What is Transurethral Resection of the Prostate (TURP)?
Transurethral Resection of the Prostate (TURP) is a procedure to remove excessive growth of the prostate gland, resulting from Benign Prostatic Hyperplasia (BPH). The prostate gland plays an essential role in the functioning of the male reproductive system, secreting fluid into the urethra during ejaculation. It surrounds the urethra and is located immediately below the neck of the urinary bladder.
TURP is an invasive procedure to remove the overgrowth of prostate tissue. Despite the more recent development of less-invasive treatments, TURP is still considered the “gold standard” of prostate surgery options and the preferred treatment for BPH. It is performed by a urologist in a hospital under general anesthesia or spinal anesthesia coupled with a sedative. A resectoscope (an instrument much like a cystoscope with the advantages of a microscope, light, irrigation capability, and a wire loop) or a spring-action cutting tool, is inserted into the urethra to access the enlarged prostate gland. The electricity generated through the cutting tool removes small pieces of tissue until the urethra is no longer restricted. To control bleeding, the vessels are cauterized by the wire loop and the bladder and urethra are irrigated with a saline solution. A urinary catheter is put in for the purpose of resting the bladder and prostate, keeping the urethra open if swelling develops, and to empty the bladder of blood to avoid clotting. The procedure takes about 90 minutes to two hours.
Benefits of TURP
Recent technological advances to reduce the invasive aspect of surgical treatments of BPH offer options such as lasers, microwave, radio waves, and ultrasound. A new and promising laser procedure, GreenLight™ Laser PVP (photoselective vaporization of the prostates) has been demonstrated to remove prostate gland overgrowths using pulses of light with nearly no bleeding, less catheterization, and a greatly reduced recovery time.
TURP has several advantages over the newer technologies. For men with other health problems that make the newer procedures inadvisable, TURP is the best option for treatment of BPH. If the prostate has grown too large, newer procedures they may not be effective, and some may feel more comfortable with surgery than an unfamiliar technology.
Additional advantages include:
- Visual, hands-on access to the prostate
- Immediate removal of excess tissue
- Can be coupled with other procedures, e.g., removing small bladder stones
- Longevity of use with supportive data on overall efficiency, safety, and success rates
- Traditionally taught in medical schoolsso doctors have extensive experience
Recovery after TURP
Commonly, there is a one-night hospital stay for observation and flushing of the catheter. Light bleeding will continue, presented in the urine and when the catheter is flushed out. The catheter will remain in for a few days to a week and must be flushed regularly by the patient after discharge; instructions on how to do this are given while in the hospital.
After discharge, precautions are recommended for the purpose of healing, comfort, and preventing damage to the treated area. Patients will require rest and should drink large quantities of water to flush out the bladder to prevent a urinary tract infection. No straining, lifting or pushing heavy items should occur. A significant improvement in recovery is seen after the catheter has been removed and, while some of the pre-operative symptoms may continue, they will slowly decrease over a period of two to eight weeks. Complete reversal of all prior symptoms may take several months.
Sex after TURP Prostate Surgery
Sexual function returns for most men, but the doctor may advise against ejaculation for up to two months. While the ability to orgasm is unaffected by TURP, your ejaculate may no longer exit through the penis. This occurs if the valve to the bladder, which controls the direction of semen, is damaged during the procedure.