TURP Treatment

About TURP Treatment and Its Advantages

Transurethral resection of the prostate, or TURP, is a procedure in which a section of prostate tissue is removed.  While the procedure has many side effects, it does alleviate more symptoms than any of the other treatments available for BPH.  Up to 90% of patients who undergo TURP see a dramatic improvement in their symptoms with little or no complication from the surgery.

During this procedure, the prostate is visualized through the urethra using a special cystoscope called a resectoscope.  With this instrument, the prostate section to be removed is shaved into manageable pieces, which are then removed as the tissue is cauterized (heat is applied so that bleeding is minimized).  The patient is under general anesthesia during this time.  After the surgery, a Foley catheter is used to drain the bladder.  Urine will initially be bloody, but will soon become clear.  As with all surgeries, there are some risks, but these are generally low, especially if the patient fully discloses all current medication they regularly take which might interfere with the surgery (such as blood thinners).  Generally, patients who undergo TURP will remain in the hospital from one to three days.

Patients with prostates estimated to be in between 30 and 90 grams are best suited for TURP surgery, whereas in patients with a prostate measuring 90 grams and above, an open prostatectomy is recommended since it can be very difficult for a surgeon to remove a large prostate using TURP.   Once prostate size reaches 90 grams or higher, bleeding may become more difficult to control during the TURP surgery.   Additionally, patients may also absorb excessive fluids during this extensive surgery which can cause brain swelling and other complications. 

Generally, patients with larger prostates may choose to undergo an open prostatectomy, in which an incision is made through the lower abdomen.   This procedure is more involved than the TURP treatment and the patient will have longer post-operative recovery time in the hospital.  In addition, they will remain on the Foley catheter for several days.
If the patient is having less severe symptoms and opts for a less invasive surgery, their physician may recommend a laser prostatectomy, in which highly powered light is used to destroy prostate tissue.  This procedure removes only the tissue immediately blocking the urethra, and the patient generally does not remain in the hospital.  A catheter is used to drain urine for several days following this procedure.  

Patient Instructions

TURP is generally quite successful at removal of symptom-causing enlarged prostates.  Bleeding, fluid absorption and infection are the most common risks associated with the procedure.  Other less common risks of the surgery may include problems with urine control, infertility, the flow of semen into the bladder instead of through the urethra (retrograde ejaculation), and trouble obtaining and maintaining an erection. 

For most patients, the benefits of the procedure outweigh the risks.  Patients should remain off of their feet for several days following the procedure, and should allow up to 3 weeks for a complete recovery.  In addition, they should avoid alcoholic beverages, spicy foods, and caffeine, as these may slow down the healing process.  Patients should avoid strenuous activity for 3 to 4 weeks to allow for complete healing of the tissue, and may wish to take dietary supplements to avoid constipation, which can impede the healing process.  Those patients who are on blood thinning medication should stop their medication after consulting with their physician at least one week prior to their surgery and should not resume taking them until they have been cleared by their urologist.  With the proper precautions, the patient’s post-operative time will be pain-free, and the patient will see a reduction in symptoms.  

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