What is a Transurethral Resection Of the Prostate (TURP)?

A transurethral resection of the prostate (TURP) is surgery to remove parts of the prostate gland through the penis. No incisions are needed.

The surgeon reaches the prostate by putting an instrument into the end of the penis and through the urethra. This instrument, called a resectoscope, is about 12 inches long and .5 inch in diameter. It contains a lighted camera and valves that control irrigating fluid. It also contains an electrical wire loop that cuts tissue and seals blood vessels. The wire loop is guided by the surgeon to remove the tissue blocking the urethra one piece at a time. The pieces of tissue are carried by the irrigating fluid into the bladder and then flushed out at the end of the procedure.

Why Might I Need TURP?

TURP is most often done to relieve symptoms caused by an enlarged prostate. This is often due to benign prostate hyperplasia (BPH). BPH is not cancer. It is a common part of aging. When the prostate gland is enlarged, it can press against the urethra and interfere with or block the passage of urine out of the body.

Sometimes a TURP is done to treat symptoms only, not to cure the disease. For example, if you’re unable to urinate because of prostate cancer, but surgery to remove the prostate isn’t an option for you, you may need a TURP.

There may be other reasons for your healthcare provider to recommend a TURP.

What Are the Risks of a TURP?

As with any surgery, certain complications can occur with TURP. Some possible complications may include:

• Bladder injury
• Bleeding
• Blood in the urine after surgery
• Electrolyte abnormalities
• Infection
• Loss of erections
• Painful or difficult urination
• Retrograde ejaculation (when ejaculate goes into the bladder and not out the penis)

There may be other risks depending on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.

How Do I Get Ready for a TURP?

Some things you can expect before the procedure include:

• Your healthcare provider will explain the procedure and you can ask questions.
• You will be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything isn’t clear.
• Your healthcare provider will review your medical history, and do a physical exam to be sure you’re in good health before you have the procedure. You may also need blood tests and other tests.
• You will be asked not to eat or drink anything for 8 hours before the procedure, generally after midnight.
• Tell your healthcare provider if you are sensitive to or allergic to any medicines, latex, iodine, tape, contrast dyes, or anesthesia.
• Make sure your healthcare provider has a list of all medicines herbs, vitamins, and supplements that you are taking. This includes both prescribed and over-the-counter.
• Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicines (anticoagulants), aspirin, or any other medicines that affect blood clotting. You may need to stop these medicines before the procedure.
• If you smoke, stop as soon as possible to improve recovery and your overall health.
• You may be given a sedative before the procedure to help you relax.

Based on your medical condition, your healthcare provider may request other specific preparation.

What Happens During TURP?

TURP requires a hospital stay. Procedures may vary depending on your condition and your healthcare provider’s practices.

Generally, a TURP follows this process:

1. You will be asked to remove any jewelry or other objects that might get in the way during surgery.
2. You will be asked to remove your clothing and will be given a gown to wear
3. You'll be asked to empty your bladder.
4. An IV line will be put in your arm or hand.
5. You will be positioned on an operating table, lying on your back.
6. You will be given anesthesia to put you to sleep for the procedure. Your legs will be placed in stirrups.
7. Your heart rate, blood pressure, breathing, and blood oxygen level will be monitored during the surgery.
8. Once you’re sedated, a breathing tube may be put through your throat into your lungs and you will be connected to a ventilator. This will breathe for you during the surgery.
9. The surgeon may first inspect the urethra and bladder with an endoscope. This is done by passing the scope through the tip of the penis, then into the urethra and bladder. This allows the healthcare provider to examine these areas for any tumors or stones in the bladder.
10. Next, the resectoscope is passed into the urethra. It is used to cut away the pieces of prostate tissue that are bulging or blocking the urethra. Electricity will be applied through the resectoscope to stop any bleeding. The pieces are flushed into the bladder, and then drained out through the urethra.
11. The resectoscope is removed.
12. The healthcare provider will put a soft, flexible tube called a catheter into your bladder to drain urine.

What Happens After TURP?

In the Hospital

After the procedure, you may be taken to a recovery room and watched closely. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room.

You may get pain medicine as needed, either by a nurse, or by giving it yourself through a device connected to your IV line.

Once you are awake, you may start to drink liquids. You will be able to eat solid foods as you are able to handle them.

The catheter will stay in place for 1 to 3 days to help urine drain while your prostate gland heals. You will probably have blood in your urine after surgery. A bag of solution may be attached to the catheter to flush the blood and potential clots out of your bladder and the catheter. The bleeding will slowly decrease, and then the catheter will be removed.

Arrangements will be made for a follow-up visit with your healthcare provider. Your healthcare provider may give you other instructions after the procedure, depending on your situation.

At Home

Once you are home, it will be important to drink lots of fluids. This helps to flush out any remaining blood or clots from your bladder.

You will be told not to do any heavy lifting for several weeks after the TURP. This is to help prevent bleeding.

You may be tender or sore for several days after a TURP. Take a pain reliever for soreness as recommended by your healthcare provider.

You shouldn’t drive until your healthcare provider tells you to. Other activity restrictions may also apply.

Tell your healthcare provider to report any of the following:

• Fever and/or chills ;
• Trouble urinating ;
• Trouble controlling your bladder ;
• Changes in your urine output, color, or odor ;
• Increasing blood or clots in your urine.

Your healthcare provider may give you other instructions after the procedure, depending on your particular situation.