Tuesday, June 11, 2024

What Is A Bipolar Turp

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What You Need To Know About Bipolar Turp

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Bipolar TURP is available for patients of New York Urology Specialists. Bipolar TURP is a newer, safer variation of the time-tested TURP procedure for enlarged prostate. Our urologists have extensive experience treating men with an enlarged prostate. We treat men with urinary retention, hematuria, bladder stones, and other problems caused by BPH. Our experienced urologists have helped hundreds of men live better. We offer medical therapy, minimally invasive office therapy for BPH including Rezum and Urolift, bipolar TURP, Greenlight laser, Evolve diode laser, as well as suprapubic prostatectomy.

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. Dr. Engel has his patients take out their own catheters the night before seeing him in the office so that urinary retention can be ruled out.

Offsetting these risks is a higher success rate 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.

Insurance Coverage For Turp Procedure

All health insurance plans in the United States cover the cost of the TURP procedure. At New York Urology Specialists we work with many insurances to get patient pre-qualified for Urolift:

  • Medicare coverage for TURP
  • Oxford Health Plan bipolar TURP Coverage
  • 1199 Insurance Coverage for TURP surgery for Enlarged Prostate
  • Empire Blue Cross Prostate TURP Coverage
  • CIGNA Coverage for BPH Treatment with bipolar TURP

New York Urology Specialists works with many insurance companies nationwide to obtain insurance coverage for patients who desire the Urolift Procedure for BPH.

Did you know?Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.

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What Is A Transurethral Resection Of The Prostate

A TURP is an operation for men who have problems passing urine because of an enlargement of the prostate gland. The aim of the operation is to remove the prostate tissue which is causing the blockage, so you get relief of your symptoms.

A cystoscope is passed through the urethra to visualise the prostate and bladder. A cautery loop is used to cut away the enlarged lobes of prostate tissue. The capsule of the prostate is left intact. The effect of this is to remove the obstructing prostate tissue. A catheter is then inserted which drains urine from the bladder. It is usually removed the following day.

An anaesthetic is required for this procedure. This may be a general anaesthetic, but could also be a spinal anaesthetic. Your anaesthetist will discuss the benefits and risks of each of these with you prior to your operation.

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  • Charalampos MamoulakisCorrespondenceAddress correspondence to: Charalampos Mamoulakis, M.D., M.Sc., Ph.D., F.E.B.U., Department of Urology, University General Hospital of Heraklion, University of Crete, Medical School, Voutes-Stavrakia 71110 Heraklion Crete, Greece.
  • Jean J.M.C.H. de la RosetteAffiliations

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What To Expect Afterwards:

You are usually able to eat and drink what you feel like after the surgery. Pain relief is always available however, it is not usual to have significant pain after this procedure. A combination of the surgery and the catheter can cause bladder irritation and sometimes bladder spasm.

After removal of the catheter there will most likely still be some blood in the urine. Once we can see that you are passing urine satisfactorily then you are able to go home.

You will be given pain relief if required and antibiotics if necessary to take home with you.

It is important to be aware of the potential risks associated with this surgery including

Analysis Of Both Procedures

Both button TURP and green light laser have similar advantages: both are either an outpatient or overnight procedure, bothhave less chance of bleeding, theres a faster return to activities, and reduced time period of catheterization.

An advantage button TURP has over green light laser is that the surgeon is able to retrieve a sample of the prostate tissue to be examined for any signs of prostate cancer. In addition, it takes a shorter period of time, about 60 minutes, to remove more tissue with button TURP over green light laser. Many men will also experience fewer post-surgery symptoms when button TURP is performed over laser surgery.

Ultimately, the decision of which one to use should be guided by an experienced urologist who has performed numerous surgeries using both button TURP and green light laser. They can help a man determine the course of action to take to achieve the best results.

Patients newly diagnosed with Benign prostatic hyperplasia can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free consultation by calling 212-365-5000.

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How Do I Get Ready For A Turp

Some things you can expect before the procedure include:

  • Your healthcare provider will explain the procedure and you can ask questions.
  • You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything isnt clear.
  • Your healthcare provider will review your medical history, and do a physical exam to be sure youre in good health before you have the procedure. You may also need blood tests and other tests.
  • You will be asked not to eat or drink anything for 8 hours before the procedure, generally after midnight.
  • Tell your healthcare provider if you are sensitive to or allergic to any medicines, latex, iodine, tape, contrast dyes, or anesthesia.
  • Make sure your healthcare provider has a list of all medicines herbs, vitamins, and supplements that you are taking. This includes both prescribed and over-the-counter.
  • Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicines , aspirin, or any other medicines that affect blood clotting. You may need to stop these medicines before the procedure.
  • If you smoke, stop as soon as possible to improve recovery and your overall health.
  • You may be given a sedative before the procedure to help you relax.

Based on your medical condition, your healthcare provider may request otherspecific preparation.

My Post Turp Recovery And Experience

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I just want to thank everyone who followed and contributed in my earlier discussion ” MY BPH EXPERIENCE”.

I had my TURP on June 1, 2016. Procedure went well, in OR less than 2 hours. Got pictures from my urologist with before and after surgery. Stayed overnight in

hospital. Did not have much pain at all and had 3-way catheter for continius bladder irrigation. Did not bleed much. Next morning urologist came to see me and removed catheter. With voiding trial I did not have much luck. My first PVR was 335 and 2nd PVR went to 425 and I already felt I won’t go home without catheter. Started urinating about every 5-10 minutes very small amounts of urine less or about 100 ml. Nurse checked 3rd time my PVR and it was over 500 ml. Urologist ordered catheter to be inserted and I could be discharged home. Came back home orotund 4 pm on Thursday June 2nd. Dealing with catheter, tubing and bag is different story or better said “pain in the neck” and I dealt with that for 8 days until my appointment with urologist on June 9th. I worked on Saturday June 4th and regularly after that. I am very lucky to have job from home. Sitting was fairly uncomfortable but I managed to work every day 8-9.5 hrs.

Minutes later, urologist came in and ask about recovery and how I feel after catheter removal. We talked about procedure and what to expect on the road of recovery.

Than comes huge and unexpected very negative surprise:

I am still in shock.

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What Is Button Turp

Button TURP, also called bipolar cautery vaporization, is a newer, less invasive variation of the procedure. Instead of a wire loop on the end of the scope, the surgeon uses a device with a small, button-shaped tip to vaporize prostate tissue.

Button TURP uses low-temperature plasma energy, instead of heat or electrical energy, to remove prostate tissue. Once the extra tissue is removed, the area around it is sealed off to prevent bleeding.

Button, or bipolar, TURP is an umbrella term for a number of different treatments that aim to achieve the same overall outcome, but with different tools, techniques, or device manufactures.

Any procedure that uses an electrode button with bipolar vaporization is a button procedure. Innovations in the procedure involve modifying the shape of the button or making slight changes to the surgical techniques.

How Bipolar Turp Works

Bipolar refers to the use of a two-way electrical current, as opposed to the older monopolar technology, which can be riskier due to potential water or glycerine buildup in the body. Because bipolar TURP uses a conductive saline solution, the procedure is much safer, allowing for longer surgical time as necessary for more complicated cases, as well as more efficient elimination of excised prostate tissue.

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What Is Bipolar Turp Procedure

Bipolar TURP: A newer technique, Bipolar TURP uses bipolar current to remove the tissue. Because it allows for saline irrigation it reduces complications such as TUR syndrome. This allows for longer procedure length.

What is TURP syndrome?

Transurethral resection of prostate syndrome is a complication characterised by symptoms changing from an asymptomatic hyponatremic state to convulsions, coma and death due to absorption of irrigation fluid during TURP.

Why Turp Is Carried Out

TURP Resectoscope Sheath Manufacturer

TURP is often recommended when prostate enlargement causes troublesome symptoms and fails to respond to treatment with medication.

Symptoms that may improve after TURP include:

  • problems with starting to pee
  • a weak flow of pee, or stopping and starting
  • having to strain to pee
  • a frequent need to pee
  • waking up frequently during the night to pee
  • a sudden urge to pee
  • being unable to empty your bladder fully

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My Bipolar Turp Experience

I had B-TURP, bipolar resection of the prostate, on August 26, 2016, at the age of 59 years and 8 months.

After my head-spinning, perhaps-too-thorough research of all the treatments, including steam ablation and a study at a local hospital of prostate artery embolization, in the end I came back to B-TURP, which is the tried-and-true surgery my urologist in Plantation, Florida, recommends and performs. (To quote the conclusion of one of many articles on the subject, Bipolar TURP is safer than monopolar TURP because of lower risk for TUR syndrome , less intraoperative bleeding, and lower incidence of postoperative complications.

Next up, I scheduled the surgery four weeks out with the staffs surgical coordinator, who told me I needed to consult with my primary care physician to get cleared for surgery, which included blood work, an EKG, and a chest X-ray, all of which had to be done no earlier than 30 days from surgery. The tests came back and I was good to go.

4 likes, 68 replies

  • Posted 6 years ago

    Same here about the strangers John. Went from a short list of people to half the hospital seeing my junk. Lol. And I don’t think one of them was more than half my age.

  • Functional Outcomes Among B

    Preoperative total IPSS score was similar between groups . After surgery, total IPSS score improved at 1-and 3-months in each group as compared to baseline evaluation . However, at each follow up assessment, total IPSS score did not differ according to prostate volume. Both storage and voiding symptoms significantly improved after surgery, irrespective of PV . The ICIQ-SF score was higher at 1 months after surgery in each group as compared to baseline , but it returned to preoperative value at 3 months. No differences were found in terms of ICIQ-SF scores at each follow up assessment according to prostate size.

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    Cost/ Benefit Ratio Of Turp Versus Pvp

    One of the most popular BPH laser techniques is GreenLight Prostate Laser Vaporization . As its chromophore is blood, this laser has a deep penetration into soft tissues. High power green laser energy is delivered sideways into prostate tissue, producing tissue vaporization and soft tissue ablation, with an excellent hemostatic property.

    Since its introduction, PVP has emerged as a promising surgical treatment for the management of BPH, exhibiting both efficacy and safety outcomes comparable to the standard of care , with a durable response.17,18 Moreover, PVP has started to gain increasing acceptance worldwide due to a shorter LOS and catheterization, a faster return to stable health status, and the possibility of an outpatient surgery regimen. PVP has also demonstrated to provide real-time tissue debulking with an excellent hemostasis, even in high-risk patients and those on ongoing oral anticoagulation or antiplatelet agents.19,20 Despite these main advantages, PVP has been criticized for limited reduction of PV, prolonged storage symptoms, and the cost of equipment and accessories. To date, only few studies have assessed a cost- effectiveness analysis comparing TURP and PVP.

    Bipolar Turp Procedure Steps Overview

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    There are a variety of new BPH treatments that can be categorized in a multitude of ways: minimally invasive vs. full anesthesia, ablative vs. non-ablative, permanent vs. temporary device implantation, and laser vs. other energy sources. The bipolar TURP procedure was historically considered as the gold standard treatment for benign prostate hyperplasia . The TURP procedure steps are as follows: sterile solution is delivered into the urethra and a transurethral cystoscopy is performed to visualize the patients prostate and bladder anatomy. Then, a transurethral resectoscope is inserted, allowing the urologist to trim excess prostate tissue that protrudes into the urethra. The fluid carries the prostate tissue into the bladder, and the excess tissue is eventually removed. Bipolar and monopolar TURP procedures are differentiated with regard to the energy source of the resectoscope the recently developed bipolar TURP procedure uses a low-frequency bipolar electrical current and saline irrigation while traditional monopolar TURP procedure uses a high-frequency monopolar electrical current and electrolyte-free irrigation.

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    Bipolar Turp Associated With Substantial Cost Savings

    Bipolar transurethral resection of the prostate offers an economic benefit compared with monopolar TURP that follows from the clinical differences between the two procedures, concluded investigators who presented their findings at the 2017 Western Section of the AUA annual meeting in Vancouver, BC.

    Bipolar transurethral resection of the prostate offers an economic benefit compared with monopolar TURP that follows from the clinical differences between the two procedures, concluded investigators who presented their findings at the 2017 Western Section of the AUA annual meeting in Vancouver, BC.

    Results of a number of clinical studies demonstrate the effectiveness of bipolar TURP and show that compared with monopolar TURP, the bipolar procedure is associated with lower rates of complications, including TUR syndrome, blood transfusions, and clot retention, said senior author Christina L. Cool, MPH, manager of Life Sciences Consulting at Baker Tilly Virchow Krause, New York.

    To our knowledge, however, ours is the first U.S. cost analysis comparing bipolar and monopolar TURP, and its results show that bipolar TURP clearly provides cost savings. Technology such as bipolar TURP that improves care quality while reducing cost is inarguably a win for providers, payers, and patients.

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    Prostate Size And Blockage Of The Urethra

    If the inner part of the prostate gland obstructs the urethra during urination, this will irritate the bladder and cause urinary symptoms.Urinary symptoms may include:

    • frequent urination, particularly at night
    • urgency and possible urgency incontinence
    • passing drops of urine involuntarily after you think youve finished
    • blood in the urine although this can never be assumed to be due to the prostate until other causes have been excluded.

    The actual size of the prostate does not appear to determine whether or not there is a blockage. Some men with large prostates never develop obstruction, but some men with small prostates can have severe bladder obstruction, which causes difficulty with urinating.Around one in three Victorian men over the age of 50 years have some urinary symptoms. In most cases, these symptoms are due to a blockage caused by an enlarged prostate, but they may be due to other causes.

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    Cost Of Treatment And Insurances

    At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.

    We accept many health insurance plans. We would be happy to verify your eligibility and benefits and to provide you with detailed information on your health plans coverage. and credit options are available to help you pay for medical care.

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