What is TURP?

By Dr. Ananya Mandal, MDReviewed by Sally Robertson, B.Sc.

The term TURP stands for transurethral resection of the prostate, an operation that is mainly performed to treat men with an enlarged prostate, a condition called benign prostate hyperplasia (BPH). Usually, TURP is performed to remove excess prostate tissue that is obstructing the flow of urine through the urethra and out of the penis.

Procedure

This operation is generally performed under general anesthesia, while a patient is unconscious. Nowadays, however, the operation is also performed under spinal or epidural anesthesia, where an injection is administered to numb the patient from the waist down.

A surgeon passes an instrument called a resectoscope through the opening of the penis and into the urethra and up towards the prostate. The resectoscope combines a camera with a surgical cutting instrument valves for controlling irrigating fluid. Excess tissue is removed from the inside of the prostate bit by bit and washed out into the bladder, where it stays until the end of the procedure when it is removed. Although BPH is not a risk factor for prostate cancer, a sample of the removed prostate tissue is saved and sent for laboratory analysis to check for the presence of cancer.

Advantages and disadvantages of TURP

Advantages

• This is a relatively simple operation that does not cause the complications associated with open surgery such as infection, bleeding, pain, and a prolonged hospital stay and recovery time.
• The procedure significantly improves urine flow and other symptoms such as incontinence and straining to urinate
• If prostate cancer is detected on biopsy examination, a radical prostatectomy and other treatments for prostate cancer can be chosen.

TURP cannot be used to cure prostate cancer, owing to the fact that only parts of the prostate that closely surround the urethra are removed, with the majority of the gland remaining in tact. However, it may be used for palliative purposes to relieve symptoms in men who cannot tolerate a radical prostatectomy

Disadvantages

•  Men may lose the ability to ejaculate semen, although they still experience the sensation of climax. This is termed retrograde ejaculation and can occur in up to 90% of men who undergo TURP. Many men temporarily lose bladder control and become incontinent, although this usually passes after a few weeks.
• There is a risk of bleeding, infection and pain afterwards that may require further medical attention.

Further Reading

• All Prostate Cancer Content
• Prostate Cancer
• The Prostate
• Prostate Cancer Risk Factors
• Prostate Cancer Screening