Trans Urethral Resection of the Prostate - TURP
What does the operation involve?
The operation is known as a TURP. This stands for Trans Urethral Resection of the Prostate. The procedure is carried out using a telescope, the prostate being removed from the inside. Rather like coring out an apple from the inside. After the operation you will have a tube in your bladder which comes out through the penis. This will have fluid washing through the bladder so that blood clots do not collect over the first few days.
You should continue your normal medications. However, if you are on Warfarin
or Aspirin you will need to stop taking it before your operation. Make
sure your surgeon is aware you are on Warfarin or Aspirin and follow advice
about stopping it.
What risks or complications may occur?
We make every effort to ensure your operation is safe. This may include prescribing medication to reduce the risk of complications. The vast majority of operations are successful with few complications.
every procedure has risks and potential complications. Those most
relevant to this operation are listed below. Please discuss them
with your doctor if there is anything you do not understand.
Specific complications of this operation:
Bleeding occurs during all prostate surgery. Normally it is mild but if severe may necessitate a blood transfusion or cause problems such as a stroke or heart attack. (Risk of bleeding 1 in 100).
Infection can occur, especially if you have had a catheter or rubber tube in your bladder before surgery. You will be given antibiotics to prevent or cure infection. (Risk 1 in 10)
Impotence may occur after prostate surgery. The over all risk of developing problems with erection may be as high as 1 in 5. Research has shown however that prostate surgery may just cause impotence to occur a year or two earlier than would have happened without surgery.
Incontinence initially after prostate surgery is quite common for a short while. Symptoms consist of passing a few drops of water before having time to reach the lavatory. It is rare however for this to be severe or last for a long time. The risk of disabling incontinence due to the operation is less than 1 in 1000.
Retrograde ejaculation. After prostate surgery sexual intercourse is unlikely to result in the production of sperm, this is because the fluid produced at ejaculation passes backwards into the bladder rather than coming from the end of the penis. This does not mean however that you can rely on this as a form of contraception. You will notice that after intercourse your urine will be cloudy due to sperm in the urine.
Stricture Any operation can result in scar tissue formation. If this occurs in a hollow tube such as the urethra (water pipe from the bladder) then the tube will narrow, slowing the flow as it does. This may need further surgery the stretch the pipe up again. Risk less than 1 in 200.
soon will I recover?
After the operation you will be transferred to the recovery room and then to the ward. After a day or two the bags of fluid which drip through the catheter will be taken down and once your urine is clear for a time your catheter will be removed. The first couple of times that you pass water it will sting. Do not let this put you off. Keep drinking as it will decrease the pain and decrease your chance of having problems with blood clots. Approximately 24 hours after this you will be allowed home.
2) Return to normal activities
As there is no external cut many patients forget that they have had an operation. You have had one and it is normal to be tired for at least two weeks. During this time light activity is acceptable (house and garden - no digging, golf etc.). For the next two weeks build up gradually. If you work depending on the level of exertion needed at work you can return at 4 to 6 weeks after surgery. If in doubt have a check up at your GP's.
not drive until you are confident about controlling your vehicle
in an emergency and always check with your insurance company first.
3) The longer term
vast majority of patients make an excellent recovery, with much improved
TURP is not however an instant cure and although progress is
most rapid in the first 6 weeks improvement can continue for many months.
The group of patients who have to wait longest for their recovery are
those who had severe urgency to pass water, particularly those who
prior to surgery would sometimes
be wet before reaching the lavatory. This occurs because the bladder
has been made overactive by the blockage. It usually resolves during
of the first few months but in some patients can take up to a year
and a half. Avoiding caffeinated drinks will help, in addition tablets
may be beneficial. Extremely unusually in-ability to control urination
may continue and further treatment or surgery may be needed.
Prostate trouble is very common. If tablets fail or you have severe symptoms then prostate surgery offers a good chance of giving a dramatic improvement in quality of life.
How is the procedure performed
Watch this video to see.
What's normal after a TURP
Discomfort passing water is very common for up to 2 weeks after surgery. It is usually a mild burning, anything more severe should be discussed with your doctor
It is normal to pass blood after the op for 2 weeks or so. After the op a scab forms on the internal surface of the gland, as this falls of you will see blood staining of the urine. Only if this is very excessive with clots do you need to seek medical advice
Mild incontinence is common after the op for up to 6 weeks. Many peoples bladders respond to the blockage by growing extra muscle, this make the bladder jumpy just after surgery. It settles with time