Transurethral Resection of the Prostate (TURP) for Benign Prostatic Hyperplasia
Surgery Overview
During transurethral resection of the
prostate (TURP), an instrument is inserted up the
urethra
to remove the section of the prostate that is
blocking urine flow.
TURP usually requires a stay in the hospital. And is
done using a
general
or
spinal anesthetic
.
What To Expect After Surgery
The hospital stay after TURP is
commonly 1 to 2 days.
Following surgery, a
catheter
is used to remove urine and blood or blood clots in the
bladder
that may result from the procedure. When the
urine is free of significant bleeding or blood clots, the catheter can be
removed and you can go home.
Strenuous activity, constipation, and
sexual activity should be avoided for about 4 to 6 weeks. Symptoms such as frequent
urination will continue for a while because of irritation and inflammation
caused by the surgery. But they should ease during the first 6 weeks.
How Well It Works
For men who have moderate to severe
symptoms of prostate enlargement, TURP is more effective than watchful waiting
in relieving urinary symptoms. Studies have found that:
- Men who had TURP had a lower symptom score
compared with those who used watchful waiting.
1
- Symptoms get better for 7 to 10 out of 10 men
who have the surgery.
2
Men experience about an 85% improvement in their
American Urological Association (AUA) symptom index
scores.
2
For example, if you had a score of 25, after
this surgery it might be at about 4. Men who are very bothered by their
symptoms are most likely to notice great improvement in their symptoms after
TURP. Men who are not very bothered by their symptoms are less likely to notice
a big change.
Risks
The risks of transurethral resection of the
prostate (TURP) include problems with sexual performance, incontinence, and
problems from surgery.
Problems with sexual performance
- Ejaculation into the bladder (retrograde
ejaculation) is very common. It occurs in about 25 to 99 men out of
100.
2
This does not affect sexual
function.
- Men who have TURP appear to have no greater risk for
erection problems
than men who do not have surgery.
3
For men who do have trouble getting an erection, medicine can help.
Loss of ability to control urine flow (incontinence)
- A small number of men (about 1 out of 100) say they are
completely unable to hold back their urine after the surgery.
2
But some experts say that men who have TURP appear to have no greater risk for incontinence than men who do not have surgery.
3
- Some men find that they can still hold in their
urine after the surgery, but they tend to leak or dribble.
Problems related to having surgery
- About 5 out of 100 men have severe bleeding and need a blood transfusion.
4
- Transurethral resection (TUR) syndrome occurs in about 2 out of 100 men who have TURP.
2
This syndrome occurs when the body absorbs too much of the
fluid used to wash the area around the prostate while prostate tissue is being
removed. The symptoms of TUR syndrome include mental confusion, nausea,
vomiting, high blood pressure, slowed heartbeat, and visual disturbances. TUR
syndrome is temporary (usually lasting only the first 6 hours after surgery)
and is treated with medicine that removes excess water from the body
(diuretic).
- About 2 men out of 100 need to have another
operation after 3 years. And about 8 men out of 100 need to have another operation after 5 years.
2
- Repeat surgery
because of a complication of the surgery is needed less than 10% of the
time.
2
What To Think About
TUR syndrome doesn't happen when TURP is done using a bipolar tool (resectoscope) compared to a monopolar resectoscope. You may want to ask your doctor which kind of tool he or she uses.
Surgery usually is not required to
treat BPH, although some men may choose it because their symptoms bother them
so much. Choosing surgery depends mostly on your preferences and comfort with
the idea of having surgery. Things to think about include your expectation of the
results of the surgery, the severity of your symptoms, and the possibility of
having complications from the surgery.
Men who have severe
symptoms often have great improvement in quality of life following surgery. Men
whose symptoms are mild may find that surgery does not greatly improve quality
of life. Men with only mild symptoms may want to think carefully before
deciding to have surgery to treat BPH.
Complete the
surgery information form (PDF)
(What is a
PDF
document?)
to help you prepare for this surgery.
References
Citations
-
McNicholas T, Kirby R (2011). Benign prostatic hyperplasia, search date July 2009. Online version of BMJ Clinical Evidence
: http://www.clinicalevidence.com.
-
Fitzpatrick JM (2012). Minimally invasive and endoscopic management of benign prostatic hyperplasia. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2655–2694. Philadelphia: Saunders.
-
AUA Practice Guidelines Committee (2010). AUA guideline on management of benign prostatic hyperplasia. Chapter 1: Guideline on the management of benign prostatic hyperplasia (BPH). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
-
Wilt TJ, N'Dow J (2008). Benign prostatic hyperplasia. Part 2—Management. BMJ, 336(7637): 206–210.
Credits
|
By
| Healthwise Staff |
|
Primary Medical Reviewer
| E. Gregory Thompson, MD - Internal Medicine |
|
Specialist Medical Reviewer
| J. Curtis Nickel, MD, FRCSC - Urology |
|
Last Revised
| March 5, 2012 |
Last Revised:
March 5, 2012
McNicholas T, Kirby R (2011). Benign prostatic hyperplasia, search date July 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Fitzpatrick JM (2012). Minimally invasive and endoscopic management of benign prostatic hyperplasia. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2655–2694. Philadelphia: Saunders.
AUA Practice Guidelines Committee (2010). AUA guideline on management of benign prostatic hyperplasia. Chapter 1: Guideline on the management of benign prostatic hyperplasia (BPH). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
Wilt TJ, N'Dow J (2008). Benign prostatic hyperplasia. Part 2—Management. BMJ, 336(7637): 206–210.
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