Transurethral resection of the prostate
Information for patients from the British Association of Urological Surgeons August 2016
TURP_benign.pdf
Adobe Acrobat document [310.9 KB]

TRANSURETHRAL RESECTION of the PROSTATE
(TURP)

 

 

 

 
The prostate is a gland, shaped something like a small orange, situated inside the male body just in front of the rectum and just beneath the bladder. The urine flows out of the bladder and through the 'urinepipe', the urethra, which passes through the 'core' of the prostate.As men get older the prostate may enlarge gradually. This enlargement may press on the urethra and affect the urine flow out of the bladder. For some men, this may not cause symptoms. Others experience many problems such as going to the toilet frequently, not emptying the bladder fully, getting up to urinate at night, or some incontinence.

The effects will differ with individuals. Some men will suddenly find they are unable to pass urine as normal and will need a 'plastic' tube, called a catheter, to be inserted into the bladder to drain the urine as an emergency. Other men notice a gradual decline in urine flow. Eventually some men will need an operation to remove part of the prostate and relieve this urine flow. The operation A TURP is performed under an anaesthetic using instruments which are passed up your penis. Pieces of the prostate are 'chipped' or 'scraped' off and removed through the penis, so you will not have a cut on your abdomen from this procedure.

The operation may take an hour, but you may be off the ward for longer as you are observed in a recovery area after theatre. You will then return to the ward for an average length of hospital stay of 3-5 days. During the operation the surgeon will have placed a catheter in your penis to drain the urine from your bladder. This will be removed after 2-3 days when your drained urine is reduced / free of blood and clots. Although you have no visible scar, you have had a major operation. There are certain things you need to be aware of during your recovery.
 
 
 

Discharge information for patients

Physical activity

It is common to feel quite tired during your recovery which usually subsides over the first month. It is important that you get up and about when at home after surgery, though physical activity should be restricted for the first 2 weeks. It is safe for you to take short walks (no more than 1 mile in length) but strenuous activities such as heavy lifting, digging the garden and mowing the lawn should be avoided. After the first 2 weeks you may gradually increase your physical activity to pre-operative levels depending on your usual level of fitness.

Driving

We recommend that you do not drive for at least one week after you return home, until you feel comfortable doing an emergency stop. A return to work may be planned for about 4 weeks after leaving hospital. Your full recovery may take 3 months. Very occasionally some men will need a further operation to resolve urinary symptoms. Also, some men may require a redo-TURP within 5-15 years simply because the prostate can re-grow.
Urinary Symptoms

You may experience a small amount of bleeding into your urine at any
time for the first few weeks at home even after several days of clear urine.
This is usually harmless but it may be aggravated by strenuous physical activity as detailed above. Should it occur you should rest completely and drink plenty of fluid, particularly water, (at least 1½ litres/3 pints per day), and it should resolve within 48 hours. If the bleeding is heavy and persists for more than 24 hours, or you are unable to pass urine at all, please contact either your GP or Consultant.

The benefits of the TURP operation may not be fully seen for many weeks, sometimes months. Frequent visits to the toilet, getting up at night, small clots of blood in the urine, slight discomfort on passing urine are all to be expected during you recovery; gradually everything will settle down. Only very occasionally do men experience a long-term problem with the incontinence. About ten days after the operation you can start doing regular pelvic floor exercises which strengthen the internal muscles which help urine control.
 
Sexual activity

Although a few men may experience problems achieving an erection in the long term, removal of part or all of the prostate seldom affects the man's sexual desires nor his ability to have full and satisfying intercourse. Having erections after your operation will do no harm, but it is advisable not to have intercourse for two weeks after leaving hospital as it may cause further bleeding. The fluid which men ejaculate contains sperm from the testicles, but is mostly fluid produced by the prostate.
However, many men after a TURP may experience 'retrograde ejaculation' where they have the sensation of ejaculation but no fluid comes out of the penis. This is because the fluid moves back into the bladder and is then passed out of the body with the urine when the man next goes to the toilet. It is a harmless side-effect of the operation which means fathering children may be difficult, though absolute sterility is not guaranteed.

Also..

Keep your bowels moving regularly to prevent straining. If you notice an offensive smell or cloudiness to your urine, or you feel any temperature or fever, you may have a urinary infection and it is important that you contact your GP for treatment.