Transurethral resection of the prostate (TURP) is the gold-standard treatment for BPH (enlarged prostate). It is usually performed under general anaesthetic.
Key points
- Minimally invasive
- Requires general anaesthetic
- 1-hour operation
- 1-2 days hospital stay
- Up to 12 weeks recovery
Why choose Urocare?
At Urocare London, our commitment to excellence in urology is driven by the expertise and dedication of our leading specialist, Mr. Maneesh Ghei. Located at leading private hospitals in London, Urocare London offers the convenience and accessibility you need.
What is TURP?
Transurethral Resection of the Prostate (TURP) is a surgical procedure used to treat urinary problems due to an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). The procedure involves removing parts of the prostate gland through the urethra, offering relief from symptoms like difficulty urinating, frequent urination, and inability to completely empty the bladder. TURP is an inpatient procedure with a required stay of 1-2 nights.
Who is TURP suitable for?
TURP is suitable for all patients diagnosed with BPH who have not found relief through medication or less invasive treatments. It is particularly recommended for those experiencing significant urinary symptoms that impact their quality of life, including:
- Urinary retention
- Recurrent urinary tract infections
- Bladder stones
- Kidney problems due to an enlarged prostate.
Is TURP a major operation?
Yes, TURP is considered a major surgical procedure. It is performed in an operating theatre under general anaesthesia and typically requires a hospital stay of 1-2 days for recovery and monitoring. This allows healthcare professionals to ensure the patient’s well-being post-operation and manage any immediate post-operative care needs.
How long does a TURP operation last?
The TURP operation itself usually takes up to one hour. The duration can vary slightly depending on the size of the prostate and the extent of tissue removal required. Despite its relatively short duration, the precise nature of the procedure and the need for anaesthesia means that patients will need time to recover immediately afterwards.
How does TURP work?
- Preparation: Patients are required to fast for 6 hours before the procedure to prepare for general anaesthesia.
- Insertion Of Electrical Loop: Following anaesthesia, an electrical loop is inserted into the urethra via a telescope.
- Removal Of Prostate Tissue: The enlarged part of the prostate is visualised, and the loop is used to cut the tissue and seal the blood vessels as it removes the prostate in slivers. The slivers of tissue are washed out at the end of the operation.
- Catheter Insertion: A catheter is inserted and remains for approximately 2 days post-operation. This ensures proper urine flow and allows for the irrigation fluid to rinse away any remaining blood in the bladder.
What to expect after a TURP operation
After a TURP operation, patients can typically expect to be discharged from the hospital within 48 hours. It is advised to avoid heavy physical exercise for at least 2 weeks to allow the body to heal properly. While urinary flow often improves significantly immediately after surgery, it may take 6-12 weeks for urinary frequency to fully settle.
A common side effect experienced by all patients is retrograde ejaculation, where semen enters the bladder during climax instead of being expelled. This is generally considered harmless and is expelled during subsequent urination.
Alternative treatments to TURP
For patients seeking alternatives to TURP, several options are available depending on the severity of symptoms and individual health conditions.
Holmium Laser Enucleation of the Prostate (HoLEP)
HoLEP is a minimally invasive procedure that uses a high-powered holmium laser to enucleate and remove the entire prostate tissue blocking the urethra. This method is highly effective for patients with varying sizes of prostate enlargement and has several advantages, including a shorter hospital stay.
Steam treatment of the Prostate
UroLift
The UroLift System is another minimally invasive approach that involves placing small implants to lift and hold the enlarged prostate tissue away from the urethra, thus relieving obstruction without cutting, heating, or removing prostate tissue. The procedure is often done on an outpatient basis under local anaesthesia, allowing patients to return home the same day.
Frequently asked questions
Can a TURP be reversed?
No, a TURP procedure cannot be reversed. The process involves removing parts of the prostate tissue to relieve urinary symptoms caused by benign prostatic hyperplasia (BPH). Once the tissue is removed, it cannot be restored. Patients considering TURP should discuss all aspects of the surgery, including its permanent nature, with their urologist.
What are the risks of TURP?
While TURP is generally safe, like all surgical procedures, it carries certain risks. These can include:
- Bleeding: Some patients may experience significant bleeding during or after surgery.
- Infection: Risk of urinary tract infections or, in rare cases, sepsis.
- Incontinence (<1%): Some men may experience loss of bladder control.
- Failure To Void: Approximately 10% of patients may not be able to pass urine straight after the operation and may need a catheter for 1-2 weeks.
- Impotence (approx. 5%): A potential risk, although less common.
- Retrograde Ejaculation: Most patients will experience ejaculation of semen into the bladder rather than out through the penis during climax.
How soon after TURP can I drink alcohol?
Patients are advised to avoid alcohol for at least a few weeks after TURP surgery, as alcohol can interfere with the recovery process, especially with anaesthesia recovery and bladder healing. It’s important to follow your doctor’s specific recommendations, which may vary based on individual health and recovery progress.
Can you drive after TURP surgery?
Patients should not drive immediately after TURP surgery, especially while taking prescription pain medication, which can impair judgement and reaction times. Typically, it is safe to resume driving once you are no longer taking pain medication and can comfortably perform emergency stops without pain or hesitation. This is usually within a few days to a week after surgery, but follow your doctor’s advice.
How much of the prostate is removed in a TURP?
The amount of prostate tissue removed during a TURP varies depending on the size of the prostate and the severity of the symptoms. TURP specifically targets and removes the enlarged portion of the prostate that is causing obstruction of the urethra, rather than removing the entire prostate. The objective is to alleviate symptoms while preserving as much normal prostate function as possible.
Can the prostate regrow after TURP?
Yes, the prostate can regrow after TURP. Regrowth is a slow process and may take several years. In some cases, this regrowth can lead to a recurrence of BPH symptoms, and a small percentage of patients may eventually require a repeat procedure or alternative treatment. Regular follow-up with a urologist is important to monitor prostate health and manage any recurring symptoms.
Click here for TURP patient information from the British Association of Urological Surgeons.
