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TURP Surgery- Procedure, Benefits, Recovery, and Complications
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What is TURP surgery?
Let us discuss a little bit about the treatment options available for BPH and the gold standard for BPH management- TURP surgery.
How does prostate resection surgery work?
Since prostate enlargement is a normal age-related change of the prostate gland, it is not inherently painful. Instead, BPH usually causes urinary discomfort and dysfunction by compressing the urethra. Hence, when the prostate doctor removes the extra part of the enlarged prostate gland, it relieves the urethra and restores urinary function.
BPH surgery can be performed in a number of ways. However, the most effective and widely performed surgical procedures are TURP and HoLEP surgery.
When does the surgeon recommend getting TURP surgery?
TURP is usually the first treatment a surgeon recommends if your symptoms are not being relieved via medicines and other non-surgical management techniques. Your doctor may advise TURP surgery to you if you have the following symptoms:
- Nocturia, frequent urge to urinate during the night
- Slow and intermittent urination
- Inability to easily start a urine stream
- Urinary retention, i.e., inability to completely empty the bladder
- Painful and uncomfortable urination
Also read: What Is The Best Treatment For An Enlarged Prostate?
What are the benefits of TURP surgery over other BPH treatments?
If you are experiencing urinary symptoms, and have just been diagnosed with BPH, your next course of action is deciding what kind of BPH treatment you want to go for.
The most effective treatments of BPH are medical management and surgery. While some patients try alternative treatment therapies such as Ayurveda and Homeopathy, their efficacy is not proven. In most cases, the decision of choosing between medical management and surgery is taken out of the patient’s hands depending on the severity of the condition and their symptoms. However, since medical management is only effective for mild cases, surgery is inevitable for most patients. Even among the different surgeries for BPH, TURP is still considered to be the gold standard because it is effective and has a fast recovery.
Also Read: 5 Best BPH Medications For Enlarged Prostate Treatment
Benefits of TURP surgery are:
- Minimally invasive
- Minimal bleeding
- Fast recovery
- Low chances of complications
- Low operating time
- Preservation of sexual function
- Low retreatment rate
What presurgical preparations should a patient make?
If you’ve decided to undergo TURP surgery for BPH, then your surgeon will relay a set of instructions to help you prepare for the surgery. Before undergoing TURP, you have to:
- Fast for at least 6 hours prior to the procedure. If you are diabetic, then you have to let your surgeon know in advance so that they can modify the procedure accordingly.
- You may have to get an enema to completely empty your bladder, especially if you have trouble with bowel function.
- Make sure to inform your surgeon about all the medicines you are currently taking. Normally, you can continue taking medicines for your other pre-existing medical conditions, but if you are taking any anti-coagulants, then it is necessary to cease taking the medicines at least 5 days before the surgery or as the doctor says.
- Bring an overnight bag to the hospital, as you may have to stay at least 1-2 days in the hospital after the surgery.
What happens during TURP surgery?
During TURP surgery, you might undergo the following steps:
- Patient preparation: Once you are admitted to the hospital, you will need to change into a hospital gown and remove any jewelry or other objects that may hinder the surgeon while performing the procedure.
- Anesthesia: Depending on your condition, you will be given either spinal or general anesthesia.
- Pre-operative inspection: The surgeon will then examine the urethra and bladder using an endoscope to check for any signs of tumors or stones in the surrounding area.
- Surgery: Once the inspection is complete, the surgeon will insert a resectoscope through the urethra and cut excess part of the prostate. Then he will cauterize the wound via electricity to limit the bleeding.
- Post-operative care: Next, the surgeon will remove the resectoscope and insert a catheter to help urine drainage till the swelling in the urethra has gone down.
The surgery takes about 60-90 minutes and is performed under either general or spinal anesthesia, depending on the patient’s condition and the surgeon’s preference. There are no cuts or stitches required in the surgery.
What happens after the surgery?
After the surgery, you will be moved to a recovery ward. You may need a catheter for at least 1-2 weeks after the surgery, or at least until the swelling in the urethra has gone down. There may be mild to moderate pain in the surgical site for 7-10 days after the procedure. However, it is easily manageable via over-the-counter pain medication. Your normal urinary flow usually resumes as soon as the catheter is removed.
What can you do to improve recovery?
Recovery is usually fast after TURP surgery as it is a minimally invasive procedure. You can also improve the recovery time by following a few easy tips:
- Stay well hydrated during the first couple of weeks after the surgery. Drink plenty of water and avoid alcohol, caffeine, and other diuretic foods.
- Make sure to complete your antibiotic course to prevent infection.
- Avoid lifting, gardening, and other physically taxing activities for at least two weeks after the surgery. Avoid sex for at least 3-4 weeks to ensure the urethra is completely healed.
- Include extra fiber in your diet to make bowel movement easier.
What are the risks and complications associated with TURP surgery?
Although TURP is a very safe procedure, sometimes, in rare cases, there may be complications like:
- Injury to the bladder or urethra
- Hemorrhage
- Infection
- Electrolyte abnormalities
- Erectile dysfunction
- Retrograde ejaculation
- TURP syndrome, etc.
If you notice any bleeding or pus discharge from the surgical site, then it is a sign that you may have an infection. Get in touch with your urologist immediately if you notice any complications.
What is TURP syndrome?
TURP syndrome is an extremely rare but potentially life-threatening complication of the TURP procedure. It occurs when the irrigation fluids used during the TURP procedure are absorbed by the prostatic venous sinuses. It can cause electrolyte imbalance and hyponatremia, along with many other nervous, cardiovascular, and systemic dysfunctions. If you notice any confusion, breathlessness, headache, seizure, etc., after the surgery, immediately contact your prostate doctor as it may be a sign of TURP syndrome.
In conclusion, TURP is still among the most effective and common treatments for benign prostatic hyperplasia. Around 95% of BPH patients still get TURP surgery, even with other treatment techniques available. This is because, in addition to being effective, it is still one of the most affordable BPH surgeries available. If you are suffering from BPH and wish for long-lasting relief from your symptoms, TURP surgery is your best option.
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