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Transurethral Resection of the Prostate (TURP): Topic Overview

  • Posted on- Oct 30, 2015
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Transurethral resection of the prostate (TURP) is a type of prostate surgery done to relieve moderate to severe urinary symptoms caused by an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).

During transurethral resection of the prostate, a combined visual and surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The urethra is surrounded by the prostate. Using the resectoscope, your doctor trims away excess prostate tissue that's blocking urine flow and increases the size of the channel that allows you to empty your bladder.

Transurethral resection of the prostate (TURP) is one of the most effective options for treating urinary symptoms caused by benign prostatic hyperplasia. To determine whether TURP or another treatment is the right choice for you, your doctor will consider how severe your symptoms are, what other health problems you have, and the size and shape of your prostate.

Why Transurethral resection of the prostate (TURP) is performed?

Transurethral resection of the prostate helps minimize urinary symptoms caused by benign prostatic hyperplasia. Urinary symptoms caused by benign prostatic hyperplasia include:

  • Frequent, urgent need to urinate
  • Difficulty starting urination
  • Slow (prolonged) urination
  • Increased frequency of urination at night
  • Stopping and starting again while urinating
  • The feeling you can't completely empty your bladder
  • Urinary tract infections
  • The inability to urinate

Transurethral resection of the prostate may also be done to treat or prevent complications due to blocked urine flow, such as:
  • Recurring urinary tract infections
  • Bladder or kidney damage
  • Inability to control urination (incontinence)
  • Bladder stones
  • Recurring blood in your urine

Risks associated with transurethral resection of the prostate (TURP)

  • Heavy bleeding: Some men lose enough blood during transurethral resection of the prostate to require a blood transfusion. This is rare. Men with larger prostates appear to be at higher risk of significant blood loss.
  • Low sodium in the blood: This rare complication is called TURP syndrome or transurethral resection (TUR) syndrome. It occurs when the body absorbs too much of the fluid used to wash (irrigate) the surgical area during the procedure. TURP syndrome can be life-threatening if it isn't treated. A technique called bipolar TURP allows the use of a salt (saline) solution for irrigation, which lessens the risk of TURP syndrome.
  • Temporary difficulty urinating: You may have trouble urinating (urinary retention) for a few days after the procedure. Until you can urinate on your own, you will need to have a tube inserted through your penis to carry urine out of your bladder (urinary catheter).
  • Urinary tract infection: Urinary tract infections are a possible complication after any enlarged prostate procedure. An infection is increasingly likely to occur the longer you have a catheter in place and may require antibiotics or other treatment. In some cases, men who have transurethral resection of the prostate have recurring urinary tract infections.
  • Difficulty holding urine: Rarely, loss of bladder control (incontinence) is a long-term complication of transurethral resection of the prostate.
  • Dry orgasm: TURP can cause retrograde ejaculation, which means semen released during sexual climax (ejaculation) enters your bladder rather than exiting the penis. Retrograde ejaculation isn't harmful and generally doesn't affect sexual pleasure. But it can interfere with your ability to father a child. This long-term side effect occurs in about 75 percent of men who have transurethral resection of the prostate.
  • Erectile dysfunction: The inability to keep or maintain an erection is a possible long-term side effect of transurethral resection of the prostate. While this isn't common with TURP, it can occur.
  • Need for re-treatment: Some men require follow-up treatment after transurethral resection of the prostate, either because symptoms return over time or because they never adequately improve. This is less common with transurethral resection of the prostate than with less invasive office-based prostate treatments. In some cases, further treatment is needed because TURP causes narrowing (stricture) of the urethra or the bladder neck.

What happens during transurethral resection of the prostate (TURP)?

A combined visual and surgical instrument (resectoscope) is inserted into the tip of your penis and extended through your urethra and into the prostate area. By accessing the prostate through your penis, your doctor won't need to make any cuts (incisions) on the outside of your body. The resectoscope has a light, valves for controlling irrigating fluid, and an electrical loop to cut tissue and seal blood vessels.

The doctor will use the resectoscope to trim tissue from the inside of your prostate gland, one small piece at a time. As small pieces of tissue are cut from inside your prostate, irrigating fluid carries them into your bladder. They're removed at the end of the operation.

What to expect after transurethral resection of the prostate (TURP)?

After surgery, you'll need to stay in the hospital for one to two days. Talk to your doctor about what you can expect and any precautions you need to take after you go home.
  • You'll have a catheter. The catheter enters through the tip of your penis and goes into your bladder to drain your urine into a collection bag. The catheter is generally left in place for four to seven days, until you're able to urinate on your own. In some cases, a catheter is needed for a longer period of time - especially if you have a relatively large prostate. You may urinate around the catheter, which is normal because your bladder may try and squeeze out more urine than the catheter can accommodate.
  • Urination may be painful. You may have a sense of urgency as urine passes over the surgical area. You may also need to urinate frequently. Painful urination generally improves in one to four weeks.
  • You may see blood in your urine. This is common right after surgery. If you have clots or so much blood in your urine that you can't see through it, contact your doctor.

Following transurethral resection of the prostate (TURP), most men experience significant relief of symptoms. Because surgery leaves behind part of the prostate gland, it is possible for BPH symptoms to redevelop. However, surgery can offer relief for between seven and 15 years for most people.