.

3. How does the TUR-P technique work?

Answer: During TUR-P, a surgeon inserts a resectoscope into the urethra and uses it to cut away excess prostate tissue. The removed tissue is flushed out with a special solution. This helps to relieve the obstruction caused by the enlarged prostate and improves urine flow.

4. What are the benefits of TUR-P?

Answer: The benefits of TUR-P include significant relief from urinary symptoms, improved urine flow, and a reduction in the frequency and urgency of urination. It is a minimally invasive procedure with a relatively short recovery time compared to open surgery.

5. Who is a good candidate for TUR-P?

Answer: Good candidates for TUR-P are men with moderate to severe urinary symptoms due to BPH who have not responded to medication. It is also suitable for those who have complications like bladder stones or recurrent urinary tract infections.

6. What are the risks and complications associated with TUR-P?

Answer: Risks and complications of TUR-P can include bleeding, infection, urinary incontinence, retrograde ejaculation, and, rarely, damage to the urethra or bladder. Long-term complications may include urethral strictures and bladder neck contracture.

7. How should I prepare for TUR-P?

Answer: Preparation for TUR-P may include undergoing preoperative tests, stopping certain medications, fasting for a specific period before surgery, and arranging for post-operative care. Your doctor will provide detailed instructions.

8. What can I expect during the recovery period?

Answer: Recovery from TUR-P typically involves a hospital stay of 1-2 days. You may have a urinary catheter for a few days to help with urination. Common post-operative symptoms include blood in the urine, frequent urination, and discomfort during urination, which usually resolve within a few weeks.

9. How long does it take to see improvement in symptoms?

Answer: Most patients notice an improvement in their symptoms within a few days to weeks after the procedure. Full recovery and the complete benefits of the surgery are typically realized within 6 to 12 weeks.

10. Are there any lifestyle changes required after TUR-P?

Answer: After TUR-P, it is important to avoid strenuous activities and heavy lifting for a few weeks. Drinking plenty of fluids helps flush out the bladder. Follow-up appointments with your doctor are crucial to monitor your recovery and manage any long-term complications.

11. Can TUR-P be repeated if necessary?

Answer: Yes, TUR-P can be repeated if symptoms recur or if there is residual prostate tissue causing problems. However, other treatment options may also be considered depending on individual circumstances.

12. What alternatives exist to TUR-P for treating BPH?

Answer: Alternatives to TUR-P include medication, minimally invasive treatments like UroLift or Rezūm, laser therapy, and open or robotic-assisted prostatectomy. The best treatment option depends on the severity of symptoms, prostate size, and overall health.

13.What is Plasmakinetic TUR-P?

Answer: Plasmakinetic TUR-P (Transurethral Resection of the Prostate) is a minimally invasive surgical technique used to treat BPH. It utilizes bipolar energy to remove excess prostate tissue, which helps to alleviate urinary obstruction and improve urine flow.

14. Are there any lifestyle changes required after Plasmakinetic TUR-P?

Answer: After Plasmakinetic TUR-P, it is important to avoid strenuous activities and heavy lifting for a few weeks. Drinking plenty of fluids helps flush out the bladder. Follow-up appointments with your doctor are crucial to monitor recovery and manage any long-term complications.

15. Can Plasmakinetic TUR-P be repeated if necessary?

Answer: Yes, Plasmakinetic TUR-P can be repeated if symptoms recur or if residual prostate tissue causes problems. However, other treatment options may also be considered depending on the individual case.

16. What alternatives exist to Plasmakinetic TUR-P for treating BPH?

Answer: Alternatives include medication, minimally invasive treatments like UroLift or Rezūm, laser therapy, and open or robotic-assisted prostatectomy. The best treatment option depends on the severity of symptoms, prostate size, and overall health.

17. What are the benefits of Plasmakinetic TUR-P compared to traditional TUR-P?

Answer: The benefits of Plasmakinetic TUR-P include reduced risk of bleeding due to the bipolar energy, shorter catheterization and hospital stay, lower chance of developing TUR syndrome (a rare but serious condition caused by fluid absorption), and quicker recovery time.

18. What can I expect during the recovery period?

Answer: Recovery from Plasmakinetic TUR-P usually involves a short hospital stay of 1-2 days. A urinary catheter may be placed for a few days to aid in urination. Post-operative symptoms such as blood in the urine, frequent urination, and discomfort typically resolve within a few weeks.

19. How long does it take to see improvement in symptoms?

Answer: Most patients notice an improvement in urinary symptoms within a few days to weeks after the procedure. Complete recovery and the full benefits of the surgery are typically achieved within 6 to 12 weeks.

20. Main Differences Between Traditional TUR-P and Plasmakinetic TUR-P

 Energy Source

• Traditional TUR-P: Utilizes monopolar electrical current to cut and remove prostate tissue. It requires a grounding pad on the patient’s body to complete the electrical circuit.
• Plasmakinetic TUR-P: Uses bipolar energy, which means the electrical current is confined to the area between two electrodes at the tip of the resectoscope.

Fluid Used for Irrigation

• Traditional TUR-P: Uses non-conductive irrigation fluids (e.g., glycine) to prevent the electrical current from spreading. This can lead to a rare but serious complication called TUR syndrome, which occurs when the irrigation fluid is absorbed into the bloodstream.
• Plasmakinetic TUR-P: Uses saline (a conductive fluid) for irrigation. This significantly reduces the risk of TUR syndrome.  .

Risk of Complications

• Traditional TUR-P: Higher risk of bleeding and TUR syndrome due to the type of electrical current and irrigation fluid used.
• Plasmakinetic TUR-P: Lower risk of bleeding and virtually eliminates the risk of TUR syndrome due to the use of bipolar energy and saline irrigation.

Hemostasis (Control of Bleeding)

• Traditional TUR-P: Hemostasis is achieved using monopolar cautery, which can sometimes be less effective and may result in more postoperative bleeding.
• Plasmakinetic TUR-P: Provides better hemostasis due to the bipolar cautery, which can coagulate blood vessels more efficiently, leading to reduced intraoperative and postoperative bleeding.

Tissue Removal Precision

• Traditional TUR-P: Effective in removing prostate tissue but may be less precise due to the broader spread of electrical current.
• Plasmakinetic TUR-P: Offers more precise tissue removal with minimal thermal damage to surrounding tissues, thanks to the controlled bipolar energy.

Patient Recovery and Hospital Stay

• Traditional TUR-P: May result in a longer hospital stay and recovery time due to higher bleeding risk and potential for TUR syndrome.
• Plasmakinetic TUR-P: Generally associated with a shorter hospital stay and quicker recovery time due to reduced bleeding and lower risk of complications.

 Procedure Safety

• Traditional TUR-P: Effective but carries higher risks related to the energy source and irrigation fluid.
• Plasmakinetic TUR-P: Considered safer due to the use of bipolar energy and saline, reducing the likelihood of serious complications.

Summary

In summary, while both traditional TUR-P and Plasmakinetic TUR-P are effective treatments for BPH, the latter offers several advantages in terms of safety, precision, and recovery due to its use of bipolar energy and saline irrigation.

Prof. Dr. Emin ÖZBEK

Urologist

Istanbul- TUIRKIYE