Transurethral Resection of the Prostate (TURP) Procedure

Overview

Transurethral resection of the prostate (TURP) is a widely-used surgical solution for urinary issues linked to an enlarged prostate gland. The surgeon uses a special instrument, called a resectoscope, and inserts it through the urethra—the urine-carrying tube that runs from the bladder out through the tip of the penis.

Key Points About TURP:

• No surgical cuts are necessary.
• The surgeon removes extra prostate tissue that blocks urine flow.
• Most people choose this procedure when medicine does not help their symptoms.

Here is a simple table summarizing the main steps and features of TURP:

Step	Description
Instrument Used	Resectoscope
Entry Point	Through the urethra via the penis
Main Goal	Remove excess prostate tissue for better flow

Other treatments exist, some of which offer similar results to TURP. Alternatives often lead to fewer side effects and can allow for faster recovery.

Reasons for Choosing This Procedure

Doctors often recommend TURP for people with an enlarged prostate, also called benign prostatic hyperplasia (BPH). This treatment helps manage common urinary issues such as:

• Needing to urinate often or urgently
• Difficulty starting to urinate
• Weak or slow urine stream
• Frequent urination at night
• Stopping and starting during urination
• Not fully emptying the bladder
• Urinary tract infections

Other medical reasons include:

• Preventing or treating repeated infections.
• Reducing kidney or bladder problems.
• Solving issues with urine control.
• Eliminating bladder stones.
• Fixing blood in the urine.

Risks

TURP involves certain risks, both right after the surgery and later on. Some people may have difficulty urinating for a few days. During this time, doctors often place a catheter to help drain urine from the bladder until normal function returns.

Bleeding can happen during or after the procedure. In rare situations, blood loss may be heavy enough that a person needs a blood transfusion, especially if the prostate is larger. Infection, such as a urinary tract infection, can occur. The chance of infection increases the longer someone has a catheter in place.

Some people might have repeat infections after the operation. Retrograde ejaculation (dry orgasm) is common after TURP. In this situation, semen flows backward into the bladder instead of leaving through the penis during orgasm. While this does not affect sexual pleasure or safety, it can reduce fertility.

Occasionally, erectile dysfunction may occur after surgery. This means trouble getting or maintaining an erection, but the overall risk is low. Urinary incontinence, or trouble controlling urine, is rare but possible. Some people might have trouble holding their urine for the long term after the procedure.

TURP syndrome is a rare but serious condition. It happens when the body absorbs too much of the fluid used during the surgery, causing low sodium levels in the blood (hyponatremia). Symptoms can be serious and require fast treatment. Newer surgical techniques, such as bipolar TURP, help reduce this risk.

Urethral strictures and bladder neck contractures, where the channel for urine becomes narrow, may develop later. This can lead to symptoms coming back. Some people need repeat treatments to address these issues. Below is a summary of possible risks after TURP:

Complication	How Common	Comments
Trouble urinating	Short-term	Needs catheter temporarily
Bleeding	Rare-moderate	May require transfusion in rare cases
Urinary tract infection	Common	Higher risk with longer catheter use
Retrograde ejaculation	Common	Affects fertility, not sexual pleasure
Erectile dysfunction	Rare	Can occur but the risk is low
Urinary incontinence	Rare	Some experience lasting loss of control
TURP syndrome	Very rare	Risk lowered with newer techniques
Urethral strictures	Uncommon	May need more treatment

Each person’s outcome can be different, and not everyone will experience these issues.

Getting Ready for Surgery

Doctors may ask patients to stop taking certain medicines, especially those that thin the blood. Over-the-counter painkillers such as aspirin, ibuprofen, or naproxen sodium may also need to be stopped.

This lowers the chances of bleeding during the procedure. Doctors may give an antibiotic before surgery to help prevent infections in the urinary tract. It is important to follow these instructions closely.

Key Steps to Prepare

• Stop taking specific medicines if advised by your doctor.
• Use antibiotics as prescribed.
• Arrange for a ride to and from the hospital.
• Plan for time off work and limit heavy activities after surgery.

Most patients need to rest and avoid heavy lifting or tough tasks for a few weeks while healing.

What You Can Expect

What Happens While Having Surgery

The whole procedure usually takes between 60 and 90 minutes. Before starting, the care team gives anesthesia. This may make the patient sleep or just numb the lower body so they are awake but do not feel pain.

The surgeon carefully inserts a resectoscope, a thin tube with a light and camera, into the penis and moves it up the urethra to reach the prostate gland. The surgeon does not make any cuts on the outside of the body. Using the resectoscope, the surgeon trims away extra tissue from inside the prostate, removing tissue little by little.

As the surgeon removes tissue, fluid carries the small tissue pieces to the bladder. The surgeon later flushes these pieces out. The resectoscope serves as both a cutting tool and a way to see inside the body, so no outside scars form.

What Happens After the Operation

Most people stay in the hospital for 1 to 2 days so the team can monitor their recovery. Swelling in the prostate area after surgery can make it hard to urinate. To help with this, the care team places a soft tube called a catheter into the bladder. The catheter usually stays in for about 24 to 48 hours, until swelling goes down and normal urination begins again. Common effects right after surgery include:

• Blood in the urine: This is common at first. If it looks thick like ketchup, or if bleeding gets worse, seek medical help.
• Some pain during urination.
• Frequent or urgent need to urinate.

Pain while peeing often takes several weeks to get better. Doctors usually advise patients to drink lots of water to help flush out the bladder and clear up blood in the urine. They may also recommend high-fiber foods or a stool softener to prevent constipation, since straining can slow recovery. A table below shows common aftercare advice:

Advice	Details
Drink water.	Helps clear the bladder and avoid infections.
Eat fiber-rich foods.	Reduces risk of constipation.
Avoid blood thinners.	Wait until the doctor says it is safe.
Rest from heavy activity.	No lifting or hard work for 4–6 weeks.
No sex or biking.	Wait 4–6 weeks to avoid strain to the prostate area.
No driving.	Wait until off pain meds and catheter is removed.

When to Contact a Doctor

• Unable to urinate
• Bright red blood, thick clots, or blocked urine flow
• Urine stays dark after drinking water and resting for a day
• Signs of infection like fever, chills, or feeling dizzy

Outcomes

TURP usually improves symptoms, and these benefits can last for over 15 years. However, some patients might require more procedures or treatments in the future to manage ongoing or returning symptoms.

Feature	Detail
Purpose	Treat blocked urine flow
Method	Surgical instrument via urethra
Recovery Time	1-2 days (in most cases)
Main Benefit	Eases urination