Transurethral resection of the prostate (TURP)

TURP (transurethral resection of the prostate)  is the standard surgery for BPE. The aim is to remove the part of the prostate which causes the symptoms. The procedure is done through the urethra without making an incision in your lower abdomen. This type of surgery is known as a minimally invasive treatment.

When should I consider TURP?

TURP is the preferred surgical option for men with moderate to severe symptoms caused by BPE. It is most suited for men with prostates between 30-80 millilitres.

How is TURP performed?

For TURP you will receive general or spinal anaesthesia. Once you are under anaesthesia, the doctor uses a resectoscope to enter the bladder through the urethra (Fig. 1). A resectoscope is a type of endoscope with a wire loop which uses a high-frequency electrical current to cut the prostate tissue. It also has a camera which allows the doctor to see a high-quality image of the prostate on a video monitor.

During the procedure, the doctor removes the adenoma in small parts with the wire loop (Fig. 2). The doctor then flushes the cut tissue out of the bladder and the urethra through the resectoscope.

After the operation, a catheter is placed in your bladder to drain urine. It is also used to continuously flush your bladder and urethra with a sterile solution to prevent blood clots. You will need the catheter for 1-3 days until the wound is healed and you can urinate on your own.

Fig. 1: Surgery through the urethra.
Fig. 1: Surgery through the urethra.
Fig. 2: The resectoscope removes parts of the prostate tissue during TURP.
Fig. 2: The resectoscope removes parts of the prostate tissue during TURP.

How to prepare for the procedure

Your doctor will advise you in detail about how to prepare for the procedure. You must not eat, drink, or smoke for 6 hours before surgery to prepare for the anaesthesia. If you are taking any prescribed medication, discuss it with your doctor. You may need to stop taking it several days before surgery.

After the procedure

How long will it take me to get back to my daily activities?

Usually, you can leave the hospital 2 or 3 days after surgery. The length of hospital stay can vary in different countries. There may be some blood in your urine for several days. You may also suffer from urgency and feel pain when you urinate, which can last up to several weeks.

For 4-6 weeks after the surgery:

  • Drink 1-2 litres every day, especially water
  • Do not lift anything heavier than 5 kilograms
  • Do not do any heavy exercise and avoid bike riding
  • Do not take thermal baths or go to the sauna
  • Prevent constipation by adapting your diet
  • Discuss any prescribed medication with your doctor

Avoid having sex for 2-3 weeks. After TURP, you may suffer from retrograde ejaculation. This is a chronic condition where semen can no longer leave through the urethra during orgasm. Instead, it goes into the bladder and later leaves your body during urination.

You need to go to your doctor or go back to the hospital right away if you:

  • Develop a fever
  • Are unable to urinate on your own
  • Have heavy blood loss or pain

Advantages

  • The procedure is safe and widely used
  • Optimal and long-lasting improvement of the symptoms
  • Short hospital stay

Disadvantages

  • Risk of bleeding
  • Risk of retrograde ejaculation
  • Risk of urethral stricture
  • Risk of urinary retention
  • Low risk of urinary tract infection and urgency
  • Very low risk of incontinence