TURP Prostate

TURP Prostate (Transurethral Resection of the Prostate)

During transurethral resection of the prostate (TURP), an instrument is inserted up the urethra to remove the section of the prostate that is blocking urine flow.

TURP usually requires hospitalization and is done using a general or spinal anesthetic.

What to Expect After Surgery

The hospital stay after TURP is commonly 1 to 2 days.

Following surgery, a catheter is used to remove blood or blood clots in the bladder that may result from the procedure. When the urine is free of significant bleeding or blood clots, the catheter can be removed and the man can go home.

Strenuous activity, constipation, and sexual activity should be avoided for about 6 weeks. Symptoms such as frequent urination will continue for a while due to irritation and inflammation caused by the surgery, but they should ease during the first 6 weeks.

Why it is Done

Your doctor may recommend TURP if symptoms caused by benign prostatic hyperplasia (BPH) have not improved in response to home treatment and medications.

TURP is now the most common surgery used to remove part of an enlarged prostate. Open prostatectomies (in which an incision is made into the abdomen) generally are needed only when the prostate is very large.

How Well does it Work

On the average, men experience an 85% improvement in their American Urological Association (AUA) symptom index score.1 For example, if you had a score of 25, after this surgery it might be reduced to about 4. Men who are very bothered by their symptoms are most likely to notice great improvement in their symptoms after TURP; men who are not very bothered by their symptoms are less likely to notice a significant change.

In men who have moderate to severe symptoms of prostate enlargement, TURP is more effective than watchful waiting in relieving urinary symptoms. Studies have found that:

• 90% of men undergoing TURP had reduced symptoms compared to 39% of those who used watchful waiting.
  
  
• After 5 years, 10% of those who had undergone TURP had a "treatment failure," mainly inability to urinate, urine left in the bladder, and an increase in the severity of symptoms. This compares to 21% of men using watchful waiting during the same period who had an increase in symptom severity or complications.
  
  
• TURP improved the AUA symptom score by about 10 points over 8 months.
  TURP and transurethral incision of the prostate (TUIP) had equal effectiveness.

Compared to visual laser ablation, TURP was more effective at relieving symptoms but required a longer hospital stay. Another laser treatment method, contact laser vaporization, is as effective at reducing symptoms as TURP.

What to think About

Surgery usually is not required to treat BPH, although some men may choose it because their symptoms bother them so much. Choosing surgery depends largely on your preferences and comfort with the idea of having surgery. Things to consider include your expectation of the results of the surgery, the severity of your symptoms, and the possibility of developing complications from the surgery.

Men who have severe symptoms often have great improvement in their quality of life following surgery. Men whose symptoms are mild may find that surgery does not greatly improve their quality of life. Men with only mild symptoms may want to think carefully before deciding to have surgery to treat their BPH.

For men who have clear indications for surgery, TURP may be less effective than open prostatectomy in relieving the symptoms of BPH. (See the Surgery section of the topic Benign Prostatic Hyperplasia [BPH].)

About 10% of men who have TURP or open prostatectomy are found to have previously undetected early-stage prostate cancer. Cancer discovered this way generally is slow-growing, often requires no additional treatment, and will not be the eventual cause of death in most men. For more information on prostate cancer, see the topic Prostate Cancer.

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