Transurethral Resection of the Prostate (TURP Procedure)
Transurethral Resection of the Prostate (TURP) is a surgical procedure commonly used to treat urinary symptoms caused by an enlarged prostate gland, also known as benign prostatic hyperplasia (BPH).
What is TURP?
TURP is a minimally invasive procedure that aims to remove or reduce the obstructing prostate tissue, relieving urinary symptoms caused by BPH. It is considered the gold standard surgical treatment for moderate to severe urinary symptoms associated with BPH.
How is TURP performed?
During a TURP procedure:
1. Anaesthesia: You will typically receive either general anaesthesia (being asleep) or spinal anaesthesia (numbing from the waist down).
2. Insertion of Resectoscope: A thin tube called a resectoscope is inserted through the urethra (urine tube) into the prostate gland. The resectoscope contains a light, camera, and surgical instruments.
3. Removal of Prostate Tissue: The surgeon uses the resectoscope to remove excess prostate tissue that is blocking urine flow. Electrical current is used to cut and remove the tissue, and to control any bleeding
4. Bladder Irrigation: After the tissue removal, sterile saline (salt water) is used to irrigate the bladder to flush out any blood.
5. Catheter Placement: A catheter is inserted into the bladder through the urethra to drain urine and help with healing.
What to expect before TURP:
Before undergoing TURP:
1. Evaluation: Your surgeon will perform a thorough evaluation to determine if TURP is the right procedure for you. This includes an examination of the prostate, medical history review, imaging tests, and urine tests.
2. Medication Adjustments: You may need to temporarily stop certain medications that can increase bleeding risk, such as blood thinners.
3. Preoperative Instructions: Your surgeon will provide specific instructions about fasting before surgery, medications to take, and any necessary preparation.
What to expect after TURP:
After the TURP procedure:
1. Hospital Stay: You will stay in the hospital for a day or two to monitor your recovery.
2. Catheter: The catheter will remain in place for 1-2 days to help drain urine and allow the healing process.
3. Recovery: Within the first 6 weeks it is normal to have intermittent bleeding in the urine, burning or stinging while urinating, the need to rush to the toilet frequently, going to the toilet at night, and occasional incontinence (loss of control of urine). This typically improves by 6 weeks.
Potential risks and benefits:
As with any surgical procedure, TURP carries potential risks and benefits. Risks may include bleeding, infection, urinary incontinence, retrograde ejaculation, and rarely, urinary stricture or bladder injury. Benefits of TURP include improved urinary flow, reduced urinary symptoms, and improved quality of life.
Tips for a successful recovery:
To improve your recovery after TURP:
Hydration: Drink plenty of fluids to help flush out the bladder and promote healing.
Regular paracetamol (1g 4 times per day) and ibuprofen (400mg 3 times per day with food) can help if there is pain.
Ural sachets (1 sachet 3 times per day) can help with stinging in the urine.
You should not need to continue prostate medications such as duodart after the surgery, although you can confirm this with your surgeon.
3. Physical Activity: Gradually resume normal activities and avoid heavy lifting or strenuous exercise during the initial 4 week period. Being physically active (walking etc.) is important to your recovery, and you should avoid spending long periods sitting or in bed. You should be ready to drive within 2 weeks of the surgery.
4. Follow a Healthy Lifestyle: Maintain a healthy diet, exercise regularly, and see your GP regularly to manage any chronic health conditions.
5. Call up if you are worried you may have an infection after the operation - usually noted because of fevers, sweats, chills, and marked worsening of urinary symptoms.