Prostate resection (TURP)

When is TURP surgery necessary?

TURP (transurethral resection of the prostate) surgery, i.e., the partial or total removal or incision of the prostate through the urethra, may be necessary in cases of urinary dysfunction after failure of conservative medication.

The prostate is the size of a chestnut, surrounding the posterior urethral segment between the bladder neck and the urethral sphincter. Around the age of 35 the prostate starts to grow, and by the age of 50 this growth can be so pronounced that it can compress the posterior urethral segment, obstructing the flow of urine. Symptoms of urinary dysfunction include:

  • weakened, and in some cases intermittent, urine stream
  • post-micturition dribble
  • frequent urination
  • sudden urge to urinate
  • slow onset of urination
  • straining to maintain the urine stream during urination
  • difficult urination 
  • sudden onset of complete inability to urinate, i.e., urinary retention
  • frequent urination at night (nocturia)
  • inability to empty the bladder completely (urinary retention)

In addition to prostate enlargement, these complaints may also be caused by narrowing or stiffness of the bladder neck (stenosis) and other neurogenic bladder diseases (e.g., hypo-/hypercontractile bladder, overactive bladder). If medical treatment is unsatisfactory, resection of the prostate through the urethra with high-frequency current (diathermy) is recommended and has been the best-established treatment for decades. As a result of the surgery, the symptoms associated with frequent urination are reduced in most cases: urination difficulty improves, the urinary stream becomes stronger and the amount of urine remaining in the bladder after urination is reduced.

How should patients prepare for TURP surgery?

The procedure requires no special preparation on the part of the patient.

What preliminary tests are required? 

In addition to a urological examination, a laboratory test and an anesthetic consultation are required prior to the procedure.

How is TURP surgery performed?

The operation is performed under general anesthesia or spinal anesthesia. During the operation, a special bladder scope (resectoscope) is inserted into the bladder through the urethra. This device has an electric element at its end to cut and stop bleeding using high frequency current. The prostate tissue that is blocking the flow of urine in the posterior urethra is removed layer by layer. The operation removes only the enlarged part of the prostate, leaving the so-called surgical capsule intact. This is important because over the years, although rarely, there is a possibility that the prostate may become enlarged again. Furthermore, regular prostate cancer screening is recommended after surgery as for any other patient. This will help in the early detection and treatment of any malignant lesions in the prostate. The removed prostate tissue will be examined histologically. In contrast to removal, the prostate is incised through the bladder neck or the section of the urethra that passes through the prostate, so no material suitable for histological examination is removed in this case. Following the operation, after the wound surface in the urethra has been stopped from bleeding, a bladder catheter is inserted for 2-5 days.

What to do after TURP surgery?

After the procedure, depending on the size of the prostate, you will usually need to stay in hospital for 2-3 nights. On the first day, the bladder is flushed with physiological saline to help remove blood clots and clear the urine. Once the urine becomes clear, the flushing is stopped, and the permanent catheter is removed.

After surgery, you will be advised to take antibiotics and anti-inflammatories at home.

After the procedure, adequate fluid intake is of paramount importance, with 2-3 liters of fluids per day recommended. It is recommended to avoid heavy exertion, strenuous physical work and sports activities for at least 4 weeks.

If you have any complaints about urination after the operation, these will be checked and the urine flow measured at the post-operative check-up.

What are the risks of TURP surgery?

The surgery does not usually affect your ability to get an erection. However, the ability to procreate is lost in about 70 per cent of cases, as the incision in the bladder neck causes the semen to enter the bladder rather than the urethra during ejaculation. The semen leaves the bladder during the next urination. There is no health risk associated with this condition.

It is important to note that this surgery is not a sterilization procedure, so it does not mean that the patient becomes completely infertile, and therefore adequate protection during sexual intercourse is still recommended. If the patient's family planning is not yet complete, it is worth considering the options before the operation. The chance of spontaneous fertilization after surgery is about 10 per cent due to retrograde ejaculation. If unsuccessful, an IVF program is recommended.

After surgery, bloody urine may occur for up to 1-2 weeks. You may also experience post-operative bleeding, irritative symptoms and temporary urinary retention problems. Less commonly, there may be inflammatory complications, hospital-acquired infections or deep vein thrombosis, the risk of which is minimal if proper protocols are followed.

TURP surgery fee

You can find our current fee on our price list.

WHY CHOOSE DR. ROSE PRIVATE HOSPITAL?

  • Qualified specialists, modern diagnostic and therapeutic equipment.
  • Empathetic, people-oriented approach. Our specialists always keep the comfort and safety of our patients in mind.
  • Premium quality inpatient department. 3 operating theaters and 24 patient rooms with 33 beds to meet all your needs. The highest professional standards are combined with an exclusive healing environment where you can recover in safety and with complete peace of mind.
  • Fast and predictable appointments. Within 1-2 weeks from the first consultation with a specialist, we will arrange an appointment for the necessary intervention.

For all your urological complaints, feel free to contact the doctors at Dr. Rose Private Hospital.