Transurethral resection

Transurethral resection of the prostate (often abbreviated as TURP) is a surgical procedure that involves the removal of a portion of the prostate gland using an instrument inserted through the urethra. The procedure is commonly used to treat benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that can lead to urinary symptoms.

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Overview

The prostate gland surrounds the urethra, the tube through which urine exits the body. When the prostate becomes enlarged, it can constrict the urethra, leading to a variety of urinary symptoms. TURP aims to relieve these symptoms by removing the obstructing tissue.

Procedure

The procedure typically involves:

• Administration of anesthesia to the patient.
• Insertion of a specialized instrument called a resectoscope through the tip of the penis into the urethra.
• Using the resectoscope, the surgeon trims away excess prostate tissue that is obstructing urine flow.
• Removal of the excised tissue fragments from the bladder.
• Placement of a catheter to allow urine to drain and to help in the healing process.

Indications

TURP is indicated for men with moderate to severe urinary symptoms attributed to BPH that have not responded to medication. Symptoms may include:

• Frequent urination, especially at night.
• Difficulty starting urination.
• Weak urine stream or dribbling.
• Sensation of incomplete bladder emptying.
• Recurrent urinary tract infections.

Risks and Complications

As with any surgical procedure, TURP has potential risks, including:

• Bleeding during or after the procedure.
• Infection of the urinary tract or surgical site.
• Retrograde ejaculation (semen flows backward into the bladder during ejaculation).
• Urethral stricture or narrowing.
• TUR syndrome (absorption of too much fluid during the procedure).
• Need for repeat surgery.

Post-operative Care

After the procedure:

• Patients are usually hospitalized for a short period for monitoring.
• A catheter remains in place to help the bladder drain until swelling reduces.
• Patients are advised to drink plenty of fluids to flush out blood and clots from the bladder.
• Regular follow-up is essential to monitor for complications and to assess symptom improvement.

Alternatives

There are several alternatives to TURP, including:

• Medications to shrink or relax the prostate.
• Laser surgery to vaporize prostate tissue.
• Prostate artery embolization.
• UroLift, a procedure to pull the prostate tissue away from the urethra.

See Also

• Prostate gland
• Benign prostatic hyperplasia
• Urethra
• Laser surgery
• Urology

References

• McVary, K.T., et al. "Transurethral Resection of the Prostate (TURP) for Benign Prostatic Hyperplasia". Urologic Clinics of North America, 2020, 47(3), 311-322.
• Tan, W.S., & Chapple, C.R. "Surgical Techniques: Transurethral Resection of the Prostate (TURP)". BJU International, 2019, 124(4), 582-585.

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