Transurethral Resection of the Prostate (TURP)
What is a transurethral resection of the prostate (TURP)?
The prostate gland is found only in males. It sits below the bladder and wraps around the urethra, the tube that carries urine out of the body. The prostate helps produce semen.
A transurethral resection of the prostate (TURP) is surgery to remove parts of the prostate gland through the penis. No incisions are needed.
The surgeon reaches the prostate by putting an instrument into the end of the penis and through the urethra. This instrument, called a resectoscope, is about 12 inches long and one-half inch in diameter. It contains a lighted camera and valves that control irrigating fluid. It also contains an electrical loop that cuts tissue and seals blood vessels. The wire loop is guided by the surgeon to remove the tissue blocking the urethra one piece at a time. The pieces of tissue are carried by the irrigating fluid into the bladder and then flushed out at the end of the procedure.
Why might I need TURP?
TURP most often done to relieve symptoms caused by an enlarged prostate. This is often due to benign prostate hyperplasia (BPH). BPH is not cancer, and is a common part of aging. When the prostate gland is enlarged, it can press against the urethra and interfere with or block the passage of urine out of the body.
Sometimes a TURP is done to treat symptoms only, not to cure the disease. For example, if you're unable to urinate because of prostate cancer, but surgery to remove the prostate isn't an option for you, you may need a TURP.
There may be other reasons for your healthcare provider to recommend a TURP.
What are the risks of a TURP?
As with any surgery, certain complications can occur with TURP. Some possible complications may include:
- Blood in the urine after surgery
- Painful or difficult urination
- Retrograde ejaculation (when ejaculate goes into the bladder and not out the penis)
There may be other risks depending on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
How do I get ready for a TURP?
Some things you can expect before the procedure include:
- Your healthcare provider will explain the procedure and you can ask questions.
- You'll be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything isn't clear.
- Your healthcare provider will review your medical history, and do a physical exam to be sure you're in good health before you have the procedure. You may also need blood tests and other tests.
- You'll be asked to not eat or drink anything for 8 hours before the procedure, generally after midnight.
- Tell your healthcare provider if you're sensitive to or are allergic to any medicines, latex, iodine, tape, contrast dyes, or anesthesia.
- Make sure your healthcare provider has a list of all medicines (prescribed and over the counter), herbs, vitamins, and supplements that you're taking.
- Tell your healthcare provider if you have a history of bleeding disorders or if you're taking any blood-thinning medicines (anticoagulants), aspirin, or any other medicines that affect blood clotting. You may need to stop these medicines before the procedure.
- If you smoke, stop as soon as possible to improve recovery and your overall health.
- You may be given a sedative before the procedure to help you relax.
Based on your medical condition, your healthcare provider may request other specific preparation.
What happens during TURP?
TURP requires a hospital stay. Procedures may vary depending on your condition and your healthcare provider's practices.
Generally, a TURP follows this process:
- You'll need to remove any jewelry or other objects that might get in the way during the procedure. A bracelet with your name and an identification number will be put on your wrist. You may get a second bracelet if you have allergies.
- You'll need to remove your clothing and put on a hospital gown.
- You'll be asked to empty your bladder.
- An intravenous (IV) line will be started in your arm or hand.
- You'll be positioned on an operating table, lying on your back.
- You will be given anesthesia to put you to sleep for the procedure.
- Your heart rate, blood pressure, breathing, and blood oxygen level will be monitored during the surgery. Once you're sedated, a breathing tube will be put through your throat into your windpipe and you'll be connected to a ventilator, which will breathe for you during the surgery.
- The surgeon may first inspect the urethra and bladder with an endoscope. This is done by passing the scope through the tip of the penis, then into the urethra and bladder. This allows the health care provider to examine these areas for any tumors or stones in the bladder.
- Next, the resectoscope is passed into the urethra. It is used to cut away the pieces of prostate tissue that are bulging or blocking the urethra. Electricity will be applied through the resectoscope to stop any bleeding. The pieces are flushed into the bladder, and then drained out through the urethra.
- The resectoscope is removed.
- The healthcare provider will put a soft, flexible tube called a Foley catheter into your bladder to drain urine.
What happens after TURP?
In the hospital
After the procedure, you may be taken to a recovery room and watched closely. Once your blood pressure, pulse, and breathing are stable and you're alert, you'll be taken to your hospital room.
You may get pain medicine as needed, either by a nurse, or by giving it yourself through a device connected to your IV line.
Once you're awake, you may start to drink liquids. You’ll be able to eat solid foods as you are able to handle them.
The Foley catheter will stay in place for 1 to 3 days to help urine drain while your prostate gland heals. You'll probably have blood in your urine after surgery. A bag of solution may be attached to the catheter to flush the blood and potential clots out of your bladder and the catheter. The bleeding will slowly decrease, and then the catheter will be removed.
Arrangements will be made for a follow-up visit with your healthcare provider.
Your healthcare provider may give you other instructions after the procedure, depending on your situation.
Once you're home, it'll be important to drink lots of fluids. This helps to flush out any remaining blood or clots from your bladder.
You'll be told to not do any heavy lifting for several weeks after the TURP. This is to help prevent bleeding.
You may be tender or sore for several days after a TURP. Take a pain reliever for soreness as recommended by your healthcare provider.
You shouldn't drive until your healthcare provider tells you to. Other activity restrictions may also apply.
Tell your healthcare provider to report any of the following:
- Fever and/or chills
- Trouble urinating
- Trouble controlling your bladder
- Changes in your urine output, color, or odor
- Increasing blood or clots in your urine
Your healthcare provider may give you other instructions after the procedure, depending on your particular situation.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- The risks and benefits of the test or procedure
- When and where you are to have the test or procedure and who will do it
- When and how will you get the results
- How much will you have to pay for the test or procedure