Doctor holding a stethoscope

What Is TURP and Do I Need One for My BPH?

Highlights

  • In a Transurethral Resection of the Prostate (TURP), doctors remove small sections of the prostate by guiding a tool up the urethra and cutting away prostate tissue.
  • Although it’s more effective and safer than previous approaches, other surgical procedures are beginning to become more common.
  • Talk to your doctor about your BPH symptoms and whether surgery would be an effective intervention.

Around the age of forty, a man’s prostate begins to grow again, and can potentially cause problems with the urinary tract. A transurethral resection of the prostate (TURP) can help. Before you go to the doctor, learn how TURP works, its risks and benefits, and whether you should ask your doctor about the procedure.

What Is a Transurethral Resection of the Prostate (TURP) and Why Is It Used?

TURP is most commonly used to treat the urinary symptoms of benign prostatic hyperplasia (BPH). As the prostate grows, it presses on the urethra, narrowing it and making it difficult to urinate and completely empty the bladder. 

TURP is a possibility if non-surgical interventions such as daily Cialis aren’t delivering satisfactory results, or if symptoms are becoming more severe over time. In a TURP procedure, a doctor threads a device called a cystoscope up the urethra and uses electrocauterizing tools or surgical blades to cut away prostate tissue. The body is protected from electric current with an irrigation fluid.

Generally speaking, doctors remove less than an ounce of tissue, reducing the size of the prostate by up to 50 percent. A catheter is inserted as part of the procedure to allow emptying the bladder with minimal discomfort during the healing process.

There are two kinds of TURP, monopolar and bipolar, describing the direction of the current for the electrocautery tools. Bipolar TURP is more common, as it needs fewer safety precautions and lowers the risk of post-surgery complications.

What Are The Advantages of TURP?

Medical equipment

TURP has several advantages over the past procedure, which involved making an incision in the lower torso and accessing the prostate through the body.

  • Fewer and smaller incisions. By using the urethra and making fewer incisions, there’s less risk of infection. This also means the recovery process is faster and simpler, as there’s less to heal.
  • Faster overall surgery times. Less time in surgery lowers the chances of complications and overall stress on patients.
  • Less anesthetic. The procedure can be done with spinal anesthetic, which carries less risk and simplifies the procedure.
  • Less risk of some symptoms. Unlike previous surgeries, erectile dysfunction (ED) symptoms are rare after a successful TURP operation.

How Effective Is TURP?

Studies looking at the procedure state that approximately 75 out of 100 people who undergo it see major relief from symptoms. The rest generally see at least some relief. The high rate of relief contrasted with the low risk of serious complications or post-recovery issues generally means the procedure is viewed as highly effective and an option for most men.

What Are The Possible Complications of TURP?

Patient undergoing surgery

In most cases, post-surgical symptoms of TURP are rare and resolve within six months. The most common are urinary incontinence and erectile dysfunction.

There are some more serious possible complications with a TURP procedure. Some are inherent to any surgery, such as bleeding risk or clots. Others include:

  • Retrograde ejaculation. Caused by an injury to the prostatic urethra, in retrograde ejaculation semen goes into the bladder instead of out of the body. This is the most common post-surgery complication, with estimates of up to 65% of all patients experiencing it. It’s not harmful or painful, but may cause fertility problems in the future. Some patients will collect sperm before the procedure for fertility purposes.
  • Bladder and urinary tract injury. The tools used for TURP may damage the bladder or urinary tract in the course of surgery, causing long-term problems such as urinary incontinence or bladder neck stenosis (stricture).
  • Risks from irrigation fluid. The various irrigation fluids used for electrocautery with TURP all have different risks depending on the patient and how much fluid is used. In extreme cases it can cause “TURP syndrome,” overloading the body with fluid and causing water intoxication. 

Is TURP Right For Me?

While TURP has been the gold standard for BPH surgery for a long time, that’s beginning to change. Procedures including laser enucleation, laser resection, and “green light” laser surgery, which vaporizes tissue, are becoming more popular. They’re about as effective and safe as TURP, but have shorter recovery times and reduce the already small risks. Robotic surgery is also becoming more common for the same reasons.

That said, not all of these surgical options are available to all patients, and they can be more costly than TURP. Similarly, TURP is well understood and has been performed for years, so it’s easier to find a surgeon familiar with the procedure. As imaging tools that show the body in real time become more common, the already low risks of TURP and its post-surgery complications are dropping.

Doctor performing surgery

If you’re considering TURP, or if your current BPH treatment isn’t satisfactory, ask your doctor the following questions:

  • Is TURP an option at a nearby facility, and what type of TURP is available there?
  • What are the specific risks to me as a patient?
  • What pre-surgical care is recommended?
  • How long is recovery likely to take and what will I need to plan in advance?
  • What follow-up care is recommended?
  • What other surgical options are available, and are they recommended in my circumstances?
  • Will this procedure be covered by my insurance?

Once you have the answers to these questions, whether TURP is a workable choice will be easier to determine.

Where Can I Learn More About BPH, ED, and Sexual Health?

As we age, there are questions and issues for which we have to prepare. eDrugstore is here to help, with detailed discussion of medication for men, telehealth consultations, and ongoing blog entries and updates about BPH, prostate cancer, and men’s health concerns.

Learn more about how we can help with erectile dysfunction on our ED page!

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