Voluminous Prostate Adenoma Treated via TURP and Plasma Vaporisation at SANADOR

Matei, aged 78, had several health conditions that he managed with medication prescribed by his doctor. One day, he noticed he was completely unable to urinate. Although urinary retention is a medical emergency requiring immediate hospital attendance, Matei only sought help after 48 hours, when his son took him to the accident and emergency department in the town where he lived.

Following investigations, he was diagnosed with prostatic adenoma, and the doctors initially recommended medication. As the urinary retention did not resolve, Matei was subsequently transferred to a nephrology hospital in Bucharest, where a urinary catheter was inserted to drain the urine, with doctors advising him to continue his medication.

Concerned about his father's condition, Matei's son sought out an experienced doctor who could provide appropriate treatment. He arranged an appointment with Assoc. Prof. Dr. Marcian Manu, consultant urologist and Head of the Urology Department at SANADOR Clinical Hospital. He recommended a minimally invasive surgical procedure under spinal anaesthesia.

Pre-operative investigations and assessment

At SANADOR Clinical Hospital, Matei underwent the necessary pre-operative assessment for his conditions, which included consultations in cardiology, internal medicine, ENT, and gastroenterology, as well as a pre-anaesthetic evaluation. Based on these investigations, the medical team determined that the procedure could be safely performed.

Following removal of the urinary catheter, Assoc. Prof. Dr. Marcian Manu performed a urethrocystoscopy, which revealed a navicular fossa stenosis — a narrowing of the terminal portion of the urethra. To address this, the doctor carried out progressive urethral dilatation using bougies. Cystoscopy further showed that the lateral lobes of the prostate were significantly enlarged, substantially narrowing the urethra, and also identified diverticula as well as small calculi within the bladder.

Surgical procedure

The doctor first removed the bladder calculi endoscopically, then performed a TURP procedure — transurethral resection of the obstructive prostatic tissue — complemented by plasma vaporisation, to ensure controlled removal of the remaining tissue and clearance of the urinary channel.

All procedures were carried out via a transurethral, endourological approach, without any external incisions, and proceeded without complication. Several days later, Matei was discharged in good general health, urinating spontaneously and without a catheter.

Treatment options for prostatic adenoma

At SANADOR Clinical Hospital, patients with an enlarged prostate have access to modern minimally invasive treatment methods, including TURP, plasma vaporisation, and laser enucleation of the prostate, selected according to each individual case. Where indicated, Rezūm water vapour therapy may also be used, recommended for carefully selected patients.

In cases where the prostatic adenoma is very large or specific individual factors are present, treatment may involve a prostatectomy, performed via robotic, laparoscopic, or open surgical approach, depending on the indication established for each patient. Procedures take place in one of the best-equipped operating theatres in Romania, connected to a Category I ITU with an extended level of competence.