BPKRP for
Enlarged Prostate
Modern bipolar plasma technology offering effective prostate treatment with minimal bleeding and shorter hospital stay — no open incision required.
What is BPKRP?
BPKRP (Bipolar Plasma Kinetic Resection of the Prostate) is a modern, endoscopic procedure for treating BPH (benign prostatic hyperplasia). It uses bipolar plasma energy delivered in normal saline to resect the obstructing prostate tissue — relieving urinary symptoms without any skin incision.
Bipolar Plasma Energy
Unlike conventional monopolar TURP, BPKRP completes the electrical circuit between two electrodes on the resectoscope itself — using isotonic saline as the irrigant instead of hypotonic fluid, eliminating the risk of TUR syndrome.
Via Resectoscope — No Incision
A specialised bipolar resectoscope is passed through the urethra. The plasma loop resects obstructing prostate lobes under direct vision, restoring the urinary channel without any skin wound or external incision.
Resection & Vaporisation
Prostate chips are resected and flushed out through the sheath, or the bipolar electrode can be used in vaporisation mode to ablate tissue simultaneously — allowing the approach to be tailored to prostate size and anatomy.
Superior Haemostasis
The bipolar plasma provides excellent coagulation as tissue is resected, resulting in minimal intraoperative bleeding — a critical advantage over monopolar TURP, particularly for patients on anticoagulants or with large prostates.
BPKRP Approaches for Different Prostate Sizes
Dr. Anand Utture selects the most appropriate bipolar technique based on prostate volume, anatomy, and patient-specific factors.
Bipolar TURP (B-TURP)
The standard bipolar resection technique using a loop electrode to resect prostate chips systematically. Effective for prostates up to approximately 80 ml, with significantly reduced blood loss compared to monopolar TURP.
Bipolar Vaporisation (BPVP)
Uses a button or mushroom electrode to vaporise prostate tissue rather than resect chips. Minimal bleeding, suitable for patients on anticoagulation, and avoids the need to retrieve resected tissue from the bladder.
Bipolar Enucleation (BPEP)
A more advanced technique that enucleates the prostate adenoma along anatomical planes — similar to HoLEP — offering superior outcomes for larger prostates while retaining the safety advantages of bipolar plasma energy.
How BPKRP is Performed
The procedure follows a structured sequence to ensure complete symptom relief with maximal patient safety.
Anaesthesia
Spinal or general anaesthesia is administered. Pre-operative antibiotics are given. The patient is positioned in the lithotomy position.
Resectoscope Insertion
The bipolar resectoscope is passed through the urethra. The urethra, verumontanum, bladder neck, and prostate lobes are inspected under direct vision.
Prostate Resection
The obstructing adenoma is systematically resected using the plasma loop. Continuous saline irrigation maintains a clear operative field and simultaneous haemostasis.
Chip Evacuation
Resected prostate chips are evacuated from the bladder using an Ellik evacuator. A specimen is sent for histopathological analysis to exclude incidental prostate cancer.
Catheter & Discharge
A urethral catheter is placed for 24–48 hours. Once urine clears and voiding is satisfactory after catheter removal, the patient is discharged.
Advantages of Bipolar Plasma Resection
BPKRP has become the preferred endoscopic technique for BPH surgery at most high-volume centres — combining the efficacy of TURP with a significantly improved safety profile.
Zero TUR syndrome risk
Saline irrigation eliminates the risk of dilutional hyponatraemia (TUR syndrome) — the most feared complication of conventional monopolar TURP.
No skin incision or scar
The entire procedure is performed endoscopically through the urethra — no external wound, no drain, no scar.
Minimal blood loss
Bipolar plasma provides superior haemostasis during resection, significantly reducing intraoperative bleeding compared to monopolar TURP.
Shorter catheterisation
Due to reduced bleeding, the catheter is typically removed within 24–48 hours — faster than conventional TURP, with most patients discharged the next morning.
Safe for high-risk patients
The absence of TUR syndrome risk and reduced blood loss makes BPKRP significantly safer for elderly patients and those with cardiac or renal comorbidities.
Tissue sent for histology
Resected prostate chips are sent for pathological examination — allowing incidental prostate cancer to be detected in a small but important subset of patients.
Durable symptom relief
Long-term outcomes for BPKRP are equivalent to monopolar TURP — with sustained improvement in flow rate and IPSS symptom scores at 5-year follow-up.
Suitable for anticoagulated patients
The bipolar vaporisation mode allows safe treatment of patients who cannot safely discontinue blood-thinning medications before surgery.
When is BPKRP Recommended?
BPKRP is the preferred surgical option for BPH in a wide range of clinical scenarios — particularly where safety and reduced blood loss are priorities.
BPKRP vs. Other Prostate Treatments
Understanding how BPKRP compares helps Dr. Anand Utture recommend the most appropriate approach for your prostate size and health profile.
| Feature | BPKRP | Monopolar TURP | HoLEP | Open Prostatectomy |
|---|---|---|---|---|
| No skin incision | ✓ | ✓ | ✓ | ✗ |
| TUR syndrome risk | None | Up to 2% | None | Minimal |
| Suitable for large prostates | Up to ~100 ml | Up to ~80 ml | Any size | Any size |
| Hospital stay | 24–48 h | 2–3 days | 24–48 h | 5–7 days |
| Tissue for histology | ✓ | ✓ | ✓ | ✓ |
| Safe on anticoagulation | ✓ | ✗ | Selective | ✗ |
What to Expect Before, During & After BPKRP
Preparing for the Procedure
Dr. Anand Utture will arrange pre-operative evaluation including a urine culture to rule out active infection before surgery. Urodynamic studies and a transrectal or transabdominal ultrasound are used to assess prostate size and post-void residual volume.
Blood tests assess haemoglobin, kidney function, and PSA. Any anticoagulant medications are reviewed and paused in consultation with your prescribing physician. A urology consultation will discuss expectations, risks, and the likely outcome for your prostate size.
You will be asked to fast for 6 hours before the procedure. An enema is not routinely required for endoscopic prostate surgery.
Recovery & Post-Operative Care
A urethral catheter remains in place for 24–48 hours after surgery to allow the resection cavity to settle and urine to drain freely. Once the urine clears and the catheter is removed, voiding is assessed before discharge.
Some burning on urination and urinary frequency in the first 2–4 weeks is normal as the resection cavity heals. Strenuous activity, heavy lifting, and sexual intercourse should be avoided for 3–4 weeks. Staying well hydrated accelerates recovery.
A follow-up appointment at 6 weeks assesses symptom scores and uroflowmetry. Most patients notice a marked improvement in urinary flow within days of catheter removal.
Enlarged prostate diagnosed? Consult Dr. Anand Utture for BPKRP in Mumbai.
With over 27 years of experience in urological surgery, Dr. Anand Utture offers bipolar plasma resection for BPH — effective, scarless, and with minimal bleeding and a short hospital stay. Serving patients across Mumbai, Thane, and Maharashtra.
Frequently Asked Questions — BPKRP for Enlarged Prostate in Mumbai
What is BPKRP?
BPKRP (Bipolar Plasma Kinetic Resection of the Prostate) is a modern endoscopic procedure for BPH. It uses bipolar plasma energy in normal saline to resect obstructing prostate tissue through a resectoscope passed via the urethra — no skin incision is made. It is considered a safer evolution of the conventional monopolar TURP.
Is BPKRP safe for elderly patients?
Yes — BPKRP is significantly safer than monopolar TURP for elderly and high-risk patients. Because it uses isotonic saline instead of hypotonic fluid, TUR syndrome (dilutional hyponatraemia) is virtually eliminated. Reduced blood loss and a shorter catheter time further reduce the physiological stress of surgery.
What prostate size can be treated with BPKRP?
Standard bipolar resection is effective for prostates up to approximately 80–100 ml. For larger glands, the bipolar enucleation technique (BPEP) — which follows anatomical planes — can treat any size prostate endoscopically. Very large prostates (above 100 ml) may alternatively be treated with HoLEP or open prostatectomy.
How long is recovery after BPKRP?
The catheter is typically removed after 24–48 hours. Most patients are discharged the morning after surgery once voiding is satisfactory. Burning, frequency, and mild blood in urine for 2–4 weeks is expected and settles as the resection cavity heals. Strenuous activity is avoided for 3–4 weeks.
Will BPKRP affect sexual function?
Retrograde ejaculation (dry orgasm) occurs in approximately 60–90% of patients after BPKRP — similar to conventional TURP — as the bladder neck mechanism is disrupted during resection. Erectile function and the sensation of orgasm are not affected by the procedure. Dr. Anand Utture will discuss this and other potential side effects at your consultation.
Is the procedure permanent? Can BPH come back?
BPKRP removes the obstructing prostate adenoma and provides durable, long-term symptom relief in the vast majority of patients. A small proportion may develop recurrent symptoms over many years if the remaining prostate tissue enlarges further. Long-term outcomes for bipolar resection are equivalent to conventional TURP at 5-year follow-up.