Transurethral resection of the prostate (TURP) 

Introduction 

Illustration of TURP

Illustration of enlarged prostate blocking urethra

 

  1. Bladder containing urine
  2. Pubic bone
  3. Enlarged prostate, blocking flow of urine through the urethra
  4. Opening of urethra

 

Prostate enlargement

The prostate is a small gland in the pelvis only found in men. It is located between the penis and bladder, and surrounds the urethra (the tube that carries urine from the bladder to the penis).

If the prostate becomes enlarged, it can place pressure on the bladder and urethra. This can cause symptoms that affect urination (passing urine when going to the toilet).

Read more about the symptoms of prostate enlargement.

Having an operation

If your GP has suggested you may need surgery, this guide is for you

A transurethral resection of the prostate (TURP) is a surgical procedure that involves cutting away a section of the prostate gland.

It is often used to treat prostate enlargement (benign prostate hyperplasia).

A TURP may be necessary if:

  • the first treatments for prostate enlargement, such as medication, fail to control symptoms - this occurs in around one in 10 men
  • an enlarged prostate leads to complications - such as bladder stones or a bladder infection, because the man is unable to empty his bladder properly

Read more information about why a TURP may be necessary.

How it is performed

A TURP is performed under general or spinal anaesthesia, so you will not feel any pain during the procedure.

The surgeon will insert a thin metal wire with a loop at the end into your urethra and up against your prostate. An electrical current is then used to heat the loop, which cuts away a section of your prostate.

Read more about how a TURP is performed.

Recovery

Most men can leave hospital two to three days after surgery and resume most normal activities within one week.

However, it can take up to six weeks before you are fit enough to return to work if your job is physically strenuous.

Read more about recovering from a TURP.

Advantages

Most men who have a TURP find it improves both their symptoms and quality of life.

You should notice the symptoms that bothered you before are no longer there, or are present to a much lesser extent. For example:

  • you should no longer need to strain to urinate
  • you should be able to go about your normal activities without having to worry about being near a toilet
  • you should be more in control of holding your urine in
  • you may not need to get up in the night to urinate as much as you used to
  • you should also notice you have a stronger stream of urine
  • you may no longer need to wear incontinence pads if you do so already

Disadvantages

In most cases, a TURP is a safe procedure and the risk of serious complications occurring during surgery is very small.

However, many men who have had a TURP lose the ability to ejaculate semen during sex or masturbation, although they still have the physical pleasure associated with ejaculation (the climax). This is known as retrograde ejaculation, and can occur in as many as 9 out of 10 cases.

Also, many men temporarily lose the ability to control their bladder (they develop urinary incontinence), although this usually passes a few weeks after surgery. In rare cases, urinary incontinence may be persistent and need further treatment. As with all surgery there is a risk of infection and bleeding afterwards, which may need additional treatment.

Read more detailed information about the disadvantages of TURP.

Alternatives

There are a number of alternatives to a TURP. Some are not suitable for all men with prostate enlargement and may not be as effective in the long term.

They include the following.

  • Holmium laser enucleation of the prostate (HOLEP) - a laser is used to separate excess tissue from the prostate into the bladder and the tissue is then removed. HOLEP causes less blood loss, involves a shorter stay in hospital and is suitable for moderate to large prostates. Access to this type of treatment is currently limited in England.
  • Potassium-titanyl-phosphate (KTP) laser vaporisation of the prostate - this involves placing a small fibre optic cable into the urethra (the opening through which you pass urine) and up towards the prostate. Lasers can then be directed out of the fibre optic cable and used to burn away excess prostate tissue.

Both HOLEP and KTP laser vaporisation of the prostate may be more suitable for very large prostates, older men who are not fit, or for those using blood thinning medication such as warfarin.

Read more about the alternatives to TURP.




Page last reviewed: 09/08/2013

Next review due: 09/08/2015

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Comments

The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

wiltspatient said on 03 August 2013

I put off this procedure for almost 10 years and wonder why! The results from day 5 after the removal of the catheter were marvellous. I can now drive again after 2 weeks and am looking forward to resuming an active sex life in a fortnight or so. My advice is to go and get it done - why wait?!

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andyaction said on 28 March 2012

40000 TURPS a year..... I'll bet many of these could be treated more simply with the Gat Goren procedure which is minimally invasive, taking around 2 hours to complete and allows the patient to walk out of the treatment room within minutes. NO side effects and unlike TURPS which does not treat the cause, the Gat Goren procedure actual targets the cause. As the process has not undergone clinical trials the NHS appear to turn a blind eye to it with what appears to be no interest in investigating what appears to be a high success rate (85%) with also a high rate of success on a small number of men who had PCa. If you want this procedure you therefore have to go to Israel where two pioneering world renowned doctors undertake the procedure.. With no long term effects, even if it failed, the patient could resort to TURPS as a last resort... sad to see the complacency yet again in the NHS. Finally the treatment is based on using a sclerosing agent to close internal spermatic veins and their retroperitoneal collaterals. This stops the flow of free testosterone now known to cause build up in the prostate and "food' for PCa. The treatment is somewhat similar, only more technical to using a sclerosing agent to close varicose veins in the leg - a tried and tested procedure. The doctors have to image the process to identify and close the network of collateral and connecting veins contributing to the varicocele. By allowing normal levels of free testosterone to return, it is shown that the prostate size reduces and BPH associated problems reduce or go away. The Gat Goren site is not a good one and these chaps are having to major on fertility and some commercialisation. (no different really to Consultants doing private work). check them out. These Doctors are happy to speak to Anyone - and they do have scientific papers to back their claims and results. NHS are you listening?

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