Transurethral Resection of Prostate (TURP)

Transurethral Resection of Prostate (TURP)

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Transurethral resection of the prostate (TURP) is done for men with significantly obstructive benign prostate enlargement (BPH). It is done using a resectoscope (a loop instrument) that is passed through the urethra. The enlarged prostate gland is scraped away piece by piece, leaving a raw prostate cavity that heals over the next 3 weeks.

The operation takes up to 1 hour. General or spinal anaesthesia is usually given. Even after the anaesthesia wears off, the discomfort is very minimal. A catheter is inserted into the bladder after the surgery with continuous irrigation fluid to prevent blood clots from forming in the bladder. As this can potentially be a very bloody operation, any blood-thinning medication, such as Aspirin or Plavix must be stopped 1 week beforehand. Hospital stay is 3 to 4 days depending on the bleeding. For the laser method, the hospitalization period is shorter and most of the time, just an overnight stay.

Complications include:

  • bloody urine. This can last up to 3 weeks. Up to two-thirds of patients may also experience frequent urination, urgency and incontinence but usually subside by 3 months.
  • dry ejaculation. This is the backward passage of sperm during sexual intercourse. It is inevitable because the bladder neck is cut open during TURP and the semen preferentially goes into the bladder. The semen will be passed out during urination and is not harmful at all whilst it is in the bladder.
  • re-bleeding. This event occurs in 3% of patients and occurs between the 7th to 10th day after TURP. It is due to urine infection or re-opening of a blood vessel. If the bleeding is heavy, clot retention can occur. Re-hospitalisation is needed because a catheter needs to be re-inserted evacuate the blood clots. Rarely, one may be brought back to the operating theatre to seal the bleeding areas.