Transurethral resection of the prostate (TURP)

Transurethral resection of the prostate (TURP) is a common surgery that's used to treat urinary problems that are caused by an enlarged prostate. An instrument called a resectoscope is placed through the tip of the penis. It is then passed through the tube that carries urine from your bladder, called the urethra. The resectoscope helps a surgeon see and trim away extra prostate tissue that's blocking urine flow.

TURP helps ease urinary symptoms caused by benign prostatic hyperplasia (BPH), including: Frequent, urgent need to urinate. Trouble starting urination. Slow or prolonged urination. More trips to the bathroom at night. Stopping and starting again while urinating. The feeling that you can't fully empty your bladder. Urinary tract infections. TURP also might be done to treat or prevent complications due to blocked urine flow, such as: Repeated urinary tract infections. Kidney or bladder damage. Not being able to control urination or to urinate at all. Bladder stones. Blood in urine.

Risks of TURP can include: Short-term trouble urinating. This might last for a few days after the procedure. Until you can urinate on your own, you will need to have a thin, flexible tube called a catheter placed into your penis. It carries urine out of your bladder. Urinary tract infection. This type of infection can happen after any prostate procedure. It becomes more and more likely the longer you have a catheter in place. Some men who have TURP have repeated urinary tract infections. Dry orgasm. This is the release of semen during orgasm into the bladder rather than out of the penis. It's a common and long-term effect of any type of prostate surgery. Dry orgasm isn't harmful, and it doesn't tend to affect sexual pleasure. But it can make you less likely to get a female partner pregnant. Another name for it is retrograde ejaculation. Erectile dysfunction. This is trouble getting or keeping an erection. The risk is very small, but erectile dysfunction can happen after prostate treatments. Heavy bleeding. Very rarely, men lose enough blood during TURP that they need to receive donated blood through a vein. This is called a blood transfusion. Men with larger prostates seem to be at higher risk of heavy blood loss. Trouble holding urine. Rarely, loss of bladder control is a long-term side effect of TURP . It's also called incontinence. Low sodium in the blood, called hyponatremia. Rarely, the body absorbs too much of the fluid used to wash the surgery area during TURP . This can lead to having too much fluid and not enough sodium in the blood. When this happens, it's known as TURP syndrome or transurethral resection (TUR) syndrome. Without treatment, TURP syndrome can be life-threatening. A technique called bipolar TURP gets rid of the risk of this condition. Need for re-treatment. Some men need follow-up treatment after TURP . Their symptoms come back or don't get better over time. Sometimes, more treatment is needed because TURP causes the urethra or the bladder neck to narrow, also called a stricture.

Several days before surgery, your healthcare professional might recommend that you stop taking medicines that raise your risk of bleeding, including: Blood thinners such as warfarin (Jantoven) or clopidogrel (Plavix). Pain relievers sold over the counter, such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). You might be prescribed medicine called an antibiotic to prevent a urinary tract infection. Arrange to have a family member or friend drive you to and from the hospital. You won't be able to drive yourself home after the procedure that day or in general if you have a catheter in your bladder. You might not be able to work or do strenuous activities for up to six weeks after surgery. Ask a member of your surgery team how much recovery time you might need.

The TURP procedure takes about 60 to 90 minutes to do. Before surgery you'll be given medicine that keeps you from feeling pain, called anesthesia. You might receive general anesthesia, which also puts you in a sleep-like state. Or you might get spinal anesthesia, which means you'll stay conscious. You also might be given a dose of antibiotics to prevent infection.