What is a transurethral resection of the prostate?
Transurethral resection of the prostate (TURP) is surgery to relieve problems caused by an enlarged prostate gland.
The prostate gland is part of a man’s reproductive system. It is about the size of a walnut and is inside the body between the bladder and the penis. It surrounds the upper part of the urethra, the tube that carries urine from the bladder out through the penis. The prostate makes fluid that nourishes sperm and helps carry it out of the body during sex. Another term for this surgery is transurethral prostatectomy.
When is it used?
When the prostate gland is enlarged it is called benign prostate hyperplasia, or BPH. When the prostate gets bigger than normal, it may put pressure on the urethra and cause problems with urination. You may have trouble passing urine, and you may feel the need to urinate more often, sometimes even at night. The need to urinate can come on suddenly, which can make travel, work, and some social situations difficult or awkward. In severe cases BPH can completely block your ability to pass urine. This can cause kidney damage if it is not treated promptly.
TURP makes the prostate smaller, relieves the blockage, and reduces pressure on the urethra. Often bladder symptoms are better within 2 to 3 weeks after the surgery. You may not feel the need to urinate as often and you may have few or no urination â€œemergencies.â€
Ask your healthcare provider about your choices for treatment and the risks.
How do I prepare for this procedure?
Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
Follow your provider’s instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
Tell your provider if you have any food or medicine allergies.
You may or may not need to take your regular medicines the day of the procedure. Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Tell your healthcare provider about all medicines and supplements that you take. Ask your provider if you need to avoid taking any medicine or supplements before the procedure.
Your healthcare provider may prescribe antibiotics for you to take a few days before and after surgery to help prevent infection.
Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
Follow any instructions your healthcare provider may give you.
Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for tests or procedures.
What happens during the procedure?
The procedure is done at the hospital.
You will be given general or regional anesthesia to keep you from feeling pain during the procedure. General anesthesia relaxes your muscles and you will be asleep. Regional anesthesia numbs part of your body while you stay awake. You may also be given medicine to help you relax.
Your healthcare provider will pass a cystoscope (a small, lighted tube) through the urethra and into your bladder. With the scope your provider will be able to see the area where the enlarged prostate is causing problems. Fluid will be passed into the bladder to stretch the bladder and help your provider see the area better. Your provider will use a scope with a heated wire loop or a laser to remove pieces of prostate tissue. The pieces of tissue will be flushed out of the bladder.
The procedure usually takes about 2 hours.
What happens after the procedure?
After the procedure you may stay in a recovery area for at least a few hours or overnight, depending on what was done during the procedure.
You will likely have some pain or discomfort in the area over your bladder, as well as at the base of your penis.
You will have a catheter (tube) in your bladder to help it drain and flush out any blood clots that have formed. Do not try to remove the catheter. Your healthcare provider will remove the catheter after the bleeding stops, usually in 2 to 3 days. After the catheter is removed, you may have trouble controlling your bladder. You may notice blood in your urine or have trouble urinating. These symptoms usually go away as you heal.
Ask your healthcare provider:
How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
What are the risks of this procedure?
Every procedure or treatment has risks. Some possible risks of this procedure include:
You may have problems with anesthesia.
You may have infection, bleeding, or blood clots.
Other parts of your body may be injured during the surgery.
You may have low sodium in the blood, a condition known as TURP syndrome that can be life threatening if it is not treated.
If you have been diagnosed with heart failure, your heart symptoms may be worse right after the procedure because of the extra fluid passed into the bladder during the procedure.
Your ability to have an erection may be affected. Also, when you have an orgasm, semen may not come out of your penis. Instead it may flow backward into your bladder. You may become sterile and unable to have children after the procedure.
Ask your healthcare provider how the risks apply to you. Be sure to discuss any other questions or concerns that you may have.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-01-29 Last reviewed: 2014-01-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Del Rosso A, et al. TURP in the young man: is it possible to preserve the anterograde ejaculation? Urologia. 2013 Jan-Mar;80(1):64-9.
Gilling P. TURP remains a safe and effective alternative for benign prostatic hyperplasia (BPH) surgery. BJU Int. 2014 Jan;113(1):5-6.
Muschter R, et al. Transurethral resection of the prostate and current modifications (bipolar, electrovaporization). Urologe A. 2013 Mar;52(3):331-8.
Zhao C, et al. Comparative safety analysis of surgical smoke from transurethral resection of the bladder tumors and transurethral resection of the prostate. Urology. 2013 Sep;82(3):744.
Bruschini H, et al. Urinary incontinence following surgery for BPH: the role of aging on the incidence of bladder dysfunction. Int Braz J Urol. 2011 May-Jun;37(3):380-6; discussion 387.
Demirel I, et al. TURP syndrome and severe hyponatremia under general anaesthesia. BMJ Case Rep. 2012 Nov 19;2012.
Elhilali MM. Overview of interventional treatment options for benign prostatic hyperplasia. Can Urol Assoc J. 2012 Oct;6.
Gilling PJ, et al. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int. 2011 Aug 23. doi: 10.1111/j.1464-410X.2011.10359.
Kacker R, and Williams SB. Endourologic procedures for benign prostatic hyperplasia: review of indications and outcomes. Urol J. 2011 Summer;8(3):171-6.
Kaplan SA. Effect of Transurethral Resection of the Prostate on Erectile Function: A Prospective Comparative Study. J Urol. 2011 Feb;185(2):604.
Lusuardi L, Hruby S, Janetschek G. New emerging technologies in benign prostatic hyperplasia. Curr Opin Urol. 2012 Nov 7.
Pastore AL, et al. Transurethral Resection of Prostate and the Role of Pharmacological Treatment with Dutasteride in Decreasing Surgical Blood Loss. J Endourol. 2012 Oct 3.
Schroeck FR, et al. Population based trends in the surgical treatment of benign prostatic hyperplasia. J Urol. 2012 Nov;188(5):1837-41.
TascÄ± AI, et al. Transurethral Resection of the Prostate With Monopolar Resectoscope: Single-surgeon Experience and Long-term Results of After 3589 Procedures. Urology. 2011 Nov;78(5):1151-5.