Transurethral Resection of the Prostate (TURP)

Transurethral resection of the prostate (TURP) is a surgical procedure used to treat urinary problems caused by an enlarged prostate. The prostate gland is a small, walnut-sized gland in men that surrounds the urethra, which carries urine from the bladder out of the body.

Indications for TURP

• Benign prostatic hyperplasia (BPH), also known as enlarged prostate
• Urinary retention, or inability to empty the bladder completely
• Weak urine flow or straining to urinate
• Frequent urination, especially at night
• Painful urination
• Blood in the urine

How TURP is Performed

TURP is typically performed under general anesthesia or spinal anesthesia. The procedure involves the following steps:

1. A cystoscope, a thin, flexible tube with a camera and light on the end, is inserted through the urethra into the bladder.
2. The surgeon uses the cystoscope to visualize the prostate gland and identify the areas that need to be removed.
3. A special instrument called a resectoscope is then inserted through the cystoscope. The resectoscope has a loop of wire on the end that is used to cut away excess prostate tissue.
4. The surgeon uses the resectoscope to remove small pieces of prostate tissue, which are then flushed out of the bladder with a saline solution.
5. The procedure typically takes 1-2 hours to complete.

Risks and Complications of TURP

As with any surgical procedure, there are risks and complications associated with TURP. These include:

• Bleeding or hemorrhage
• Infection
• Urinary incontinence or leakage
• Erectile dysfunction
• Retrograde ejaculation, where semen flows backward into the bladder instead of out of the body
• TURP syndrome, a rare but potentially life-threatening condition caused by absorption of the saline solution used during the procedure

Recovery After TURP

After TURP, patients typically spend 1-3 days in the hospital. The following are some general guidelines for recovery:

• A catheter will be inserted into the bladder to drain urine and allow the prostate to heal.
• Patients may experience discomfort, pain, or burning during urination, which can be managed with medication.
• Patients should avoid heavy lifting, bending, or strenuous activities for several weeks after surgery.
• It may take several weeks for urinary symptoms to improve and for the prostate to heal completely.

Alternatives to TURP

There are several alternative treatments for BPH and urinary problems, including:

• Medications, such as alpha-blockers or 5-alpha-reductase inhibitors
• Minimally invasive procedures, such as laser therapy or microwave therapy
• Open prostatectomy, a surgical procedure that involves removing the prostate gland through an incision in the abdomen

Long-term Results of TURP

TURP is generally a effective treatment for BPH and urinary problems. Studies have shown that:

• 90% of patients experience significant improvement in urinary symptoms
• 70-80% of patients experience complete resolution of urinary retention
• 50-60% of patients experience improvement in sexual function

However, TURP may not completely eliminate the risk of future urinary problems or prostate cancer. Regular follow-up appointments with a healthcare provider are necessary to monitor prostate health and address any concerns or complications that may arise.