Transurethral resection of the prostate (TURP) involves coring out the central part of the prostate to physically enlarge the channel one passes urine through. It was the first ‘keyhole’ operation and remains the standard to which other operations for BPH are compared. It is performed under general or spinal anaesthetic, usually lasts 45 minutes and involves no incisions on the outside. It is performed using an electrical loop inserted into the urethra via a telescope. It cuts tissue and seals blood vessels as it removes the prostate in slivers. These are washed out at the end of the operation and a catheter is inserted for 2 days, through which irrigation fluid flows into the bladder to rinse any blood in it.
Patients are discharged from hospital 48hours following TURP and should avoid heavy physical exercise for 2 weeks. Urinary flow is usually markedly improved immediately but frequency may take 6-12 weeks to completely settle. All patients experience retrograde ejaculation after TURP i.e. sperm going back into the bladder at the time of climax, rather than coming out of the penis and being washed out of the bladder the next time it is emptied. There is also a 5% risk of impotence after TURP, usually in men aged over 70 years.
Click here for TURP patient information from the British Association of Urological Surgeons.