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

A transurethral resection of the prostate (TURP) is an operation on your prostate. It can be done in males to treat problems with emptying your bladder caused by an enlarged prostate.

Who might need TURP?

A TURP may be recommended if you are male and are having trouble urinating (doing a wee) because of an enlarged prostate.

Your prostate is a walnut-sized gland that sits below your bladder. It surrounds the top part of your urethra — the tube that carries urine (wee) out of your body through the opening at the end of your penis.

Your prostate may start to get bigger as you get older. This is called ‘benign prostatic enlargement’ or ‘benign prostatic hypertrophy’. Eventually, your prostate may get big enough to block the flow of urine.

Symptoms of an enlarged prostate can include:

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

A TURP removes some of your prostate to improve the flow of urine. A TURP may be recommended if you have:

• symptoms of prostate enlargement that are bothering you and affecting your quality of life
• medicines have not helped relieve your symptoms

Sometimes, a TURP is recommended as part of the treatment for prostate cancer. It might be done to relieve symptoms of urinary blockage.

How to prepare for a TURP

Your doctor will talk to you about whether you need to stop eating and drinking several hours before the procedure.

You might also need to stop taking some medicines such as aspirin for a few days before the procedure. But don't stop taking your medicines without asking your doctor first.

What happens during a TURP?

A TURP is done either under general anaesthetic or spinal anaesthetic. A general anaesthetic means you are unconscious during the procedure.

During the procedure, a thin tube-like instrument with a small camera is guided through your urethra. Part of your prostate is removed using a special device. The device trims tissue from the inside of your prostate.

A TURP usually takes about one hour. You may be given antibiotics during the procedure to prevent infection.

Recovering from a TURP

After the procedure, you’ll probably spend a couple of days in hospital.

Your urine will probably have blood in it. A urinary catheter (tube into your bladder) will be put in place to drain your bladder. Fluid will also be used to flush out your bladder. While the catheter is in place, you may feel bladder spasms or contractions.

The catheter is usually removed in the days after the surgery. Some people go home with a catheter still in place.

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. They may also tell you to avoid sex for several weeks.

It’s also important to avoid constipation by eating plenty of fibre and drinking 2 to 3 litres of fluid per day.

Possible risks and complications of a TURP

As with any surgery, there are possible risks and complications with a TURP.

Bleeding

It is common to have blood in your urine for a couple of weeks after having a TURP. Let your doctor know if:

• your bleeding is increasing
• you are passing blood clots
• you are not able to urinate

Infection

There is a small risk of getting a urinary tract infection after having a TURP.

Erection problems

Some people have problems getting an erection after having a TURP. Talk to your doctor if you have problems with erections. There are treatments available.

Retrograde ejaculation

Many people will have retrograde ejaculation after a TURP. That means that semen flows backwards into your bladder during ejaculation. It is also called ‘dry orgasm’.

Retrograde ejaculation can cause problems with fertility. In general, it doesn’t affect sexual pleasure.

Urinary symptoms

You may need to urinate frequently and urgently. You may also feel some burning and loss of some control of urination. These symptoms usually improve with time.

Urinary incontinence is a rare complication after a TURP.

What are the alternatives to TURP?

Other treatments for benign prostatic enlargement include:

• observation (if you have minor symptoms)
• lifestyle adjustments
• medicines
• other procedures, including laser treatment
• open surgery

Minimally invasive techniques are becoming more common and may have fewer side effects and a faster recovery. You should talk to your doctor and specialist about the benefits and risks of any treatments.

Resources and support

You can read more on preparing for surgery here.

Healthy Male has information on prostate enlargement and men’s health in general.

If you want to know more about transurethral resection of the prostate (TURP), you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week