Transurethral Resection of the Prostate (TURP)
The prostate is a walnut-sized gland that produces seminal fluid in men. This gland surrounds the urethra, a tube that connects the urinary bladder to the outside of the body. As men age, the prostate often enlarges. This squeezes the urethra, making urination more difficult. This is a condition known as benign prostatic hypertrophy (BPH), or enlarged prostate.
If the prostate becomes too large, your physician may recommend a procedure known as transurethral resection of the prostate (TURP). This surgical procedure can help relieve uncomfortable and/or painful symptoms associated with an enlarged prostate.
Who Is a Candidate for the Procedure?
The prostate naturally enlarges as men age. According to the National Institutes of Health (NIH), there is usually some prostate enlargement in men over the age of 40. By the age of 80, more than 90 percent of men have an enlarged prostate (NIH, 2011).
Surgery is not typically the first course of action for symptoms, but may be recommended if medication and other treatments don’t relieve symptoms. Some indications that TURP may be necessary include:
- a bladder that never feels empty
- frequent urinary tract infections (UTIs)
- bleeding from the prostate
- increased need to urinate at night
- bladder stones
- slow urination
- kidney damage
If you experience these symptoms, your doctor will evaluate your overall health, medical history, and the size and shape of your prostate gland to determine if TURP may be for you. Other procedures may be less invasive and remove less of the prostate. According to the Mayo Clinic, TURP is associated with less need for future treatments (Mayo, 2011).
What Does the Procedure Involve?
The TURP procedure does not involve complete removal of the prostate. Instead, a portion is removed. You will be placed under general anesthesia so you’ll be asleep and pain-free. Another option is spinal anesthesia, which numbs the nerves in your lower body so you will not feel pain.
Your surgeon will use a special type of long, thin scope called a resectoscope. This scope is inserted through the end of your penis. The scope allows your surgeon to visualize your prostate gland. Your surgeon can then insert a surgical tool through the scope to remove a portion of your prostate. The amount removed will depend on the shape and size of your prostate.
Once the scope is removed, a medical provider will insert a catheter into your penis to promote urine flow following surgery and to remove any blood clots that may form. The entire procedure typically lasts one hour.
What Is the Recovery Process?
You will stay in the hospital for one to three days following the TURP procedure. During this time, you will be given many intravenous (IV) fluids to promote urine flow. You can expect some blood and blood clots in your urine during this time.
According to Aurora Healthcare, a rare condition known as TUR syndrome or TURP syndrome can occur in about two percent of patients who undergo TURP surgery (Aurora, 2011). Notify your physician if you experience any of the complications associated with TUR syndrome that typically occur within the first 24 hours after surgery. These include:
- changes in blood pressure
- abnormal heartbeat
- increase in breathing rate
- nausea and vomiting
- trouble seeing
The TURP procedure typically requires a three- to six-week recovery period where you should refrain from strenuous activity. If you experience symptoms of infection, such as a fever, persistent bleeding, impotence that lasts longer than three months, or pain that cannot be controlled with medication, notify your physician.
What Are the Procedure’s Side Effects?
Because the procedure requires anesthesia and is invasive, side effects can occur. In addition to TURP syndrome, side effects can include:
- blood clots
- difficulty breathing
- infection risk
- blood loss
- heart attack or stroke
- reaction to anesthesia
Because the prostate and surrounding areas are delicate tissue, it is possible to experience complications including:
- difficulty controlling urine stream
- difficulty maintaining or achieving an erection
- urethral stricture that limits urine flow
- retrograde ejaculation (semen flows backwards into the bladder)
- internal organ damage
Discuss each of these risks with your physician to determine if the TURP procedure is the best option for you.