Transurethral resection of the prostate

Transurethral resection of the prostate (often abbreviated as TUR or TURP) is a surgical procedure that involves the removal of prostate tissue by inserting an instrument through the penis. This procedure is primarily utilized to treat benign prostatic hyperplasia (BPH), a condition in which the prostate gland enlarges and causes urinary symptoms.

File:Nodular hyperplasia of the prostate.jpg

Nodular hyperplasia of the prostate

Overview

The prostate is a small gland situated below the bladder and encircling the urethra. Its enlargement can impede the flow of urine from the bladder, causing symptoms like frequent urination, nocturia (frequent nighttime urination), difficulty starting urination, weak flow, and the inability to completely empty the bladder. TURP aims to alleviate these symptoms by removing excess prostate tissue.

Procedure

During TURP, the patient is typically under general or spinal anesthesia. A resectoscope, a thin instrument equipped with a camera, light, and loop, is inserted through the urethra. The loop is heated and utilized to remove excess prostate tissue piece by piece, ensuring the urethra is unobstructed. The removed tissue fragments are then flushed out at the conclusion of the procedure.

Recovery and Post-Operative Care

Patients may require a short hospital stay post-TURP. A catheter is often inserted to aid urine flow while the surgical site heals. Patients are generally advised to:

• Avoid strenuous activities for several weeks.
• Refrain from driving for a minimum of a week.
• Avoid constipation and heavy lifting.
• Drink ample water to aid in flushing out blood and clots from the bladder.

Regular follow-ups are essential to monitor recovery and assess urinary function.

Risks and Complications

As with any surgery, TURP comes with potential risks, including:

• Bleeding, which might require blood transfusion.
• Infection.
• Difficulty holding urine or urinary incontinence.
• Retrograde ejaculation, where semen flows backward into the bladder.
• Erectile dysfunction.
• Need for re-treatment or additional procedures.

Alternative Treatments

TURP is one of various procedures to treat BPH. Alternatives include:

• Prostatectomy - Surgical removal of the entire prostate gland.
• Laser therapy - Use of high-energy lasers to remove or destroy prostate tissue.
• Prostatic stents - Temporary or permanent devices inserted into the urethra to keep it open.

Patients should discuss with their urologist the most suitable option based on their condition, age, and overall health.