TURP

Overview

TURP is done through the penis using a thin telescope like instrument called a resectoscope. It is passed along the urethra to the prostate.

The surgeon uses an electrically heated wire loop or similar device to remove obstructing inner prostate tissue. This helps open a wider channel for urine flow.

The procedure often takes around 60 to 90 minutes, depending on prostate size and surgical factors, and is performed under general or spinal anesthesia. Hospital stays are typically short, often 1 to 2 days.

It removes the inner tissue that is pressing on the urethra.

Why it’s done

TURP may be used to treat bothersome urinary symptoms from an enlarged prostate, BPH. These can include weak stream, difficulty starting urination, stopping and starting, frequent urination, especially at night, urgency, and a feeling of incomplete emptying.

It may also help when BPH leads to complications such as recurrent urinary retention, repeated urinary tract infections, bladder stones, bladder damage, or kidney issues from obstruction.

In some men with advanced prostate cancer, TURP may be offered to ease urinary blockage and improve comfort. It does not treat the cancer itself.

TURP is often considered when medications for BPH do not work well, are poorly tolerated, or when a patient prefers surgery.

Risks

Common or expected effects

• Burning with urination, frequent urination, and mild blood in the urine may occur for days to weeks after surgery
• Temporary difficulty controlling urination, such as urgency or leakage, can happen while the bladder adjusts

Potential complications

• Bleeding may require irrigation through the catheter, a blood transfusion in rare cases, or return to surgery
• Urinary tract or prostate infections may occur and sometimes need antibiotics
• Retrograde ejaculation is common after TURP and often permanent. It affects fertility but usually not sexual pleasure
• Temporary or, less often, longer term erectile or orgasmic issues can happen. TURP generally carries a lower risk of permanent erectile dysfunction
• Urethral stricture, narrowing of the urine tube, or bladder neck contracture, scarring at the bladder outlet, may develop and sometimes require further treatment
• TUR syndrome from fluid absorption is uncommon with modern techniques but remains a possible risk, especially in longer procedures
• In some men, symptoms may return over time, and further treatment could be needed

How you prepare

You will have an evaluation that may include a history and physical exam, urine tests, blood tests, PSA, imaging, and sometimes flow studies or cystoscopy. These help confirm obstruction and suitability for TURP.

Your doctor will review your medications. Blood thinners, such as warfarin, DOACs, aspirin, or clopidogrel, and certain supplements may need to be stopped or adjusted to help reduce bleeding risk.

You will receive instructions about fasting, not eating or drinking, for several hours before anesthesia.

Antibiotics may be given around the time of surgery to help lower infection risk.

You will sign a consent form after discussing benefits, alternatives, and risks, including effects on ejaculation and fertility.

What you can expect

Before the procedure

On the day of surgery, you will check into the hospital, often as same day or overnight admission, and change into a gown.

An intravenous line will be placed for fluids and medications. You may receive pre operative antibiotics and other drugs through it.

An anesthesiologist will discuss anesthesia options, such as general anesthesia, where you are asleep, or spinal anesthesia, which numbs the lower body while you remain awake but sedated.

Final checks are done, including confirming your identity, allergies, and the planned procedure.

During the procedure

The surgeon inserts a cystoscope or resectoscope through the urethral opening at the tip of the penis and advances it to the prostate. No skin cuts are made.

Sterile fluid is circulated through the scope to expand the area and keep the view clear.

Using the wire loop on the resectoscope, the surgeon removes small chips of prostate tissue from the inside. This creates a wider open channel from the bladder to the urethra.

The tissue fragments are flushed into the bladder and then out of the body for analysis. Bleeding vessels are sealed with cautery.

At the end, the resectoscope is removed, and a urinary catheter is placed in the bladder. It often includes continuous irrigation to prevent clots.

After the procedure

Hospital phase

• You are taken to a recovery area for monitoring of blood pressure, pulse, breathing, and urine output
• A catheter usually remains in place for 1 to 3 days, although this can vary. It drains urine that may initially be bloody and may need irrigation to stay clear
• You will receive pain relief and sometimes bladder antispasmodic medication if you have cramping
• Most people go home within 1 to 2 days when stable and urine is reasonably clear, or after catheter removal

At home

• You may go home with or without a catheter. If you have one, you’ll get instructions on care and removal timing
• Expect some burning with urination, urgency, and small amounts of blood in urine for days to weeks
• Drinking plenty of fluids can help flush the bladder, unless advised otherwise
• You’ll usually be advised to avoid heavy lifting, strenuous exercise, cycling, and sexual activity for several weeks to aid healing and reduce bleeding risk
• Driving may be restricted for a short time after anesthesia or while on strong pain medications. Your team will provide specific guidance
• Contact your doctor or emergency services if you cannot pass urine, if bleeding is heavy with large clots, if you develop fever or chills, or if pain is severe

Results

Many men notice improved urinary flow, less straining, and fewer episodes of nocturia and urgency, often within days to weeks as swelling settles.

The need for BPH medications often decreases or goes away after TURP.

Symptom relief from BPH typically lasts for many years. Some men may need further treatment later if the prostate regrows or scarring develops.

Many men report improvement in quality of life after symptom relief. Retrograde ejaculation is common and may be permanent. Discuss family planning needs in advance.

Your surgeon will usually arrange follow up visits to check symptoms, urine flow, lab tests, and the pathology report of removed tissue.