Transurethral Resection of the Prostate
(TURP)En Español (Spanish Version)
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Transurethral resection of the prostate (TURP) is a surgery to remove part of the prostate gland.
The prostate gland is part of a man's reproductive system. It makes and stores seminal fluid. This milky fluid nourishes sperm and forms part of the semen. The prostate is about the size of a walnut. It is below the bladder and in front of the rectum.
Reasons for Procedure
TURP is done when a man has an enlarged, benign (noncancerous) prostate. This is called benign prostatic hyperplasia (BPH). In BPH, the prostate grows larger and presses against the urethra and bladder, interfering with the normal flow of urine.
TURP may also be done when a man has a cancerous prostate. And the doctor thinks that a complete prostate removal surgery is too risky. In this case, TURP is done to remove part of the prostate to relieve obstruction and lessen some symptoms.
Other reasons include:
- Repeated urinary tract infections due to an enlarged prostate
- Recurrent bloody urine
- Bladder stones
- Weakened or damaged bladder
- Inability to empty the bladder, leading to kidney damage
Risk Factors for Complications During the Procedure
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical exam
- Review of medications and supplements
- Blood tests including complete blood count, renal function, PSA (prostate-specific antigen)
- Urine tests including urine culture
- Ultrasound of kidney, bladder, prostate
- Urodynamics to assess degree of obstruction
- X-rays of kidneys and chest
- The night before, eat a light dinner, and do not eat or drink anything after midnight.
Description of the Procedure
Your surgeon will insert a specialized cystoscope (a thin, lighted tube used to examine the bladder) into the urethra via the penis and up into the bladder. He will fill the bladder with a solution. This lets him see the inside of your body better. The prostate gland is examined through the scope. Your surgeon will insert a surgical loop through the cystoscope. He will remove the portion of the prostate that has enlarged. A catheter is left in the bladder to allow for urine flow after the procedure. It may also be used to flush the bladder to remove blood clots.
Several new techniques are being used, including laser vaporization, transurethral needle ablation, and bipolar resection. These techniques may result in fewer complications in some patients.
Transurethral Resection of the Prostate (TURP)
© 2008 Nucleus Medical Art, Inc.
Removed tissue is sent to a lab for testing.
How Long Will It Take?
Will It Hurt?
For several days after the surgery, you may feel some pain. The catheter may also cause some discomfort.
TURP syndrome (occurs in about 2% of patients, usually within the first 24 hours) might occur. Symptoms include:
- Increase or decrease in blood pressure
- Bradycardia (slow heart action) or abnormal heart rhythm
- Tachypnea (increased rate of respiration)
- Nausea or vomiting
- Blurred vision
- Coma and shock in serious case
Other complications include:
- Urinary tract infection (most common)
- Retrograde ejaculation—sperm flows into your bladder and is expelled when you urinate (expected after surgery and almost always occurs)
- Erectile dysfunction
- Thrombophlebitis (blood clots in the superficial veins)
- Excessive bleeding, which may require blood transfusion (second most common)
- Complications of anesthesia
- Need for recatheterization
- Need for reoperation
Average Hospital Stay
An overnight stay is typically planned for a TURP but in some cases, the stay can be as much as 2-5 days.
- There will be a catheter in your bladder to drain urine. The catheter is left in overnight. The urine may be bloody, but do not be alarmed. This is normal. Water may be flushed through the catheter into your bladder to wash out blood and clots.
- Always keep the catheter drainage bag below the level of your bladder.
- Do breathing and coughing exercises regularly.
- Rest in bed until the next morning and perhaps longer. The nurse can help you the first time you get out of bed.
- Clean the area where the catheter enters the urethra several times a day with soap, water, and a washcloth.
- Drink lots of fluids, especially during the day, to flush your bladder.
- Avoid heavy lifting or exertion for 3-4 weeks.
- Avoid sexual activity for 4-6 weeks after surgery.
- Avoid alcohol, caffeine, and spicy foods.
Recovery from surgery should take about three weeks. Symptoms such as frequent or painful urination may continue for a while, but should lessen in the first six weeks. If there is blood in your urine, lie down, relax, and drink a glass or two of fluid. The next time you urinate the bleeding should stop. If it doesn't, call your doctor.
Even though you will avoid sexual activity for 4-6 weeks after surgery, the surgery should not affect your sex drive or ability to have sex. Retrograde ejaculation is likely to occur. This should not, however, be used as birth control. If you plan on having children in the future, talk to your doctor about surgical side effects, such as retrograde ejaculation, before surgery.
Call Your Doctor If Any of the Following Occurs
After you leave the hospital, call your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the surgery site
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Difficulty or inability to urinate
- Impotence for longer than three months after surgery
American Cancer Society
National Cancer Institute
Men's Health Centre
The Prostate Centre
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TURP. National Cancer Institute website. Available at: http://www.cancer.gov/Templates/db_alpha.aspx?CdrID=44469. Accessed July 10, 2008.
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Last reviewed November 2007 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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