What is Transurethral Resection of the Prostate (TURP)?
Transurethral resection of the prostate (TURP) is a prevalent surgical procedure specifically designed to treat urinary complications arising from an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). As men age, the prostate gland may increase in size, leading to various urinary issues that can significantly impact daily life and overall well-being. TURP is often considered when non-surgical interventions, such as medication or lifestyle changes, have proven ineffective in managing symptoms.
This minimally invasive surgery offers a targeted approach, allowing surgeons to remove obstructive prostate tissue without making any external incisions. By addressing the root cause of urinary difficulties, TURP aims to restore normal urine flow, alleviate discomfort, and enhance the quality of life for patients.
Why TURP is Performed
The primary indication for TURP is benign prostatic hyperplasia (BPH), a condition where the prostate gland enlarges and obstructs urine flow. Symptoms that may lead to this procedure include:
- Frequent and Urgent Urination: A compelling need to urinate often, particularly at night.
- Difficulty Initiating Urination: Struggling to start the flow of urine.
- Prolonged Urination: A slow urinary stream that can lead to frustration.
- Inability to Fully Empty the Bladder: A sensation of incomplete voiding.
- Recurring Urinary Tract Infections: Resulting from obstruction of urine flow.
- Potential Complications: Such as kidney or bladder damage and the formation of bladder stones.
Preparing for the Procedure
Preparation for TURP typically involves several steps:
- Medical Assessment: A thorough evaluation by the healthcare provider to assess medical history and current health status.
- Medication Review: Patients may be advised to discontinue certain medications that increase bleeding risk, such as blood thinners or certain pain relievers.
- Transportation Arrangements: Due to the effects of anesthesia, patients should arrange for someone to drive them to and from the hospital.
- Recovery Planning: Patients should prepare for a recovery period, which may require time off work and assistance at home.
The TURP Procedure
The TURP surgery usually takes between 60 to 90 minutes and is performed using a resectoscope, which is a specialized instrument inserted through the urethra.
Steps of the Procedure
- Anesthesia Administration: Patients receive anesthesia, which may be general (inducing sleep) or spinal (numbing the lower body while remaining conscious).
- Insertion of the Resectoscope: The resectoscope is carefully introduced through the urethra to the prostate gland.
- Resection of Prostate Tissue: The surgeon uses the resectoscope to trim away excess prostate tissue obstructing urine flow. This is done methodically, with small pieces being removed and flushed into the bladder.
- Fluid Management: During the procedure, a special fluid is used to irrigate the area and help with tissue removal.
Postoperative Care
Following TURP, patients typically stay in the hospital for 1 to 2 days. They will have a urinary catheter in place to assist with drainage while swelling from the procedure subsides.
Expected Recovery Experience
- Initial Symptoms: Blood in the urine is common immediately after surgery, but significant changes or worsening symptoms should be reported to the healthcare team.
- Urination Challenges: Patients may experience discomfort or urgency in urination, which can take time to resolve.
- Hydration and Diet: Increased fluid intake and a diet high in fiber are encouraged to prevent complications like constipation.
Activity Restrictions
During recovery, patients are advised to avoid strenuous activities and refrain from sexual intercourse for several weeks. Driving is also discouraged until the catheter is removed and normal function is restored.
Risks and Complications
As with any surgical procedure, TURP carries certain risks, including:
- Urinary Issues: Temporary difficulties in urinating or, less commonly, long-term incontinence.
- Infections: Increased risk of urinary tract infections post-surgery.
- Ejaculation Changes: A common long-term effect is dry orgasm, where semen enters the bladder instead of exiting the body.
- Erectile Dysfunction: While rare, some men may experience difficulties with erections following the procedure.
- Heavy Bleeding: In some cases, patients may require blood transfusions due to significant blood loss.
Outcomes and Long-Term Expectations
TURP is often successful in relieving urinary symptoms and can provide lasting results for many patients, with benefits lasting 15 years or more. However, some individuals may require additional treatments over time, particularly if symptoms recur.