Transurethral resection prostate surgery (TURP)

• Stopping and starting again while urinating.
• The feeling that you can't fully empty your bladder.
• Urinary tract infections.

TURP might also be done to treat or prevent complications due to blocked urine flow, such as:

• Repeated urinary tract infections.
• Kidney or bladder damage.
• Not being able to control urination or to urinate at all.
• Bladder stones.
• Blood in urine.

Risks

Risks of TURP can include:

• Short-term trouble urinating, which might last for a few days after the procedure. Until you can urinate on your own, a thin, flexible tube called a catheter will be placed into your penis to carry urine out of your bladder.
• Urinary tract infection, which can happen after any prostate procedure and becomes more likely the longer you have a catheter in place.
• Dry orgasm, where semen is released into the bladder rather than out of the penis. This is a common and long-term effect of any type of prostate surgery.
• Erectile dysfunction, which is trouble getting or keeping an erection. The risk is very small, but it can happen after prostate treatments.
• Heavy bleeding, which is rare but can occur, especially in men with larger prostates.
• Trouble holding urine, also known as incontinence, which can be a long-term side effect.
• Low sodium in the blood (hyponatremia), which can occur if the body absorbs too much fluid used during the procedure, leading to TURP syndrome.
• Need for re-treatment, as some men may need follow-up treatment if symptoms return or worsen over time.

How You Prepare

Several days before surgery, your healthcare professional might recommend that you stop taking medicines that raise your risk of bleeding, including:

• Blood thinners such as warfarin (Jantoven) or clopidogrel (Plavix).
• Pain relievers sold over the counter, such as aspirin, ibuprofen (Advil, Motrin IB, others), or naproxen sodium (Aleve).

You might be prescribed an antibiotic to prevent a urinary tract infection.

Arrange to have a family member or friend drive you to and from the hospital, as you won't be able to drive yourself home after the procedure.

You might not be able to work or do strenuous activities for up to six weeks after surgery. Ask a member of your surgery team how much recovery time you might need.

What You Can Expect

The TURP procedure takes about 60 to 90 minutes. Before surgery, you'll be given anesthesia to prevent pain. You might receive general anesthesia, which puts you in a sleep-like state, or spinal anesthesia , which allows you to stay conscious. You may also receive a dose of antibiotics to prevent infection.

During the procedure, the resectoscope is placed into the tip of your penis and passed through your urethra into the prostate area. Your surgeon won't need to make any external cuts.

The resectoscope is used to trim tissue from the inside of the prostate gland, one small piece at a time. As tissue is cut, the resectoscope releases fluid to carry the pieces into the bladder, which are removed at the end of the operation.

You'll have a urinary catheter in place due to swelling that blocks urine flow, typically left in for at least 24 to 48 hours until swelling decreases and you can urinate on your own.

After surgery, you might notice:

• Blood in your urine, which is common right after surgery. Contact your healthcare team if the blood is thick like ketchup, if bleeding worsens, or if urine flow is blocked.
• Other symptoms such as painful urination or an urgent need to urinate, which may take weeks to improve.

Your doctor will likely recommend that you:

• Drink plenty of water to flush out the bladder.
• Eat high-fiber foods to prevent constipation and straining during bowel movements, possibly using a stool softener.
• Wait to resume blood-thinning medications until cleared by your healthcare team.
• Avoid strenuous activities, such as heavy lifting, for 4 to 6 weeks, and refrain from activities that put pressure on the area between the anus and scrotum.
• Hold off on sexual activity for 4 to 6 weeks.
• Not drive until your catheter is removed and you're no longer taking prescription pain medications.

Contact your healthcare team if you:

• Are unable to urinate.
• Notice bright red blood or clots in your urine.
• See no improvement in urine clarity after drinking more fluids and resting for 24 hours.

Seek immediate medical care if you experience fever, chills, or lightheadedness.

Results

TURP often relieves symptoms effectively, with results lasting 15 years or longer. However, follow-up treatment may be necessary if symptoms return or worsen over time.