Bipolar prostatectomy

There are a variety of newer BPH treatments that can be classified in several ways:

• Through a large open incision (conventional prostatectomy).

• Through several small incisions.

• Through the urethra, without incisions which is called transurethral resection (TURP).

The preferred method of treating benign prostatic hyperplasia is TURP. An endoscope is utilized to view the patient's prostate and bladder anatomy while a sterile fluid is injected into the urethra. The urologist can then remove excess prostate tissue that extends into the urethra by inserting a resectoscope into the urethra. The prostate tissue is transported to the bladder by the fluid, where it is eventually eliminated.

There are clear benefits to transurethral resection. 

First, there are no surgical incisions.

Second, the procedure can treat an enlarged prostate of any size. 

Third, in most cases, the catheter can be removed the day after the procedure. Other prostate surgeries may require catheterization for longer periods, up to seven days. 

Transurethral resection of the prostate (TURP) can be performed with several different energy sources, including lasers, or with bipolar energy, commonly called a bipolar prostatectomy.

Bipolar prostatectomy involves an endoscope carrying an electric current to remove excess prostate tissue in patients with benign prostatic hyperplasia, where a low-frequency bipolar electric current is used. 

• The patient who is given the option of a traditional surgery is a suitable candidate for bipolar prostatectomy because his prostate gland is exceptionally large. For big prostates that weigh more than 80 grams, a bipolar prostatectomy is a viable surgical option.

• The ideal patient for bipolar prostatectomy suffers from urinary retention and the inability to urinate without a catheter.

• In the case of a large lobe in the prostate, other therapeutic methods may be challenging. The bipolar procedure allows the surgeon to separate the lobe accurately and safely.

Performing a transurethral resection using a bipolar scope means that the electric current does not pass through the patient's body, preventing injury to the surrounding healthy tissue as might occur with monopolar equipment. The bipolar endoscope has both electrodes on the device loop, so the current affects only the involved areas of the prostate. Additionally, bipolar systems allow prostate resection for patients who have pacemakers. 

• The catheter will typically only be left in place for the first night in most cases. The following morning, the catheter will be taken out. 

• Prof. Mahmoud AbdElHakim asks his patients to limit strenuous physical activity for the next two weeks and to drink plenty of fluids to maintain a light and clear urine. 

• After two weeks, patients can resume their normal activities. Strenuous activity may cause tissue fragments or bleeding to appear.

• If the patient suffers from urinary incontinence, it tends to improve within the first three months. If the patient had multiple urinary problems before the surgery— such as urinary frequency, urgency, or nocturia — these problems may worsen for a few weeks after the surgery before improvement.

Prof. Mahmoud AbdElHakim has the knowledge and experience to provide high-quality care to patients with BPH throughout their therapeutic course. Post-procedure monitoring and evaluation are mandatory to ensure the patient feels confident in receiving the best possible treatment and outcome.