Transurethral Resection of the Prostate

Transurethral Resection of the Prostate (TURP)

Procedure Overview

What is a transurethral resection of the prostate or TURP?

A transurethral resection of the prostate (TURP) is a surgical procedure that removes portions of the prostate gland through the penis. A TURP requires no external incision.

The surgeon reaches the prostate by inserting an instrument through the urethra (the narrow channel through which urine passes from the bladder out of the body). This instrument, called a resectoscope, is about 12 inches long and one-half inch in diameter. It contains a light, valves that control irrigating fluid, and an electrical loop that cuts tissue and seals blood vessels. It's inserted through the penis and the wire loop is guided by the surgeon so it can remove the obstructing tissue one piece at a time. The pieces of tissue are carried by fluid into the bladder and flushed out at the end of the procedure.

What is the prostate gland?

Illustration of the anatomy of the male reproductive tract
Click Image to Enlarge

The prostate gland is about the size of a walnut and surrounds the neck of a man's bladder and urethra—the tube that carries urine from the bladder. It's partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It's made up of three lobes, a center lobe with one lobe on each side.

As part of the male reproductive system, the prostate gland's primary function is to secrete a slightly alkaline fluid that forms part of the seminal fluid (semen), a fluid that carries sperm. During male climax (orgasm), the muscular glands of the prostate help to propel the prostate fluid, in addition to sperm that was produced in the testicles, into the urethra. The semen then travels through the tip of the penis during ejaculation.

Researchers don't know all the functions of the prostate gland. However, the prostate gland plays an important role in both sexual and urinary function. It's common for the prostate gland to become enlarged as a man ages, and it's also likely for a man to encounter some type of prostate problem in his lifetime.

Many common problems are associated with the prostate gland. These problems may occur in men of all ages and include:

Cancer of the prostate is a common and serious health concern. According to the American Cancer Society (ACS), prostate cancer is the most common form of cancer in men older than age 50, and the third leading cause of death from cancer.

There are different ways to achieve the goal of removing the prostate gland. Methods of performing prostatectomy include:

Reasons for the Procedure

TURP is generally done to relieve symptoms due to prostate enlargement, often due to benign prostatic hypertrophy (BPH). When the prostate gland is enlarged, the gland can press against the urethra and interfere with or obstruct the passage of urine out of the body. BPH is a condition in which the prostate gland may become quite enlarged and cause problems with urination. These symptoms may include:

These symptoms can create problems such as retaining urine in the bladder, which can contribute to bladder infections or formation of stones in the bladder.

BPH can also raise prostate-specific antigen (PSA) levels two to three times higher than the normal level. An increased PSA level doesn't always indicate cancer, but the higher the PSA level, the higher the chance of having cancer. A TURP may be done in men who can't tolerate a radical prostatectomy due to their age or overall health status.

Specific treatment for BPH will be determined by your physician based on:

Eventually, BPH symptoms usually require some kind of treatment. When the gland is just mildly enlarged, treatment may not be needed, as research has shown that some of the symptoms of BPH can clear up without treatment in some mild cases. This decision can only be made by your physician after careful evaluation of your individual condition. Regular checkups are important, however, to watch for developing problems.

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

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

Risks of the Procedure

As with any surgical procedure, certain complications can occur. Some possible complications may include, but are not limited to, the following:

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Before the Procedure

Some things you can expect before the procedure include:

Based upon your medical condition, your physician may request other specific preparation.

During the Procedure

Illustration of Transurethral Resection of the Prostate (TURP)
Click Image to Enlarge

Transurethral resection of the prostate requires a stay in the hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, a TURP follows this process:

  1. You'll be asked to remove any jewelry or other objects that may interfere with the procedure.
  2. You'll be asked to remove your clothing and will be given a gown to wear.
  3. You'll be asked to empty your bladder prior to the procedure.
  4. An intravenous (IV) line will be started in your arm or hand.
  5. You'll be positioned on the operating table, lying on your back.
  6. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. Once you're sedated, a breathing tube will be inserted through your throat into your windpipe and you'll be connected to a ventilator, which will breathe for you during the surgery.
  7. The surgeon will 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 physician to examine these areas for any tumors or stones in the bladder.
  8. Next, the resectoscope (electrical loop) is passed into the urethra. It cuts out pieces of tissue from the prostate that are bulging or blocking the urethra. Electricity will be applied through the resectoscope to stop any potential bleeding.
  9. The physician will insert a catheter into the bladder to empty urine.
  10. You'll be transferred from the operating table to a bed then taken to the recovery room.

After the Procedure

In the hospital

After the procedure, you may be taken to the recovery room to be closely monitored. You'll be connected to monitors that will constantly display your electrocardiogram (ECG or EKG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level.

Once your blood pressure, pulse, and breathing are stable and you're alert, you'll be taken to your hospital room.

You may receive pain medication as needed, either by a nurse, or by administering it yourself through a device connected to your intravenous line.

Once you're awake and your condition has stabilized, you may start liquids to drink. Your diet may be gradually advanced to more solid foods as you are able to tolerate them.

The urine catheter will stay in place for one to three days to help urine drain while your prostate gland heals. You'll probably have blood in your urine after surgery.

Also, a liquid solution may be attached to the catheter to flush the blood and potential clots out of the catheter. The bleeding will gradually decrease, and then the catheter will be removed.

Arrangements will be made for a follow-up visit with your physician.

Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.

At home

Once you're home, it'll be important to drink lots of fluid. This aids in flushing out any remaining blood or clots from your bladder.

You'll be advised to not do any heavy lifting for several weeks after the TURP. This is to prevent any recurrence of bleeding.

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

You shouldn't drive until your physician tells you to. Other activity restrictions may apply.
Notify your physician to report any of the following:

Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online Resources

The content provided here is for informational purposes only, and wasn't designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we don't control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American Cancer Society

American Urological Association

American Urological Association Foundation

National Association for Continence

National Cancer Institute (NCI)

National Coalition for Cancer Survivorship

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Prostate Cancer Foundation

 

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