Product Summary: AMA rates Trans-urethral endoscopic resection of the central gland of the prostate using Bi-polar energy.

Item Number: 37203, 105

This is the procedure used to resect the inside (enlarged, obstructive part) of the prostate. Known generally as the Re-Bore&. Salt water is used as irrigant.

Why is it done?

  • This procedure is performed when the prostate gland is enlarged to such an extent that medication cannot relieve the urinary symptoms.
  • Symptoms include: a weak stream, nightly urination, frequent urination, inability to urinate, (LUTS) kidney failure due to the weak urination (obstruction), bladder stones, recurrent bladder infections.
  • Medication such as Flomaxtra, Xatral Minipress etc. should always be given as a first resort.
  • Step-up therapy should have been used for prostates larger than 35-50cc with either Duodart, Avodart or Proscar.
  • Prostate cancer first needs to be ruled out by doing a PSA, and when indicated, with a 3T MRI scan of the prostate with an abnormal PSA with a possible prostate biopsy of any suspicious lesions.
  • A TURP can also be performed to disobstruct a severe prostate cancer, to allow a normal urination process.

How is it done?

  • Patients will receive a general anaesthesia, unless contra-indicated.
  • A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant jelly and an irrigant (fluid).
  • The inside of the bladder is viewed for pathology. If any suspicious lesions are seen, a biopsy will be taken.
  • A resection of the prostate is then started and should take 60-90 minutes.
  • Prophylactic antibiotics will be given to prevent any infections.

What can go wrong?

  • Any anaesthesia has its risks and the anaethiatist will explain this to you.
  • You may in extreme cases experience blood loss, which may require a blood transfusion.(<1%)
  • Please inform the practice and the hospital if you are a Jehova’s witness, and cannot use blood products.
  • In rare circumstances you may develop a dilutional hyponatremia,(TURP Syndrome) requiring a High Care Facility admission.
  • You will wake up with a catheter in your urethra and bladder. This will remain in the bladder for 3 days.
  • You will have a continuous bladder irrigant running in and out of your bladder to prevent clot formation.
  • Lower abdominal discomfort for a few days.
  • NB! Each person is unique and for this reason symptoms vary!

What next?

  • You will spend 3-5 days in hospital.
  • You will a trial without catheter as soon as your urine is clear (day 3).
  • You will be discharged as soon as you can completely empty your bladder.
  • You may initially suffer from urge incontinence and will improve within the next 6 weeks.
  • Allow for 6 weeks for stabilization of symptoms.
  • There may be some blood in your urine. You can remedy this by drinking plenty of fluids until it clears.
  • A ward prescription will be issued on your discharge, for your own collection at any pharmacy.
  • A follow-up appointment will be scheduled for 6 weeks. Should your pathology be worrisome, you will be contacted for an earlier appointment.
  • Don’t hesitate to ask Jo if you have any queries.


  • Retrograde ejaculation in more than 90% of patients. Therefore if you have not completed your family, this procedure is not for you unless absolutely necessary.
  • Infertility as a result of the retrograde ejaculation.
  • Stress incontinence especially in the elderly and the diabetic patients
  • Patients with Multiple Sclerosis, Strokes and Parkinsons have a higher risk of incontinence and risks should be discussed and accepted prior to surgery.
  • Urethral structuring in 2-3% of patients, requiring intermittent self dilatation.
  • Regrowth of prostate lobes within 3-5 years requiring a second procedure.
  • NB! Each person is unique and for this reason symptoms vary!


You still have a peripheral zone of your prostate and regular PSA reviews are required up to the age of 75.

(This could be seen as controversial).

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TURP Bipolar Saline