What is a transurethral resection of the prostate (TURP)?

A transurethral resection of the prostate (TURP) is an operation used to treat men with serious prostate problems. Some people call this operation a rebore. It’s best reserved for when other treatments haven’t worked, and symptoms are interfering with your life.

Who might need TURP?

TURP is sometimes recommended when a man has an obstructed flow of urine due to benign prostatic hypertrophy or benign prostatic hyperplasia (BPH), which is a common cause of an enlarged prostate. It is used to treat prostate enlargement only if other non-surgical treatments such as medication have not worked.

The prostate is a gland that surrounds the top part of the urethra and in young men is normally the size of a walnut. It often starts to get bigger from about the age of 40 on. Eventually, it can get big enough to block the flow of urine. Symptoms include

• a weak urinary stream
• difficulty starting to urinate
• feeling that the bladder isn’t empty after urinating
• having to pass urine frequently day and night
• having to pass urine urgently

TURP is an option only for men who have severe symptoms from prostate enlargement and whose quality of life is affected.

What does TURP involve?

The procedure is performed either under general or local anesthetic. A small camera and device for cutting and taking out tissue from the body is guided through the urethra. Then part of the prostate is shredded and removed. Most men spend a night in hospital.

What are the risks and complications of TURP?

The main risk is to your sex life.

Some men have problems getting an erection after surgery. For some men, that lasts a few months. In about 1 in 10 men, erectile problems are permanent.

Between half and three-quarters of men have permanent problems with ejaculation after a TURP. Usually the problems arise from the semen flowing backwards into the bladder during ejaculation – this is known as retrograde ejaculation. Although it is not life threatening, it can cause infertility in couples and can change the sexual experience for men.

Other problems such as bleeding, infection, frequency of urination and urgency can occur. Occasionally, a man develops urinary incontinence after a TURP.

It’s important to talk to your partner and your doctor about the impact this surgery might have on your sex life, and to look at alternatives.

What are the alternatives to TURP?

If you have an enlarged prostate, there are a number of options, including:

• do nothing – some men will find the symptoms get no worse
• take medicines
• laser therapy, using heat to remove tissue from the prostate
• microwave treatment, using microwave energy to shrink the prostate
• other operations, such as transurethral incision of the prostate or open or retropubic prostatectomy

You should think about the benefits and risks of all approaches.

What to expect after the procedure

After the procedure, a urinary catheter will be in place to drain urine. This urine will probably have blood in it.

While the catheter is in place, some men feel bladder spasms or contractions. The catheter is usually removed the following day. A drip (intravenous fluid) may also be in place overnight to help to flush the blood out of the bladder.

At first, you may experience a burning sensation when urinating, or need to urinate frequently. These symptoms should settle with time.

Your doctor is likely to recommend that you avoid strenuous activity, straining and heavy lifting for 6 to 8 weeks after surgery. It is also important to avoid constipation by eating plenty of fibre and drinking 2 to 3 litres of fluid per day.