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Transurethral resection of the prostate
Definition
Transurethral resection of the prostate (TURP) is surgery to remove all or part of the prostate gland, to treat an enlarged prostate.
See also:
Alternative Names
TURP; Prostate resection - transurethral
Description
The surgery takes about 1 hour.
You will be given medicine before surgery so you don't feel pain. You may get one of the following:
- General anesthesia: You are asleep and pain-free
- Spinal anesthesia: You are awake, but relaxed and pain-free
The surgeon will insert a scope through the tube that carries urine from your bladder out of the penis. This tube is called the urethra. A special cutting tool is placed through the scope. It is used to remove part of your prostate gland using electricity.
Why the Procedure Is Performed
Your doctor may recommend this surgery if you have benign prostatic hyperplasia (BPH). The prostate gland often grows larger as men get older. The larger prostate play causes problems with urinating. Removing part of the prostate gland can often make these symptoms better.
Prostate removal may be recommended if you have:
- Difficulty emptying your bladder (urinary retention)
- Frequent urinary tract infections
- Bleeding from the prostate
- Bladder stones with prostate enlargement
- Extremely slow urination
- Damage to the kidneys
Before you have surgery, your doctor will suggest you make changes in how you eat or drink. You may also be asked to try taking medicine. Your prostate may need to be removed if these steps do not help. TURP is one of the most common type of prostate surgery. But other procedures are available.
Your doctor will consider the following when deciding on the type of surgery:
- Size of your prostate gland
- Your health
- What type of surgery you may want
Risks
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
- Breathing problems
- Infection, including in the surgical wound, lungs (pneumonia), or bladder or kidney
- Blood loss
- Heart attack or stroke during surgery
- Reactions to medications
Additional risks are:
- Problems with urine control (incontinence)
- Loss of sperm fertility (infertility)
- Erection problems (impotence)
- Passing the semen into the bladder instead of out through the urethra (retrograde ejaculation)
- Urethral stricture (tightening of the urinary outlet from scar tissue)
- Transurethral resection (TUR) syndrome (water buildup during surgery)
- Damage to internal organs and structures
Before the Procedure
You will have many visits with your doctor and tests before your surgery. This includes:
- Complete physical exam
- Treating and controlling diabetes, high blood pressure, heart or lung problems, and other conditions
If you are a smoker, you should stop several weeks before the surgery. Your doctor or nurse can give you tips on how to do this.
Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.
During the weeks before your surgery:
- You may be asked to stop taking medicines that can thin your blood, such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and others.
- Ask your doctor which drugs you should still take on the day of your surgery.
On the day of your surgery:
- Do not eat or drink anything after midnight the night before your surgery.
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive at the hospital.
After the Procedure
You will stay in the hospital for 1 to 3 days.
After surgery, you will have a small tube, called a Foley catheter , in your bladder to remove urine. The urine will look bloody at first, but will go away in a few days. Special solution may be used to flush out the catheter and keep it from getting clogged with blood. The catheter will be removed within 1 to 3 days.
You will be able to go back to eating a normal diet right away.
You will need to stay in bed until the next morning. Afterwards, you will be asked to move around as much as possible.
Your health care team will:
- Help you change positions in bed
- Teach you exercises to keep blood flowing
- Recommend coughing/deep breathing techniques. You should do these every 3 to 4 hours.
You may need to wear tight stockings and use a breathing device to keep your lungs clear.
You may be given medication to relieve bladder spasms.
Outlook (Prognosis)
TURP usually relieves symptoms of an enlarged prostate. You may have burning with urination, blood in your urine, urinate often, and need to urgently urinate.
References
Roehrborn CG. Male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Med Clin North Am. 2011 Jan;95(1):87-100.
McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011 May;185(5):1793-803. Epub 2011 Mar 21.
Reviewed By: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
