1. What is it? Any common name for this procedure?
Transurethral Resection of the Prostate (TURP) is the traditional "gold standard" surgical treatment for a blocked urethra due to Benign Prostatic Hyperplasia (BPH). During the procedure, a urologist inserts a thin, lighted tube called a resectoscope through the tip of the penis and into the urethra. Using an electrified wire loop, the surgeon carves away the excess prostate tissue that is blocking the flow of urine.
Because the surgery is performed entirely through the urethra, there are no external incisions or scars.
Common Names:
"Reaming" the prostate
The "Gold Standard" for BPH
Scoping the prostate
2. Common Indications: When is it Recommended?
TURP is usually recommended when medications (like Tamsulosin or Finasteride) have failed or when the obstruction is severe.
- Persistent Urinary Retention: Frequently being unable to urinate at all.
- Recurrent UTIs: Frequent infections caused by "old" urine staying in the bladder.
- Bladder Stones: Formed because the bladder cannot empty completely.
- Kidney Damage: High pressure from the bladder causing urine to back up into the kidneys.
- Gross Hematuria: Frequent heavy bleeding from the prostate.
3. List of Associated Risks and Conditions
Retrograde Ejaculation: Often called "dry orgasm." Semen enters the bladder during climax instead of exiting the penis. This is harmless but can affect fertility.
- TURP Syndrome: A rare but serious condition where the body absorbs too much of the fluid used to wash the surgical area during the procedure.
- Urethral Stricture: Scar tissue forming in the urethra months or years later, which may require stretching.
- Temporary Incontinence: A brief period of leaking urine while the pelvic muscles recover.
4. List of Screening Tests and Assessment Tools
Before surgery, the urologist must confirm that the prostate size and bladder health are suitable for TURP.
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Tool
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Purpose
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Cystoscopy
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A small camera is inserted into the urethra to "look" at the blockage and the bladder walls.
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Transrectal Ultrasound (TRUS)
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Used to measure the exact volume (size) of the prostate in grams.
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Urodynamics
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A series of tests to ensure the bladder muscle is strong enough to push urine out once the blockage is removed.
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PSA & DRE
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To ensure there are no suspicious nodules that might indicate cancer rather than BPH.
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5. Am I Eligible for This Evaluation?
- Prostate Size: Ideally suited for prostates between 30 and 80 grams. Very large prostates (over 100g) might be better treated with a laser (HoLEP) or open surgery.
- General Health: You must be able to stop blood thinners (like aspirin or warfarin) for several days before and after the surgery.
- Bladder Health: Your bladder must still be functional; if the bladder has "failed" due to years of obstruction, removing the prostate tissue may not fully fix the flow.
6. Pre and Post Care
Pre-Care:
- Antibiotics: Usually given just before the procedure to prevent infection.
- Anesthesia: Performed under general anesthesia or a spinal block (numb from the waist down).
Post-Care:
- Catheterization: A large tube (catheter) is left in the bladder for 24 to 48 hours to flush out blood and clots.
- Hydration: Drinking plenty of water is essential to keep the urine clear and "flush" the healing area.
- No Straining: Avoid heavy lifting and "straining" during bowel movements for 4 weeks to prevent the surgical site from bleeding.
7. Days Required for Hospitalization
- Surgical Time: 60 to 90 minutes.
- In-Hospital Stay: 1 to 2 Days. Most patients stay until the catheter is removed and they can urinate on their own.
- Back to Work: 1 to 2 weeks for desk jobs; 4 to 6 weeks for physical labor.
- Hospitalization: 1–2 Days.
8. Benefits of TURP
- Immediate Results: Most men notice a significantly stronger urinary stream almost as soon as the catheter is removed.
- Proven Long-term Success: TURP has been used for decades; most men do not need another surgery for at least 15 to 20 years.
- No External Scars: Faster healing of the skin and zero visible marks of surgery.
- Tissue Diagnosis: The "chips" of prostate tissue removed are sent to a lab to ensure no hidden cancer cells were present.
