Transurethral resection of the prostate (TURP) is surgery to remove all or part of the prostate gland, to treat an enlarged prostate.

See also:

• Benign prostatic hypertrophy
• Prostate resection - minimally invasive
• Simple prostatectomy

You will be given general anesthesia (asleep, pain-free) or spinal anesthesia (awake, sedated, pain-free). The procedure takes about 1 hour.

The surgeon will insert a tube-like tool called a cystoscope (or endoscope) through your urethra (the tube that carries urine from your bladder out of the penis). The surgeon then inserts a special cutting tool through the cystoscope. This tool will remove part of your prostate gland piece by piece with an electric current.

The prostate gland often grows larger as men get older. This is called benign prostatic hyperplasia (BPH). The larger prostate play causes problems with urinating. Removing part of the prostate gland can often make these symptoms better.

Before you have surgery, your doctor will suggest you make changes in how you eat or drink. You may also be asked to try taking medicine. Your prostate may also need to be removed if taking medicine and changing your diet do not help your symptoms.

TURP is one of the most common procedures for this problem. But other less invasive procedures are also available. Your doctor will consider the size of your prostate gland, your health, and what type of surgery you may want.

Prostate removal may be recommended if you have:

• Difficulty emptying your bladder (urinary retention)
• Frequent urinary tract infections
• Bleeding from the prostate
• Bladder stones with prostate enlargement
• Extremely slow urination
• Damage to the kidneys

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Infection, including in the surgical wound, lungs (pneumonia), or bladder or kidney
• Blood loss
• Heart attack or stroke during surgery
• Reactions to medications

Additional risks are:

• Problems with urine control (incontinence)
• Loss of sperm fertility (infertility)
• Erection problems (impotence)
• Passing the semen into the bladder instead of out through the urethra (retrograde ejaculation)
• Urethral stricture (tightening of the urinary outlet from scar tissue)
• Transurethral resection (TUR) syndrome (water build up during surgery)
• Damage to internal organs and structures

You will have many visits with your doctor and tests before your surgery:

• Complete physical exam
• Visits with your doctor to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems, are being treated well

If you are a smoker, you should stop several weeks before the surgery. Your doctor or nurse can help.

Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.

During the weeks before your surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and other drugs like these.
• Ask your doctor which drugs you should still take on the day of your surgery.

On the day of your surgery:

• Do not eat or drink anything after midnight the night before your surgery.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital.

You will stay in the hospital for 1 to 3 days.

After surgery, you will have a Foley catheter in your bladder to remove urine. The urine will look bloody at first. It will clear with time. A bladder irrigation solution may be attached to the catheter to continuously flush the catheter. This helps keep it from getting clogged with blood. The bleeding will gradually decrease, and the catheter will be removed within 1 to 3 days.

You will be able to resume a normal diet right away.

You will need to stay in bed until the next morning. Afterwards, you will be asked to move around as much as possible.

• Your nurse will help you change positions in bed, show you exercises to keep blood flowing, and recommend coughing/deep breathing techniques. You should do these should be done every 3 to 4 hours.
• You may need to wear special compression stockings and use a breathing device to keep your lungs clear.

You may be given medication to relieve bladder spasms.

TURP usually relieves symptoms of an enlarged prostate. You may have burning with urination, blood in your urine, urinate often, and need to urgently urinate.

Fitzpatrick JM. Minimally Invasive and Endoscopic Management of Benign Prostatic Hyperplasia. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007; chap 88.