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Transurethral resection of the prostate (TURP)

TURP is an operation to improve a man’s urination by surgically removing the inner overgrown part of the prostate.  With age the inner part of the prostate grows and becomes larger and can block the flow of urine.  This is called benign prostatic hypertrophy (BPH).  This condition is usually treated with medications first to help make urination easier but in many men this no longer helps and a surgical option is necessary.

TURP is the gold standard operation for improving urine flow due to prostate obstruction.  The procedure is carried out with a urological telescope (cystoscope).  It is passed through the penis under anaesthetic with high definition optics, light source and an electrical current resecting loop.  The overgrown tissue can be resected from the inside of the prostate and a large channel made to allow good urination after the surgery.

The operation lasts about 1 hour and involves a 2-day stay in hospital.  Recovery after the operation is usually good but patients need to be aware that bladder control and having to rush to the toilet can be a common finding as the bladder and prostate heal.

As with any surgery there are risks involved.  In the modern era these risks are uncommon.  They include bleeding, infection, pain, and the risks of an anaesthetic.  It is quite rare that a patient needs a blood transfusion after the surgery (under 5%).  The risk of leaking or incontinence after this operation is very low (<1%) and it does not affect erectile function.  In the long term there is a 5% risk of developing a narrowing or stricture of the water pipe (urethra) and after 10 years about 5% of men might need a second operation due to regrowth of the prostate tissue.

The small chips of prostate tissue, which are removed, are evacuated from the bladder and sent to the pathology laboratory for analysis.  This is to ensure all the tissue is simply normal tissue and there is no cancer present.  In fewer than 5% of men sometimes a small volume of cancer can be found incidentally and your surgeon will discuss this with you.  This is uncommon.  After the operation the patient is returned to the ward where he can eat and drink and a catheter is left in the bladder for 2 days to wash sterile fluid through the prostate and bladder to prevent bleeding and blood clots.  This catheter is removed on the second morning after surgery and the ward nursing staff then make sure that the patient can urinate properly and empty his bladder fully without any problems.  Usually the patient is able to go home on the second day after surgery.  Patients are then seen again 6 weeks later by Dr Pokorny for review and to make sure everything is progressing well.