Transurethral Resection Of The Prostate (TURP)

Transurethral resection of the prostate (TURP) surgery is the removal of part of the prostate gland. It is one option available to relieve the symptoms of an enlarged prostate or other benign (non-cancerous) prostate disease. It is by far the most common of the surgical procedures used for benign prostate disease.

Prostate gland

The prostate is a small gland that is part of the male reproductive system. It helps with making semen. The urethra is the tube that goes from the bladder, through the prostate gland, to the outside of the body. It is used to pass urine and seminal fluid.

Prostate problems

The three main problems that occur in the prostate include: 

. inflammation (prostatitis)

. non-cancerous enlargement of the middle part of the prostate. This is called benign prostatic hyperplasia (BPH)

. cancer of the prostate. This occurs mostly at the back of the prostate, but sometimes also occurs in the area where the prostate is enlarged due to BPH.

Prostate size and blockage of the urethra

If the inner part of the prostate gland obstructs the urethra during urination, this will irritate the bladder and cause urinary symptoms.

Urinary symptoms may include:

. problems with starting urination, reduced urine flow, frequent urination, particularly at night, urgency and possible urgency incontinence (when you lose control of your bladder), passing drops of urine involuntarily after you think you've finished, blood in the urine – although this can never be assumed to be due to the prostate until other causes have been excluded.

The actual size of the prostate does not appear to determine whether or not there is a blockage. Some men with large prostates never develop obstruction, but some men with small prostates can have severe bladder obstruction, which causes difficulty with urinating.

Around one in three Victorian men over the age of 50 years have some urinary symptoms. In most cases, these symptoms are due to a blockage caused by an enlarged prostate, but they may be due to other causes.

TURP procedure

Transurethral resection of the prostate (TURP) is sometimes referred to as a 'rebore'. It involves inserting a slender instrument through the urethra to the prostate and removing prostate tissue back through the urethra. Only the middle part of the prostate is removed to release the blockage and allow you to pass urine more easily.
TURP is used most often for non-cancerous blockage, but may also be used in some cases of prostate cancer. This is the most common form of surgery (around 95 per cent of surgical procedures) for BPH. The average hospital stay is three to four days.

Side effects of TURP

While surgery can improve symptoms dramatically, TURP can have significant unwanted side effects. It is recommended that you discuss the pros and cons of both medical management and surgery with your doctor before you make a decision.

Common side effects of TURP

Common side effects after surgery include:

. bleeding after the operation – this usually reduces over time and should stop after four weeks

. retrograde ejaculation – most men are able to have erections and orgasms after surgery to treat an enlarged prostate. However, they may not ejaculate because the bladder neck is removed along with prostate tissue. This causes the ejaculate to collect with urine and pass out of the body in the next urination.

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