Transurethral resection of prostate (TURP) is a surgical procedure used to treat an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).
During a TURP, a urologist uses a specialized instrument called a cystoscope to remove excess prostate tissue that blocks the smooth flow of urine. Here’s a look at how the procedure is performed.
Anesthesia
Typically, TURP is performed under general or spinal anesthesia. This ensures that the patient is comfortable and pain-free during the surgery.
Insertion Of The Cystoscope
The surgeon inserts a cystoscope through the urethra, the tube that carries urine from the bladder to the outside of the body. The cystoscope has a light and a camera that allows the surgeon to visualize the prostate and surrounding structures.
Resection Of Prostate Tissue
Using the cystoscope, the surgeon trims away the excess prostate tissue that is causing the obstruction. This is done by passing a small wire loop through the cystoscope and using it to shave off small pieces of the prostate.
Removal Of Tissue And Irrigation
As the surgeon resects the prostate tissue, it is flushed out of the bladder using a sterile fluid irrigation system. This helps maintain a clear view and prevents the accumulation of tissue fragments.
Catheter Placement
At the end of the procedure, a catheter is placed in the bladder through the urethra. The catheter allows urine to drain freely and helps with healing.
When Is A TURP Done?
- Moderate to severe urinary symptoms caused by an enlarged prostate.
- Inadequate response to medications used to treat an enlarged prostate.
- Recurrent urinary tract infections or bleeding due to prostate infections.
- Bladder stones or bladder damage caused by a large prostate.
Complications
Complications that can occur after a TURP may include the following –
Bleeding
TURP involves removing prostate tissue, which can result in bleeding. Most cases of bleeding can be controlled during the procedure, but in rare instances, a blood transfusion or further intervention may be required. The patient will require bladder irrigation for 2 to 3 days postoperatively to help manage this bleeding.
Bleeding may occur on and off for about 2 weeks after surgery. This usually is mild.
Urinary tract infections
The presence of a catheter and manipulation of the urinary tract during surgery can increase the risk of developing a urinary tract infection. Antibiotics are typically prescribed to minimize this risk.
Retrograde ejaculation
TURP may result in retrograde ejaculation, where semen flows backward into the bladder instead of out through the penis during ejaculation. This does not affect sexual function, but it may impact fertility.
Urinary incontinence
Temporary or rarely permanent urinary incontinence can occur, but it is less common with TURP compared to other prostate procedures.
Bladder neck contracture
Scar tissue can form in the area where the prostate was resected, leading to a narrowing of the bladder neck. This can cause urinary retention and may require further treatment.
Closing Remarks
It’s important to note that while TURP is a standard and effective treatment for BPH, it may not be suitable for everyone. The decision to undergo a transurethral resection of prostate is based on a thorough evaluation by a urologist who will consider factors such as overall health, prostate size, and severity of the problem.
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