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Transurethral Resection of Prostate

Overview on TURP

TURP is the classic treatment for urinary symptoms due to the prostate (prostatism) or BPH. Prostatic tissue is removed and so the physical bulk of the prostate is reduced. Obstruction is reduced and urinary symptoms considerably improved. The operation is performed through the penis and usually there are no cuts or surgical incisions. The procedure is tolerated reasonably well, although associated with retrograde ejaculation. It is the gold standard treatment for BPH with many years of history to support its use.

Why have a TURP?

There are several potential reasons for having a TURP:

Tests needed before:

In general, the tests performed before to evaluate urinary symptoms are all that required. If there is concern that the prostate is not the only cause for problems, then a flexible cystoscopy to examine the prostate, bladder and urethra (water pipe) may be necessary. If there is concern that prostate cancer may be present, then it may be necessary to take prostate biopsies.

What happens during a TURP?

Under general anaesthesia (i.e. asleep) or spinal anaesthesia (i.e. numb from the waist down), a telescope examination is made of the prostate and bladder using a camera mounted on the end of a tube passed through thewater pipe (urethra). As the instrument used for the procedure is quite large, the urethra may be enlarged slightly by performing what is known as an optical urethrotomy. A resectoscope is passed to the prostate. This has a tiny looped wire that is used to shave away layer after layer of prostatic tissue. The shaved tissue is then flushed into the bladder and washed out through the tubing at the end of the operation. For men with smaller prostates, an alternative operation may be chosen: a TUIP (transurethral incision of the prostate) also known as a bladder neck incision (BNI). In this case, the surgeon uses an instrument that makes a few small cuts in the prostate and bladder neck rather than removing tissue. These cuts reduce the obstruction in the urethra and improve urine flow. A catheter is placed in the urethra. This is used to wash the bladder gently following the procedure.

What is life like after TURP?

Recovery can take anywhere from two to eight weeks. During the first few weeks after the operation, there may be a deterioration of some of the symptoms present before surgery. You may have some temporary problems controlling urination, but long-term incontinence rarely occurs. These symptoms can be helped by pelvic floor exercises and medication sometimes, especially to reduce the urge to pass urine.During the first month after TURP or BNI, the scab inside the prostatic urethra may loosen and cause bleeding. The bleeding usually will subside if you increase your fluid intake and decrease your physical activity or by resting in bed and drinking fluids.

Contact your doctor if:

In general, you should: