Transurethral Resection of the Prostate Overview

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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 the male reproductive system. It makes and stores seminal fluid (a milky fluid that forms part of semen). The gland is below the bladder and in front of the rectum. The urethra (tube that urine flows out through) runs through the prostate.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• Review of medicines and supplements
• Blood tests, urine tests, and a urine culture
• Ultrasound —a test that uses sound waves to visualize the kidney, bladder, and/or prostate
• Urine flow studies
• X-rays

Leading up to your procedure:

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
• The night before, eat a light dinner. Do not eat or drink anything after midnight.

Anesthesia

TURP requires general or spinal anesthesia . General will make you sleep. Spinal will make your lower body numb.

Description of Procedure

Your doctor will use a special scope that looks like a thin tube with a light on the end. This scope is put into the hole at the tip of your penis where urine comes out. The bladder will then be filled with a solution. The solution will let the doctor see the inside of your body better. The prostate gland is examined through the scope. A small surgical tool will be inserted through the scope. The tool will be used to remove a part of the enlarged prostate. A catheter (tube) will be left in the bladder to allow for urine flow after the procedure. It may also be used to flush the bladder and to remove blood clots.

Transurethral Resection of the Prostate (TURP) © 2009 Nucleus Medical Media, Inc.

Immediately After Procedure

Removed tissue will be sent to a lab for testing.

How Long Will It Take?

About 60-90 minutes

Will It Hurt?

For several days after the surgery, you may feel some pain. The catheter may also cause some discomfort. Talk to your doctor about medicine to help you manage pain.

Average Hospital Stay

An overnight stay is typically planned for a TURP. In some cases, the stay can be up to 2 days.

Post-procedure Care

At the Hospital

• There will be a catheter in your bladder to drain urine. The catheter is left in place 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. The nurse can help you the first time you get out of bed.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Clean the area where the catheter enters the urethra several times a day. Use soap, water, and a washcloth.
• Drink lots of fluids, especially during the day. This will help 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.
• Be sure to follow your doctor's instructions .

Recovery from surgery should take about three weeks. Symptoms such as frequent or painful urination may continue for a while. They should lessen in the first six weeks. If there is blood in your urine, lie down, and drink a glass or two of fluid. The next time you urinate the bleeding should stop. If it does not, call your doctor.

The surgery should not affect your sex drive or ability to have sex. Retrograde ejaculation is likely to occur. This is when semen enters the bladder instead of exiting the body. This should not be relied on as birth control.

RESOURCES:

American Cancer Society
http://www.cancer.org/

National Cancer Institute
http://www.cancer.gov/

CANADIAN RESOURCE:

Men's Health Centre
http://www.menshealthcentre.net/

The Prostate Centre
http://www.prostatecentre.ca/

References:

Griffith HW, Moore S, Yoder K. Complete Guide to Symptoms, Illness & Surgery. New York, NY: Putnam Publishing Group; 2000.

Leocádio DE, Frenkl TL, Stein BS. Office based transurethral needle ablation of the prostate with analgesia and local anesthesia. J Urol. 2007 Nov;178(5):2052-4; discussion 2054.

Lynch M, Anson K. Time to rebrand transurethral resection of the prostate? Curr Opin Urol. 2006;16:20-4.

Michielsen DP, Debacker T, De Boe V, Van Lersberghe C, Kaufman L, Braeckman JG, et al. Bipolar transurethral resection in saline—an alternative surgical treatment for bladder outlet obstruction? J Urol. 2007 Nov;178(5):2035-9; discussion 2039.

Nakagawa T, Toguri AG. Early catheter removal following transurethral prostatectomy: a study of 431 patients. Med Princ Pract. 2006;15(2):126-30.

Surgical management of BPH. American Urological Association website. Available at: http://www.urologyhealth.org/adult/index.cfm?cat=09&topic=131 . Accessed October 13, 2009.

Tan A, Liao C, Mo Z, Cao Y. Meta-analysis of holmium laser enucleation versus transurethral resection of the prostate for symptomatic prostatic obstruction. Br J Surg. 2007 Oct;94(10):1201-8.

TURP. National Cancer Institute website. Available at: http://www.cancer.gov/Templates/db_alpha.aspx?CdrID=44469 . Accessed July 10, 2008.

Wendt-Nordahl G, Bucher B, Hacker A, Knoll T, Alken P, Michel MS. Improvement in mortality and morbidity in transurethral resection of the prostate over 17 years in a single center. J Endourol. 2007 Sep;21(9):1081-7.