What is Transurethral Resection of the Prostate (TURP)

Transurethral resection of the prostate is the removal (resection) of part of the gland that produces semen (prostate gland). This procedure is done to treat benign prostatic hyperplasia (BPH). BPH is an abnormal, noncancerous (benign) increase in the number of cells that make up the prostate tissue. BPH causes the prostate to get bigger.

The enlarged prostate can push against or block the tube that drains urine from the bladder out of the body (urethra). BPH can affect normal urine flow by causing bladder infections, difficulty controlling bladder function, and difficulty emptying the bladder. The goal of TURP is to remove enough prostate tissue to allow for a normal flow of urine.

In a transurethral resection, a thin telescope with a light, a tiny camera, and an electric cutting edge (resectoscope) is passed through the urethra and into the prostate. The opening of the urethra is at the end of the penis.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Any prostate infections you have had.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs, such as:
  • The urethra.
  • The bladder.
  • Muscles that surround the prostate.
• Difficulty getting an erection.
• Difficulty controlling urination (incontinence).
• Scarring, which may cause problems with urine flow.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may have a physical exam.
• You may have a blood or urine sample taken.
• You may be given antibiotic medicine to help prevent infection.
• Ask your health care provider how your surgical site will be marked or identified.
• Plan to have someone take you home after the procedure. You may not be able to drive for up to 10 days after your procedure.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• Your legs will be placed in foot rests (stirrups) so that your legs are apart and your knees are bent.
• The resectoscope will be passed through your urethra to your prostate.
• Parts of your prostate will be resected using the cutting edge of the resectoscope.
• The resectoscope will be removed.
• A thin, flexible tube (catheter) will be passed through your urethra and into your bladder. The catheter will drain urine into a bag outside of your body.
  • Fluid may be passed through the catheter to keep the catheter open.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You may continue to receive fluids and medicines through an IV tube.
• You may have some pain. Pain medicine will be available to help you.
• You will have a catheter draining your urine.
  • You may have blood in your urine. Your catheter may be kept in until your urine is clear.
  • Your urinary drainage will be monitored. If necessary, your bladder may be rinsed out (irrigated) through your catheter.
• You will be encouraged to walk around as soon as possible.
• You may have to wear compression stockings. These stockings help prevent blood clots and reduce swelling in your legs.
• Do not drive for 24 hours if you received a sedative.

Transurethral Resection of the Prostate, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild pain in your lower abdomen.
• Soreness or mild discomfort in your penis from having the catheter inserted during the procedure.
• A feeling of urgency when you need to urinate.
• A small amount of blood in your urine. You may notice some small blood clots in your urine. These are normal.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you received a sedative.
• If you were prescribed antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg) for 3 weeks after your procedure, or as long as told by your health care provider.
• Avoid intense physical activity for as long as told by your health care provider.
• Avoid sitting for a long time without moving. Get up and move around one or more times every few hours. This helps to prevent blood clots. You may increase your physical activity gradually as you start to feel better.

Lifestyle

• Do not drink alcohol for as long as told by your health care provider. This is especially important if you are taking prescription pain medicines.
• Do not engage in sexual activity until your health care provider says that you can do this.

General instructions

• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Drink enough fluid to keep your urine clear or pale yellow.
• Urinate as soon as you feel the need to. Do not try to hold your urine for long periods of time.
• If your health care provider approves, you may take a stool softener for 2–3 weeks to prevent you from straining to have a bowel movement.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have difficulty urinating.
• You have a fever.
• You have pain that gets worse or does not improve with medicine.
• You have blood in your urine that does not go away after 1 week of resting and drinking more fluids.
• You have swelling in your penis or testicles.

Get help right away if:

• You are unable to urinate.
• You are having more blood clots in your urine instead of fewer.
• You have:
  • Large blood clots.
  • A lot of blood in your urine.
  • Pain in your back or lower abdomen.
  • Pain or swelling in your legs.
  • Chills and you are shaking.