Step 2. Median lobe resection A.G. Martov

I prefer the modified Barnes technique of TURP, which means separate lobe resection, so I usually start with the median lobe. That allows to improve endoscopic picture and flow. The medial lobe is systematically resected from the bladder towards the veru. It’s important to control the loop movements from the begining to the end. You can use either cuts with the end point of resection or prolonged cuts. All cuts should be parallel, straight and systematic. After the median lobe is resected you can clearly see the ostiums and the bladder neck fibers.