TURP (Transurethral Resection of Prostate)

TURP is a surgical procedure often recommended when prostate enlargement (benign prostatic hyperplasia) causes problematic symptoms and fails to respond to treatment with medications.

The most common surgery for benign prostate hyperplasia is TURP (transurethral resection of the prostate). Transurethral resection surgery focuses on debulking the prostate to produce an adequate channel for urine to flow.

TURP is recommended for men diagnosed with benign prostate hyperplasia and prostate cancer. In such cases urethra is obliterated, leading to symptoms such as:



Procedure

Before the procedure

  • Standard investigations to undergo before the procedure includes bedside urine dipstick, blood tests, urine flow studies (uroflowmetry), urinalysis, prostate specific antigen and ultrasound.
  • All patients preparing for surgery must stop taking aspirin-containing medications and herbal supplements at least 7 days prior to surgery. These medications interfere with blood clotting, and continuing to take them could lead to excessive bleeding during and after your procedure.
  • Do not take oral medications or insulin for diabetes on the day of surgery. You will be tested for blood sugar levels and given medication that may be required.
  • You usually have a TURP under spinal anesthetic. This means that you have an anesthetic injection into your spine. You are awake but can’t feel anything below the level of the injection.

During the procedure

  • The TURP procedure is carried out using a device called a resectoscope. A resectoscope is a thin metal tube containing a light, camera and loop of wire. It is a combined cystoscope and an electrosurgical instrument that allows the resection of prostate tissue. This is passed through your urethra until it reaches your prostate, so no skin incisions or cuts are required.
  • The section of the prostate tissue causing your symptoms is then removed using the heated loop of wire, which has been heated with an electric current.
  • Then a catheter is inserted into your urethra to pump fluid into your bladder and flush away any prostate fragments that have been removed.
  • The procedure usually takes 45 to 60 minutes to complete.

After the procedure

  • You may usually stay in the hospital for 1 to 3 days after the surgery.
  • The catheter used during the procedure will be left in place while you are in the hospital as the urethra will be swollen due to surgery, and you may not be able to urinate normally at first.
  • You may find a minute amount of blood in the urine and difficulty urinating, but you will notice improvement in urinary symptoms gradually.
  • For at least a few weeks, you will be instructed to refrain from driving, lifting anything heavy, engaging in strenuous exercise, or having sex.
  • You should drink plenty of fluids to flush out the urine and eat food rich in fiber.

Benefits

Some of the benefits of the TURP procedure are it treats recurrent urinary tract infections, prevents bladder damage, and kidney damage, and relieves the symptoms associated with an enlarged prostate.


Risks

As with any surgery, certain complications can occur with TURP. Some possible complications may include the following:

  • Blood in the urine after surgery
  • Electrolyte abnormalitiesBladder injury
  • Bleeding
  • Difficulty urinating: A temporary problem associated with post-surgery swelling. A catheter may be placed until you can urinate on your own.
  • Urinary tract infections: After prostate surgery, there is a risk of a UTI. The longer a catheter is kept in place, the greater likelihood of infection. Some men experience recurring UTIs following TURP surgery.
  • Erectile dysfunction: ED is a rare side effect of TURP surgery, but it is possible.
  • Retrograde ejaculation (when ejaculate goes into the bladder and not out the penis). Also known as dry orgasm, this effect causes semen to travel into the bladder instead of out the penis during ejaculation. While this doesn’t usually affect sexual pleasure and isn’t harmful, it can affect fertility.

Patient education

  • Lifestyle factors such as weight loss or improved diabetic control should be explained to the patient to allow modifiable risk factors to be addressed.
  • Lifestyle measures such as reducing caffeine and timing of fluid intake can also be used as a measure to address specific problematic urinary symptoms.
  • Those managed with long-term catheters or intermittent self-catheterization should be guided on the importance of hygiene and catheter care to prevent urinary tract infections.

TURP Care at Medicover

We at Medicover Hospital have the most eminent experienced team of urology doctors who provide excellent healthcare services to patients with diligence. Urologists at Medicover diagnose urinary problems and treat them precisely, bringing out successful outcomes.

The entire treatment process and the follow-up schedules are tailored to corroborate lasting results. Our hospital is equipped with advanced technology to conduct investigations required for the diagnosis of urological diseases such as benign prostate hyperplasia, based on which a dedicated treatment plan is designed.


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Frequently Asked Questions

1. What is the success rate of TURP surgery?

Transurethral resection of the prostate (TURP) is considered as the gold standard surgical treatment strategy for benign prostate hyperplasia and has been for decades. It improves obstructive voiding symptoms and urinary flow rate, with success rates ranging from 85 to 90%.

2. What can I expect after TURP surgery?

You may feel tired and sick for a week or two after TURP surgery. After 3 to 4 weeks of rest, most men are ready to work but you should avoid lifting or moving heavy objects, as well as strenuous exercise.

3. What is the safest procedure for an enlarged prostate?

Transurethral resection of the prostate procedure is the most common treatment for prostate enlargement or benign prostate hyperplasia.

4. Is TURP surgery necessary?

When medication fails to relieve symptoms caused by prostate enlargement, TURP is recommended. TURP may improve symptoms such as difficulty starting to pee, a sluggish flow of pee, etc.

5. Which doctor should I consult for TURP surgery?

You should consult a urologist for TURP surgery.

6. Does the TURP surgery cause pain?

You may experience a mild burning feeling or find it uncomfortable to pass urine at first. This is because your urethra will be swollen and sore from the surgery and having the catheter in place. This is normal and should not last long.

Citations:

https://www.mountsinai.org/health-library/surgery/transurethral-resection-of-the-prostate
https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph)
https://www.urologysanantonio.com/bph-enlarged-prostate/turp-surgery
https://www.ccjm.org/content/84/1/53
https://moffitt.org/cancers/prostate-cancer/turp/
https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/turp