Trans-urethral resection of prostate (TURP) is a surgical procedure that reduces the size of an enlarged prostate gland. It helps restore the normal urination function for men who suffer from benign prostatic hyperplasia (BPH), which is the most common condition that causes an enlarged prostate in older men.
Surgery is usually recommended only when patients are experiencing moderate to severe symptoms of an enlarged prostate which has not responded to medication. The latest surgical techniques involve no external wound and usually patients are out of bed and pain free just the day after surgery.
Surgery is usually carried out under a local anaesthetic so you won’t feel anything below the waist. There are two types of operation, both of which involve inserting an instrument along the penis allowing the surgeon to remove the enlarged prostate gland in small pieces until it is no longer obstructing the flow of urine along the urinary passage (urethra).
The original procedure is called a Trans-Urethral Resection of Prostate (TURP). A telescopic instrument (resectoscope) is introduced along the penis until the surgeon can see the obstructing prostate gland. The blocking gland will then be removed in small pieces until all of the obstruction is removed.
A relatively new method of prostate removal (resection) is called Trans-Urethral Resection of Prostate in saline (TURPis). This uses bipolar technology to vaporise the tissue of the prostate gland; this is a quicker method of resection which also minimises bleeding. This method is ideal for removing smaller prostate glands and for patients who have a higher risk of bleeding. TURPis does not affect erectile function and should not affect urinary continence.
The newer TURPis is the safer of the two procedures, carrying no risk of TURP syndrome which can result from fluid absorption in the original TURP which is still performed in many hospitals.
After the operation we’ll help manage any discomfort with painkillers. You’ll have a urethral catheter inserted during surgery to continuously drain your bladder. Your urine will be blood stained for 24 to 48 hours after the operation, after which the catheter will be removed.
Any tissue removed during the operation will be sent to the laboratory for testing; you’ll be given the results at your follow-up appointment.
As with any surgical procedure there can be some risks which we’ll discuss with you before the operation, including:
- retention (inability to pass urine)
- retrograde ejaculation (semen passes backwards to the bladder during sex)
- scarring of the urethra
- absorption of fluid during the operation (very rare with newer TURPis procedure)
- erectile dysfunction (rare)
- permanent incontinence (very rare)
- Suprapubic or retropubic prostatectomy
- Laser hyperthermia