Transurethral Surgery of the Prostate

Transurethral surgery, or transurethral resection of the prostate (TURP), is a surgery to remove all or part of the prostate gland to treat an enlarged prostate.

ABOUT
The surgery is usually recommended as a treatment option for those with benign prostatic hyperplasia (BPH) and is an option for those who have urination issues as a result of their enlarged prostate. TURP usually relieves symptoms of a large prostate, which include weak stream, urinating often, the need to urinate urgently, and urinary frequency at night.

SECOND LINE THERAPY
TURP is often a second line therapy when oral medication or dietary and fluid restrictions fail to relieve urinary symptoms. TURP is more likely to be required for severe manifestations of severe prostate enlargement. These include:

  • Difficulty emptying the bladder
  • Frequent urinary tract infections
  • Bleeding from the prostate
  • Bladder stones accompanied by prostate enlargement
  • Extremely slow urination
  • Damage to the kidneys

PRE-SURGERY
You will likely undergo tests with your doctor before the surgery. This may include

  • Complete physical exam
  • Cystoscope examination of your prostate
  • Ultrasound of your urethra, prostate, and bladder
  • Ultrasound of the prostate performed through the rectum
  • Urodynamic evaluation of the bladder function

Any medical conditions will need to be stabilized prior to surgery, and blood thinning medications, such as aspirin, Plavix, or Coumadin, will need to be stopped. During the weeks before surgery, you may be asked to stop taking medications with blood-thinning as a side effect and be introduced to new drugs you may have to begin taking after the surgery.

SURGERY
During transurethral surgery, a surgeon will insert a scope through the urethra, which is the passageway that carries urine from the bladder out of your penis. A special cutting tool is placed through the scope, and it is used to remove a part of your prostate gland using electro-thermal energy. The surgery lasts approximately one hour, and you will be given either general anesthesia or spinal anesthesia.

POST-SURGERY
Overall, the surgery is relatively safe and a great way to cut back on prostate enlargement. You will need to wear a catheter for up to three days and will have to stay in bed until the morning after surgery. After that, you’ll be asked to move around as much as possible.

RISKS
Risks associated with the surgery include

  • Blood clots
  • Breathing problems
  • Infection
  • Blood loss
  • Heart attack or stroke during surgery
  • Reactions to medications
  • Incontinence
  • Infertility
  • Problems with erections
  • Scarring/damage to the bladder or ureter where it enters the bladder
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