Prostate Surgery: Transurethral Resection (TURP)

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KEY POINTS

• Transurethral resection of the prostate is a surgery to remove tissue from your prostate gland.
• Ask your provider how long it will take to recover and how to take care of yourself at home.
• Make sure you know what symptoms or problems you should watch for and what to do if you have them.

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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 “emergencies.”

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.
• You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• 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
• If there are 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. Keep all appointments for provider visits or tests.

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.
• Rarely, 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.
• Occasionally, you may leak a small amount of urine, especially when you do heavy physical activity and your bladder is full.

Ask your healthcare provider how the risks apply to you. Be sure to discuss any other questions or concerns that you may have.