Transurethral resection of the prostate (TURP) is a surgery used to treat urinary problems that are caused by an enlarged prostate. An instrument called a resectoscope is inserted through the tip of the penis and into the tube that carries urine from your bladder called the urethra. This helps your doctor see and trim away excess prostate tissue that is responsible for blocking the flow of urine.
TURP is generally considered an option for men who have moderate to severe urinary problems that haven't responded to medication. While TURP has been considered the most effective treatment for an enlarged prostate, a number of other, minimally invasive procedures are becoming more effective. These procedures generally cause fewer complications and have a quicker recovery period than TURP. TURP might also be done to treat or prevent complications due to blocked urine flow, such as, recurring urinary tract infections, kidney or bladder damage, inability to control urination or an inability to urinate at all, bladder stones and blood in your urine
-TURP is a relatively simple operation that does not cause the complications associated with open surgery such as infection, bleeding, pain, and a prolonged hospital stay and recovery time. -TURP is effective in relieving the symptoms of prostate enlargement and improving quality of life. Nine out of 10 men said they were happy they had chosen to have the surgery.
-Men may have a slight chance of losing the ability to ejaculate semen out of their penis during sex or masturbation, although they still have the physical pleasure associated with ejaculation. This is known as retrograde ejaculation and can occur in as many as nine out of 10 cases. -There is also a chance that men may lose their ability to control their bladder (urinary incontinence), although this usually passes a few weeks after surgery. -There is a risk of bleeding, infection and pain afterwards that may require further medical attention.
Transurethral resection of the prostate takes less than 90 minutes. A general or regional anesthesia may be used. During the procedure the surgeon inserts a thin tube-like telescope called a resectoscope into the penis through the urethra and up to the prostate gland. An electrical loop at the end of the scope is used to remove obstructing prostate tissue and seal blood vessels. The area then is irrigated and all tissue is removed. A hospital stay of three days is normally required during which time a catheter will remain in place to remove urine and any remaining debris from surgery.
If you smoke, you should stop several weeks before surgery. Your doctor can help you with tips on how to quit. Within days or weeks before the procedure, your doctor may ask you to stop taking any medicines that increase your risk of bleeding (blood thinners or certain pain relievers). You may also be prescribed an antibiotic to help prevent a urinary tract infection. Be sure to ask your doctor which medicine you should still take on the day of your surgery.
You’ll usually have to stay in bed until the next morning, and then move around as much as you can afterwards to help your body heal. You can eat a normal diet right away. Plan on staying in the hospital for 1 to 2 days. You’ll have some swelling where the surgery was done, so a catheter (small tube) will be in place to help you pee. The catheter is typically left in place for 1 or 2 days until the swelling goes down and you can urinate on your own. You may notice that you have fewer symptoms right away and your flow is stronger. You may also see some blood in your urine, which is normal after surgery. Let your doctor know if your urine does not start to clear or if the bleeding seems to be getting worse.
There are possible risks and complications associated with anesthesia, including respiratory or cardiac malfunction. Other complications include the possibility of: Bleeding requiring blood transfusion Infection requiring antibiotics and in some cases hospitalization Fluid – Electrolyte imbalance during and immediately after surgery , mild degree will not need treatment, Severe degree can leads to coma. Problems controlling urine flow (incontinence) and urethral stricture (tightening of the urethral outlet) Difficulties achieving and maintaining erection (impotence) Infertility Emptying of semen into the bladder instead of out of the urethra (retrograde ejaculation also called “dry orgasm”) Risks, such as long term rigidity and narrowing of bladder neck resulting in poor urination, can be reduced by following the surgeon's instructions before and after surgery.
Who is suitable for TURP?
The best candidates for TUR-P are men with moderate to severe symptoms caused by prostate enlargement that have not responded to medication. The surgeon will make the final determination of each patient’s eligibility for the transurethral surgery after an examination and consultation with the patient.
How common is TURP performed?
Due to the nature of prostate enlargement, most TURPs are carried out in men aged 60 or over, with the average age being 69 years.
When can I go back to my normal daily activities?
1. Sex - You should be able to have sexual intercourse soon after surgery, as long as there is no bleeding and you and your partner both feel ready (if you still have blood in your urine, wear a condom).
2. Heavy lifting - Do not lift anything heavy, such as a bag of shopping or a vacuum cleaner until one week after your surgery.
3. Driving - You should only drive again when you are free of pain and able to perform an emergency stop comfortably.