TRANSURETHRAL PROSTATE RESECTION (TURP)
ABOUT TRANSURETHRAL RESECTION OF THE PROSTATE
Transurethral resection of the prostate (TURP, or commonly called a “rebore”) is an operation to remove some of the tissue from the prostate for the treatment of an enlarged prostate.
WHY IS A TURP REQUIRED?
As the prostate enlarges it can press on the urethra (the tube that urine flows out of) and narrows it, restricting the flow of urine.
A TURP removes the internal tissues of the prostate to open the passage up again allowing urine to flow more easily.
WHAT DOES TURP INVOLVE?
TURP is performed under general anaesthetic (completely asleep) or spinal anaesthetic.
An instrument called a resectoscope is inserted into the urethra. This has a movable wire which an electrical current in passed through to cut off sections of the prostatic tissue. This resected tissue is then flushed into the bladder and removed through the resectoscope.
A tissue sample is sent to pathology to check for cancer cells.
A catheter will be left in your bladder at the end of the procedure, with irrigating fluid to wash out any blood. This will remain in place for two days.
Once the bleeding has settled, the irrigation fluid and catheter will be removed and you will have a “trial of void”. This tests your ability to pass urine and empty your bladder.
You will be in hospital for two to three days.
WHAT IS THE RECOVERY AFTER TURP?
When you go home you can expect there to be blood in your urine. This will come and go while the prostate heals.
You will also have some discomfort when going to the toilet to pass urine. This will resolve after a few weeks.
Urinary urgency and frequency are common initially. Since part of the prostate has been removed, it will take a while for the bladder to adjust to no longer having an obstruction at its outlet.
You can return to sedentary work approximately two weeks after the operation. If your job involves physical work, please discuss this with your doctor.
You can start doing gentle exercise such as walking approximately one week after the operation. Avoid strenuous exercise and heavy lifting for at least four weeks after the operation.
It is usually safe to drive two weeks after the procedure.
You can resume sexual intercourse when comfortable. This is usually two to six weeks following surgery. However, you may not ejaculate. Your ejaculate may no longer come out, but instead goes into the bladder where it will be washed out next time you urinate (retrograde ejaculation). This also means you will no longer be able to father children naturally.
WHAT ARE THE RISKS OF TURP?
- Temporary mild burning, frequent urination and blood in the urine.
- Retrograde ejaculation (semen goes back into bladder).
Common risks (1/2 – 1/10)
- Treatment may not relieve all of your symptoms.
Occasional risks (1/10 – 1/50)
- Deterioration in quality of erections.
- Urinary tract infection requiring antibiotics.
- Bleeding requiring a blood transfusion.
- Need to repeat the procedure in the future due to regrowth of the tissue.
- Scarring of the urethra requiring the need for further intervention.
- Inability to pass urine following surgery that requires a catheter or intermittent self-catheterisation.
- Finding unexpected cancer which may require further treatment.
Rare risks (1/50 – 1/250)
- Loss of urinary control which may be temporary or permanent.
- Irrigation fluid gets into the bloodstream, causing confusion and heart problems.
The risks of anaesthesia have not been listed here.
WHAT ARE THE ALTERNATIVE TREATMENT OPTIONS?
- Surveillance – no treatment.
- Lifestyle changes.
- Greenlight laser photovaporisation of the prostate.
- Open simple prostatectomy.
- Robotic simple prostatectomy.
- Prostate artery embolization.
- British Association of Urological Surgeons (2017) Transurethral prostatectomy (TURP) for benign disease.
- Urological Society of Australia and New Zealand (2016) Surgical treatment of an enlarged prostate – a guide for men with BPH. (5TH ed).
This is general information only. Please consult your doctor for more information and treatment options.