TURP (Transurethral Resection of the Prostate) at KIMS Secunderabad — Bipolar TURP, Safe and Proven BPH Surgery
At a glance — TURP at KIMS
- Full procedure name: Transurethral Resection of the Prostate — endoscopic resection of obstructing prostate adenoma through the urethra
- TURP type at KIMS: Bipolar TURP with normal saline irrigation — eliminates TUR syndrome risk entirely
- Best suited for: BPH with prostate volume 30–80cc · Failed medical treatment · Urinary retention · Primarily median lobe obstruction
- Symptom improvement: 85–90% of patients report significant IPSS improvement and improved uroflowmetry at 1 year
- Blood loss: Moderate and well-controlled with bipolar haemostasis — lower than monopolar TURP
- Catheter removal: 48–72 hours post-operatively
- Hospital stay: 2–3 nights · Day-care option for straightforward smaller glands in selected patients
- Histology: All resected chips sent for analysis — incidental prostate cancer detected in a small percentage
What is TURP and why does it remain relevant?
Transurethral Resection of the Prostate (TURP) is the most extensively studied surgical treatment for benign prostatic hyperplasia (BPH) in the world — backed by more than four decades of clinical evidence accumulated across hundreds of thousands of procedures. It removes the obstructing central zone of the prostate through the urethra with no skin incision, using an electrically heated wire loop that systematically shaves away the enlarged adenoma tissue in successive passes. The urethral channel is progressively widened until urinary flow is restored to a normal pattern.
For BPH with prostate volumes between 30 and 80cc, TURP delivers well-documented outcomes that few newer procedures can surpass: 85 to 90% of patients report significant symptom score improvement at 1 year, peak urine flow rate (Qmax) typically doubles or triples, and the procedure is completed within 30 to 90 minutes under spinal anaesthesia with 2 to 3 nights in hospital.
At KIMS Secunderabad, TURP is performed exclusively using the Bipolar technique with normal saline irrigation — a clinically meaningful advance over the older Monopolar TURP that used hypotonic glycine and carried a risk of TUR syndrome. Every patient presenting for BPH surgery at KIMS is assessed for all three surgical options — TURP, HoLEP, and TULSA-PRO — and the recommendation is genuinely individualised based on prostate volume, anatomy, anticoagulation status, and the patient's personal priorities.
TURP is not a second-best option. For BPH under 80cc in appropriate patients, it remains one of the most effective and best-evidenced urological procedures in existence. The KIMS recommendation of TURP carries genuine clinical meaning because KIMS also offers HoLEP and TULSA-PRO — so when KIMS recommends TURP, it is because TURP is the most appropriate choice for that specific patient.
Bipolar TURP — why the technique matters
Traditional TURP used a monopolar electrical cutting system that required hypotonic glycine irrigation fluid. if significant amounts of glycine irrigation were absorbed through the opened venous sinuses of the resection surface, a patient could develop TUR syndrome — dilutional hyponatraemia causing low blood sodium, leading to confusion, nausea, bradycardia, and severe neurological complications.
Bipolar = TUR syndrome eliminated
KIMS Secunderabad performs Bipolar TURP exclusively — using normal saline irrigation. In the bipolar system, the electrical circuit is localised, allowing physiologically normal saline to be used. TUR syndrome is completely eliminated as a risk. KIMS patients never face this complication.
| Feature | Bipolar TURP (KIMS) | Monopolar TURP |
|---|---|---|
| Irrigation fluid | Normal saline — isotonic, no disturbance if absorbed | Glycine — hypotonic, absorption causes dilutional hyponatraemia |
| TUR syndrome | Completely eliminated | Present — limits procedure to ~60–90 minutes maximum |
| Cardiac pacemakers | Safe | Contraindicated |
| Electrical circuit | Localised between two loop electrodes | Completed through patient to grounding pad |
| Safe operating time | Extended — limited by surgical judgement | Time-limited by absorption risk |
| Guideline status | EAU and AUA preferred technique | Retained only where bipolar equipment unavailable |
How TURP is performed at KIMS — step by step
TURP is an endoscopic procedure requiring no skin incision. The patient is placed under spinal or general anaesthesia and the resectoscope is passed through the urethra into the bladder.
| Stage | What happens |
|---|---|
| 1 — Cystoscopy and assessment | The resectoscope is used to inspect the bladder interior and assess the prostate anatomy — adenoma extent, pattern, and position of ureteric orifices. |
| 2 — Systematic resection | The bipolar cutting loop draws through the obstructing adenoma in successive passes from the bladder neck outward under saline irrigation. |
| 3 — Haemostasis | The resection surface is inspected and bleeding points coagulated with the bipolar current. Complete haemostasis is essential before withdrawal. |
| 4 — Chip evacuation | Resected prostate tissue chips are evacuated from the bladder using an Ellik evacuator and sent for histological analysis. |
| 5 — Catheter placement | A three-way urethral catheter for continuous bladder irrigation is placed to wash blood from the bladder as the resection surface heals. |
| 6 — Irrigation cessation | Once urine runs clear — typically at 48 to 72 hours — the catheter is removed and the patient is assessed for discharge. |
| 7 — Histological review | All resected chips are processed in the KIMS lab to screen for incidental prostate cancer. |
When is TURP the right choice for BPH?
The clinical decision at KIMS is based on prostate volume, specific pattern of obstruction, comorbidities, and patient priorities. TURP is most appropriate for:
- Prostate volume 30–80cc: Equivalent symptom improvement to HoLEP with a technically simpler procedure.
- Median lobe obstruction: Hypertrophy bulging into the bladder neck is suited to resection.
- Concurrent bladder pathology: Contracture or stones managed in a single session.
- Urinary retention: Definitely relieves obstruction efficiently.
- Shortest operating time: Typically 30 to 60 minutes for small to moderate glands.
- Personal preference: Fully considered alternatives and prefer the 40-year standard.
TURP is for BPH — not for prostate cancer. Patients with an elevated PSA or suspicious MRI findings should have their cancer pathway discussed before any BPH surgery. KIMS reviews PSA and prostate MRI at every pre-TURP consultation.
TURP vs HoLEP vs TULSA-PRO — honest comparison
| Feature | TURP | HoLEP | TULSA-PRO |
|---|---|---|---|
| Best prostate size | 30–80cc | any size, especially >80cc | under 150cc |
| Adenoma removal | partial central resection | complete enucleation | thermal ablation |
| Retreatment at 5 yrs | ~15% | <2% | ~10–15% (BPH data) |
| Blood loss | moderate | virtually bloodless | none |
| TUR syndrome | eliminated (Bipolar) | none | none |
| Anaesthesia | spinal or general | spinal or general | spinal or sedation |
| Hospital stay | 2–3 nights | 1–2 nights | same day |
| Catheter duration | 48–72 hrs | 24 hrs | few days |
| Retrograde ejaculation | ~75% | ~75% | significantly better preserved |
| Evidence base | 40+ years | 25+ years | 5+ years, FDA-approved |
Tip: For men where preserving ejaculation is a high priority — and prostate volume is appropriate — KIMS's TULSA-PRO programme (India's only centre) provides the best ejaculation preservation.
Recovery after TURP at KIMS
The absence of any external wound means there is no surgical site pain — the post-operative discomfort relates to the catheter and temporary bladder irritation.
- Continuous bladder irrigation: Saline runs for the first 24 hours to wash blood as the resection surface seals.
- Catheter removal: At 48 to 72 hours once urine runs clear — earlier than open prostatectomy.
- Hospital stay: 2 to 3 nights standard. Day-care TURP offered in selected cases.
- Blood in urine: Normal for 1–3 weeks. Visible blood common at day 10–14 when the post-resection scab separates.
- Temporary bladder symptoms: Urgency, frequency, and mild burning for 2 to 6 weeks.
- Return to desk work: 2 to 3 weeks.
- Return to strenuous activity: 4 to 6 weeks.
- Retrograde ejaculation: Occurs in approximately 75% of men. Not harmful, not erectile dysfunction.
- Follow-up: IPSS score and uroflowmetry at 6 weeks post-operatively at KIMS.
- PSA monitoring: A new post-TURP PSA baseline is established at 3 months for cancer monitoring.
Why choose KIMS Secunderabad for TURP?
Bipolar TURP as standard
Every TURP at KIMS uses the bipolar resectoscope with saline irrigation — the international standard. TUR syndrome is completely eliminated because it is impossible with saline.
Objective clinical recommendations
A TURP recommendation at KIMS carries genuine clinical meaning. The patient has been assessed for all three options, and the team has concluded TURP best serves their specific anatomy.
Incidental cancer detection
All TURP chips at KIMS are processed in our NABL-accredited laboratory. In approximately 5% of cases, incidental cancer is found, providing meaningful diagnostic value beyond symptom relief.
Nephrology integration
Men with longstanding obstruction frequently develop kidney damage. Our nephrology team co-manages patients to monitor and protect kidney function after the obstruction is relieved.
Our TURP specialists at KIMS Secunderabad
Frequently Asked Questions
Yes — for prostates between 30 and 80cc, TURP delivers equivalent symptomatic outcomes to HoLEP with a simpler endoscopic technique. For prostates above 80cc, HoLEP's complete enucleation capability and sub-2% retreatment rate make it the preferred choice.
TUR syndrome is a complication of older Monopolar TURP caused by absorption of glycine irrigation. KIMS performs Bipolar TURP with normal saline exclusively. Saline is isotonic and causes no electrolyte disturbance even if absorbed. TUR syndrome does not occur with bipolar TURP.
Open simple prostatectomy requires an abdominal incision and 5-7 days in hospital. At KIMS, the HoLEP programme eliminates the need for open surgery entirely by performing anatomically equivalent adenoma removal endoscopically, regardless of prostate size.
TURP does not typically affect erectile function as the nerves are outside the resection field. The most common sexual side effect is retrograde ejaculation (~75% of men), which is not harmful and does not affect the sensation of orgasm.
Most men notice improvement within the first week after catheter removal. Objective confirmation via uroflowmetry at 6 weeks typically shows a dramatic improvement in peak flow rate (Qmax).
TURP on anticoagulation carries higher blood loss risk than HoLEP. KIMS often recommends HoLEP for these patients, though TURP can be managed with cardio coordination on a case-by-case basis.
TURP provides long-lasting relief, but the retreatment rate is higher than HoLEP because only part of the adenoma is removed. At 5 years, approximately 15% of TURP patients require a further procedure compared to under 2% for HoLEP.
KIMS Secunderabad — Bipolar TURP as standard, full BPH programme with HoLEP and TULSA-PRO, NABL-certified histological analysis, and nephrology integration for obstruction-related damage.