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Procedures

Prostate Surgery by Trans Urethral Resection of the Prostate (TURP)

How to go about?

A TURP is intended to remove an obstruction in the centre of the prostate to reduce its size, which prevents the flow of urine and prevents the bladder from emptying completely. A resectoscope is introduced through the penis to resect the interior of the prostate. No incision of the skin is therefore necessary. This is the most common surgical procedure for BPH (link dx HBP)

Note that a first assessment meeting is required at one of our clinics.

Please note that surgeries are performed in the only accredited private hospital in Quebec, at the Metropolitan Surgical Center. One-day post-operative hospitalization is planned.

When to do a transurethral resection of the prostate (TURP)?
Surgery may be used for the treatment of BPH in cases where the symptoms are severe or if the man is totally unable to urinate, or when the drug treatment has not been effective.
How is transurethral resection of the prostate (TURP) performed?
It is practiced mainly under spinal anesthesia. A special tube with a light and a camera (resectoscope) is inserted into the urethra into the prostate. Dr. Marois observes the inside of the urethra, prostate and bladder. The excess prostate tissue is removed or vaporized in the area surrounding the urethra. It's basically enlarging the hole like a donut hole. A catheter is placed in the bladder to allow urine to flow. The catheter is removed when there is no more blood in the urine (usually after 24 to 48 hours). Bladder irrigation is often necessary depending on the amount of bleeding in the urine following the operation. If there is little bleeding and the medical condition allows, the patient can leave with his probe at the end of the day. Otherwise, a night of hospitalization is often necessary.
What are the risks and complications of a TURP?
Risks and complications may include:

- bleeding - infection - Discomfort on the probe - Retrograde cumshot - Erectile dysfunction (rare) - Incontinence (rare) - Some men may have to undergo a second intervention (10% of men after 10 years).
What are the types of TURP?
Monopolar standard TURP:
  • It consists of resecting the tissue by means of an electric current.
  • The duration of the intervention is limited to less than 45 minutes, depending on the absorption of the liquid (glycine).
  • This technology is limited to prostates under 80 g to limit bleeding.
  • It carries more risk of haemorrhage.
  • This is the most commonly performed RTUP.
Bipolar TURP by PlasmaLoop:
  • It is performed by Dr. Marois at the Metropolitan Center of Surgery.
  • It consists of resecting the tissue by means of a bipolar electric current.
  • The duration of the intervention is not limited by the absorption of liquid since the surgery takes place in saline water.
  • This technology is less limited in the volume of the prostate and is mainly used with PlasmaButton in the case of larger prostates.
  • It has less risk of bleeding.
  • This is a more affordable option than laser surgery.
Bipolar electro vaporisation TURP with PlasmaButton:
  • It is performed by Dr Marois at the Metropolitan Surgery Center.
  • It consists in vaporizing the tissue by means of a bipolar electric current.
  • The duration of the intervention is not limited by the absorption of liquid since the surgery takes place in saline water.
  • This technology is not limited to the volume of the prostate and can be used with PlasmaLoop in the case of larger prostates.
  • The duration of the procedure is shorter than for laser surgery.
  • It has less risk of bleeding.
  • This is a more affordable option than laser surgery.
Holmium laser resection:
  • A holmium laser can be used to cut (enucleate) or spray the prostate.
  • Especially useful for bulky prostates over 80g.
  • The duration of the procedure is longer than for laser surgery.
  • It carries little risk of bleeding.
  • The necessary technology is expensive and less accessible.
GreenLight Photoselective Vaporization of Prostate:
  • A powerful green laser is used to spray the prostate.
  • Spraying is said to be photoselective because the red prostate tissue selectively absorbs the green light of the laser.
  • It carries little risk of bleeding.
  • The intervention is of a long duration.
  • The necessary technology is expensive.

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