Transurethral Resection of the ProstateBy
Catherine Spader, RN
What is TURP (transurethral resection of the prostate)?
TURP (transurethral resection of the prostate), or prostatectomy, is the surgical removal of all or part of the prostate. The prostate is a walnut-sized gland that makes a component of semen. Your doctor may recommend the TURP procedure to treat an enlarged prostate due to benign prostatic hyperplasia (BPH) or prostate cancer.
TURP is a major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having TURP.
Why is TURP (transurethral resection of the prostate) performed?
Your urologist may recommend a TURP to treat an enlarged prostate due to the following conditions:
BPH (benign prostatic hyperplasia), which is a noncancerous condition in which the prostate enlarges as a man ages. When the prostate gland grows, it presses against the urethra and bladder. This causes difficulty urinating, incontinence, painful urination, and incomplete emptying of the bladder.
Prostate cancer, which causes frequent urination, painful urination, painful ejaculation, and other symptoms. Sometimes a urologist may choose TURP to treat symptoms of prostate cancer in older or ill men who cannot tolerate move invasive surgery to remove the prostate.
Your doctor may only consider A TURP for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a TURP.
Who performs TURP?
How is TURP (transurethral resection of the prostate) performed?
TURP is performed in a hospital or an outpatient surgery clinic. It involves inserting a small tube, called a cystoscope, through your urethra. The urethra is a tube that carries urine from the bladder, past the prostate, and out of the penis. Your urologist then removes part or all of your prostate in pieces using electric current or a laser.
Types of anesthesia that may be used
Your surgeon performs TURP using either general anesthesia or regional anesthesia.
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.
What to expect the day of your TURP
The day of your surgery, you can generally expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of a TURP (transurethral resection of the prostate)?
As with all surgeries, a TURP involves risks and possible complications. Most TURP procedures are successful, but complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Potential complications of TURP
Complications of TURP include:
Abnormal flow of semen into the bladder instead of out the urethra (retrograde ejaculation)
Damage to nearby organs and tissues including the urethra, bladder or rectum
Damage to tissue around the prostate due to buildup of fluid (transurethral resection syndrome or TUR syndrome)
Impotence, which is problems having or keeping an erection
Scar tissue on the urethra, which could tighten the urethra and cause a urethral narrowing, or stricture, making it difficult to urinate
Urinary or bowel incontinence
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery
Notifying your doctor immediately of any concerns, such as bleeding, bloody urine, fever, increase in pain, or decreased urination
Seeing your doctor as instructed before and after surgery
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my TURP (transurethral resection of the prostate)?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.
You can prepare for TURP by:
Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing excess weight before the surgery through a healthy diet and exercise plan
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
Why do I need a TURP procedure? Are there any other options for treating my condition?
How long will the surgery take? When can I go home?
What restrictions will I have after the surgery? When can I return to work and other activities?
How long should I wait to have sex after the surgery?
What assistance will I need at home?
How long will I need to have a urinary catheter after the surgery?
What medications will I need before and after the surgery? How should I take my medications?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my TURP (transurethral resection of the prostate)?
Knowing what to expect can help make your road to recovery after TURP as smooth as possible.
How long will it take to recover?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
You will have a tube in your penis called a catheter. This tube drains urine from your bladder and gives your urethra time to heal.
You will stay in the hospital one to three days. Your surgical and medical teams will monitor your healing during this time. You will go home the same day if you had an outpatient TURP procedure.
Your catheter will stay in place one to three days. Your urine may look bloody, and your care team will use the catheter to flush out blood and clots from the bladder with fluid.
You may have a frequent urge to urinate and small amounts of blood for up to a month after the catheter is removed. These symptoms should improve steadily over time.
Recovery after surgery is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, age, and other factors. Full recovery takes a few weeks.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your surgery, including burning during urination, which should go away gradually over several weeks. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication
When should I call my doctor?
It is important to keep your follow-up appointments after a TURP procedure. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or