Transurethral Resection Of The Prostate(Turp)

Common surgical treatment of BPE

Most men with urinary symptoms arising from BPE do not need to have surgery, but it may be an option if other treatments have not worked, or if your symptoms have worsened and you feel they are noticeably affecting your quality of life. Your doctor will discuss whether surgery is appropriate for you, and the potential options so that you can make an informed decision.

Things you may wish to consider when discussing surgery with your doctor include:

  • How your symptoms are affecting your quality of life.
  • How well you are tolerating any medication you are currently taking.
  • Whether your enlarged prostate is causing problems with your kidneys or repeated urine infections, kidney stones, or if you are unable to completely empty your bladder.
  • If your medical history makes you a suitable candidate for surgery.
  • The surgical treatments that are available at your hospital.
  • Your personal preferences.

There are many different types of surgical procedures for BPE, but all of them aim to relieve your symptoms and improve the flow of urine. Although surgery works well for most men, it can cause side-effects. It is important to discuss these with your doctor before deciding whether to proceed with surgery for your BPE.

Transurethral resection of the prostate (TURP)

This is the most common surgery for BPE and is usually done under a general anaesthetic or spinal anaesthetic so you will not feel any pain during the procedure.

During the procedure, a thin device called a resectoscope is inserted through the urethra. The resectoscope has a wire loop at the end of it which uses a high-frequency electrical current to cut the prostate tissue. It also has a camera which allows the surgeon to see a high-quality image of the prostate on a video monitor. The surgery involves removing the section of prostate tissue that is blocking the flow of urine.

At the end of the operation, a catheter is placed in your bladder to help drain urine while you recover from the surgery.

The catheter tube is inserted via the urinary opening in the penis. It is passed down the length of the penis, up the urethra and into the bladder. The catheter is inserted at the end of your surgery, so you will not feel any discomfort as you will still be asleep or numb (depending on the type of anaesthetic you have) when the catheter is placed.

You will not need to use the toilet to urinate while a catheter is in place as it drains urine out of the bladder, down the catheter tube and into a urine bag that your medical team will empty for you, as needed.

As well as draining urine away, the catheter also allows your doctor to flush your bladder and urethra with a sterile solution to help prevent blood clots.

The catheter will be removed shortly after surgery, once you can urinate on your own. Removing the catheter is usually done by a nurse and is very straightforward, with little discomfort.

You will usually be advised to avoid sexual activity for 2-3 weeks and it is not uncommon when you do to experience what is called “retrograde ejaculation”. Sometimes called a dry orgasm, retrograde ejaculation is a condition where semen goes into the bladder, rather than through your urethra and out of your penis during an orgasm. It isn’t harmful and the semen will pass through the bladder when you pee, but it can cause fertility issues.

If you have undergone TURP surgery and are producing little to no semen when you climax, have cloudy urine after sex, or your female partner is struggling to get pregnant, then you may wish to talk to your doctor about a test for retrograde ejaculation.

general anaesthetic is a controlled way of forcing you to fall asleep, so you are unaware of the procedure being done.

spinal anaesthetic is injected through a small needle in your lower back to numb the nerves from the waist down. Generally, it lasts 2-3 hours. You will be aware of what is happening around you but won’t feel any pain or discomfort.

A resectoscope is inserted through the urethra

The resectoscope removes part of the prostate

Transurethral incision of the prostate (TUIP)

A TUIP procedure is only suitable for men with very small prostates. During a TUIP procedure, rather than removing the section of prostate tissue that is blocking the flow of urine (called a TURP procedure), the surgeon uses a resectoscope to make a small incision in the neck of the bladder next to the urethra to widen it. The procedure involves having the resectoscope inserted through the urethra, but it is done under a general anaesthetic or spinal anaesthetic so you will not feel anything.

At the end of the operation, a catheter is placed in your bladder to help drain urine while you recover from the surgery.

The catheter tube is inserted via the urinary opening in the penis. It is passed down the length of the penis, up the urethra and into the bladder. The catheter is inserted at the end of your surgery, so you will not feel any discomfort as you will still be asleep or numb (depending on the type of anaesthetic you have) when the catheter is placed.

You will not need to use the toilet to urinate while a catheter is in place as it drains urine out of the bladder, down the catheter tube and into a urine bag that your medical team will empty for you, as needed.

The catheter will be removed shortly after surgery, once you can urinate on your own. Removing the catheter is usually done by a nurse and is very straightforward, with little discomfort.