PLASMA (formerly known as TURis)
For many decades the TURP (Transurethral Resection of the Prostate) has been considered the gold standard surgical treatment for men suffering with bothersome urinary symptoms resulting from growth of the prostate gland causing obstruction to the flow of urine out of the bladder. Whilst a relatively safe and reliable procedure, there are well described associated risks of the operation including heavy bleeding and the need for a blood transfusion, prolonged post-operative catheterisation and the absorption of the irrigating fluid used to maintain vision during the procedure (TUR Syndrome).
The introduction of new technology has seen a significant reduction in risk on these fronts. This new incarnation of the TURP is known as PLASMA (which used to be called TURis).
The principles of the surgery remain the same, a sheath with telescope within is passed down the water-pipe (urethra) and under direct vision energy is passed through loop, the loop being pulled systematically through the prostate tissue, cutting off small chips of the prostate and allowing the slow development of a wide cavity through the prostate, alleviating obstruction. Recent developments have seen a change in the electrical energy passed through the loop (from monopolar to bipolar), meaning less bleeding, the use of a different and safer irrigation fluid and possibly a shorter time spent in hospital.
At the end of the procedure a urinary catheter is placed, allowing a period of ongoing bladder irrigation and finally removed on average 48 hours after the procedure. Most people therefore spend 2 days in hospital.
The benefits of PLASMA over the standard monopolar TURP have been recognised by NICE in their guidance here
The following consultants offer this treatment