Health Library

Transurethral Resection of the Prostate

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Definition

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 a milky fluid that forms part of semen. The prostate is below the bladder and in front of the rectum. It also wraps around a tube called the urethra. The urethra allows urine to flow out of the body.

Reasons for Procedure

A TURP is done when a man has an enlarged, noncancerous prostate. This is called benign prostatic hyperplasia (BPH). In BPH, the prostate grows and presses against the urethra and bladder. The pressure can cause problems with the normal flow of urine. A TURP is done to improve the flow of urine.

A TURP may also be done when a man has prostate cancer. It may be done if the doctor thinks that a complete prostate removal surgery is too risky. In this case, TURP is also done to relieve urine blockage and lessen symptoms. It is not done to treat the cancer itself.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Some factors that may increase the risk of complications include:

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Review of medications 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 medications. You may be asked to stop taking some medications up to one week before the procedure.
  • The night before, eat a light dinner. Do not eat or drink anything after midnight.

Anesthesia

TURP surgery requires general or spinal anesthesia. You will sleep through the surgery with general anesthesia. Spinal anesthesia will make your lower body numb, but you may be awake.

TURP surgery requires general or spinal anesthesia. You will sleep through the surgery with general anesthesia. Spinal anesthesia will make your lower body numb, but you may be awake.

Description of Procedure

A special scope that looks like a thin tube with a light on the end will be used. The scope will be passed through the hole at the tip of the penis where urine comes out and passed into the bladder. 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. This tool will be used to remove a part of the enlarged prostate.

A catheter will be placed in the bladder. Urine will flow out the catheter to give the area time to heal. Your catheter may also be used to flush the bladder and to remove blood clots.

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

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

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

You will be taken to the recovery room where your breathing, pulse, and heart rate will be monitored. You will be given pain medication.

  • There will be a catheter in your bladder to drain urine. The catheter is left in place overnight. Water may be flushed through the catheter into your bladder to wash out blood and clots.
  • The catheter drainage bag will be kept below the level of your bladder.

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
At Home

Recovery can take up to 3 weeks. During this time, you may have to change or restrict activities until your doctor says it is okay. Arrange for help at home for a couple of days. You may be given specific exercises to do at home to promote healing and maintain strength. Pain can be managed with medications.

If you go home with a catheter, the hospital staff will teach you how to take care of it. Follow instructions carefully to promote healing and prevent infection.

Do not return to normal or sexual activity before your doctor gives you permission to do so.

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Difficulty or inability to urinate
  • Pain, burning, urgency or frequency of urination, or persistent blood in the urine that persists more than a few days.
  • Signs of infection, including fever and chills
  • Pain that you cannot control with the medications you have been given
  • Peristent nausea or vomiting
  • Impotence for longer than 3 months after surgery

If you think you have an emergency, call for medical help right away.

Resources

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

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

Canadian Resources

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

The Prostate Centre at The Princess Margaret
http://www.prostatecentre.ca

References

BPH: Medical management (benign prostatic hyperplasia/enlarged prostate. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=1. Updated April 2013. Accessed September 30, 2014.

Benign prostatic hypertrophy (BPH). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 27, 2014. Accessed September 30, 2014.

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.

Prostate enlargement: Benign prostatic hyperplasia. National Kidney Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement. Updated September 24, 2014. Accessed September 30, 2014.

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.

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.