What is TURP? Purpose, Procedure & Recovery

TURP stands for Transurethral Resection of the Prostate, a common surgical procedure that helps men with enlarged prostate glands urinate more easily. During this minimally invasive surgery, your urologist removes excess prostate tissue that's blocking your urine flow, much like clearing a clogged drain to restore normal water flow.

What is TURP?

TURP is a surgical procedure where your doctor removes portions of an enlarged prostate through your urethra without making any external cuts. The surgeon uses a special instrument called a resectoscope, which goes through your penis to reach the prostate and carefully trim away the excess tissue that's causing urinary problems.

This procedure has been safely performed for decades and remains one of the most effective treatments for benign prostatic hyperplasia (BPH), which is non-cancerous prostate enlargement. Unlike open surgery, TURP doesn't require any incisions on your abdomen or pelvis, making recovery generally faster and less painful.

Why is TURP done?

TURP is typically recommended when an enlarged prostate significantly interferes with your daily life and other treatments haven't provided adequate relief. Your doctor might suggest this procedure if you're experiencing persistent urinary symptoms that affect your quality of life or pose health risks.

The most common reasons doctors recommend TURP include several urinary complications that can develop from an enlarged prostate:

• Inability to urinate completely or at all (urinary retention)
• Frequent urinary tract infections due to incomplete bladder emptying
• Blood in your urine that persists or recurs
• Kidney problems caused by backed-up urine
• Bladder stones that form due to incomplete emptying
• Severe nighttime urination that disrupts your sleep multiple times
• Weak urine stream that makes it difficult to empty your bladder

Your urologist will also consider TURP if medications like alpha-blockers or 5-alpha reductase inhibitors haven't improved your symptoms after several months of treatment. Sometimes, even when medications help initially, symptoms can worsen over time as the prostate continues to grow.

What is the procedure for TURP?

TURP is performed in a hospital operating room under either spinal or general anesthesia, so you won't feel any discomfort during the surgery. The entire procedure typically takes between 60 to 90 minutes, depending on the size of your prostate and how much tissue needs to be removed.

Here's what happens during your TURP procedure, step by step:

1. You'll receive anesthesia to ensure you're completely comfortable throughout the surgery
2. Your surgeon inserts a resectoscope through your urethra to reach the prostate
3. A special cutting tool removes small pieces of prostate tissue that are blocking urine flow
4. The removed tissue pieces are flushed out through the resectoscope
5. Your surgeon carefully checks for any bleeding and seals blood vessels as needed
6. A catheter is placed in your bladder to help with healing and monitor your recovery

The surgery is performed entirely through your natural urinary opening, so there are no external cuts or stitches to worry about. Your surgeon will only remove the inner portion of the prostate that's causing the blockage, leaving the outer shell intact to maintain normal function.

How to prepare for your TURP?

Preparing for TURP involves several important steps that help ensure your surgery goes smoothly and reduces the risk of complications. Your healthcare team will guide you through each preparation step and answer any questions you might have about the process.

Your doctor will likely ask you to stop certain medications before surgery, particularly those that affect blood clotting:

• Blood thinners like warfarin, usually stopped 3-5 days before surgery
• Aspirin and anti-inflammatory medications, typically discontinued 7-10 days prior
• Herbal supplements that may affect bleeding, such as ginkgo or garlic
• Some diabetes medications that might need adjustment

You'll also need to arrange for someone to drive you home after the procedure since anesthesia affects your reflexes and judgment for several hours. Plan to have a responsible adult stay with you for at least the first 24 hours after surgery to help with basic needs and monitor your recovery.

The night before surgery, you'll need to fast for at least 8-12 hours, which means no food or drinks after midnight or the time specified by your surgical team. This precaution prevents complications from anesthesia and ensures your stomach is empty during the procedure.

How to read your TURP results?

TURP results are typically measured by how much your urinary symptoms improve rather than through specific numerical values like blood tests. Your doctor will evaluate your progress using symptom questionnaires and objective measurements of your urine flow and bladder function.

Most men notice significant improvement in their urinary symptoms within the first few weeks after TURP. You should expect your urine stream to become stronger, your bladder to empty more completely, and nighttime urination to decrease substantially.

Your urologist will track several key indicators to assess how well your TURP worked:

• Urine flow rate measurements during follow-up visits
• Post-void residual volume (how much urine remains in your bladder after urinating)
• Symptom severity scores using standardized questionnaires
• Quality of life improvements in sleep and daily activities
• Reduction in urinary frequency, especially at night

The tissue removed during your TURP will be sent to a laboratory for examination to rule out cancer, even though TURP is primarily performed for benign conditions. Your doctor will discuss these pathology results with you during your follow-up appointment.

How to optimize your TURP recovery?

TURP recovery involves following specific guidelines that help your prostate heal properly and minimize the risk of complications. Most men can return to light activities within a few days, but complete healing typically takes 4-6 weeks.

During your initial recovery period, you'll have a catheter in place for 1-3 days to help your bladder drain while swelling decreases. This temporary catheter prevents urinary retention and allows your doctor to monitor your healing progress through the color and clarity of your urine.

Here are the key recovery guidelines that will help ensure optimal healing:

• Drink plenty of water to flush your system and prevent blood clots
• Avoid heavy lifting, straining, or vigorous exercise for 4-6 weeks
• Take prescribed pain medications and antibiotics exactly as directed
• Avoid driving until your catheter is removed and you feel comfortable
• Refrain from sexual activity for 4-6 weeks to allow complete healing
• Don't take blood-thinning medications unless specifically approved by your doctor

It's completely normal to see some blood in your urine for several days or even weeks after TURP, and this typically decreases gradually. However, you should contact your doctor immediately if you experience heavy bleeding, inability to urinate, severe pain, or signs of infection like fever or chills.

What are the risk factors for TURP complications?

While TURP is generally safe, certain factors can increase your risk of complications during or after the procedure. Understanding these risk factors helps your medical team take appropriate precautions and helps you make an informed decision about your treatment.

Age-related factors play a significant role in TURP outcomes, as older men may have additional health conditions that affect healing and recovery. Men over 80 years old may face slightly higher risks, though many older patients still have excellent outcomes with proper medical management.

Several medical conditions can increase your risk of TURP complications:

• Heart disease or irregular heart rhythms that affect anesthesia tolerance
• Blood clotting disorders that increase bleeding risk during surgery
• Diabetes that may slow wound healing and increase infection risk
• Kidney disease that affects how your body processes medications and fluids
• Previous prostate surgery that may complicate the current procedure
• Very large prostate glands that require longer surgery times
• Active urinary tract infections that need treatment before surgery

Your surgeon will thoroughly evaluate your medical history and current health status to minimize these risks. In some cases, alternative treatments might be recommended if your risk factors make TURP less suitable for your specific situation.

What are the possible complications of TURP?

TURP complications are relatively uncommon, occurring in less than 10% of patients, but it's important to understand what might happen so you can recognize symptoms and seek appropriate care if needed. Most complications are temporary and resolve with proper treatment.

The most common complications are generally mild and temporary, affecting your urinary or sexual function for weeks to months after surgery. These issues often improve on their own as your body heals and adjusts to the changes.

Here are the potential complications you should be aware of, listed from most common to least common:

• Retrograde ejaculation (semen goes into the bladder instead of out), affecting 65-75% of men
• Temporary urinary incontinence or difficulty controlling urine flow
• Urinary tract infections that may require antibiotic treatment
• Temporary erectile dysfunction that usually improves within months
• Blood in urine that persists longer than expected
• Urethral stricture (narrowing) that may require additional treatment
• Need for repeat surgery if prostate tissue regrows over time

More serious but rare complications include TURP syndrome, which occurs when irrigating fluid enters your bloodstream and affects your body's electrolyte balance. Modern surgical techniques and monitoring have made this complication extremely rare, occurring in less than 1% of procedures.

Very rarely, some men may experience permanent incontinence or complete erectile dysfunction, but these severe complications occur in less than 1-2% of cases. Your surgeon will discuss your individual risk profile based on your specific health situation and prostate characteristics.

When should I see a doctor after TURP?

You should contact your doctor immediately if you experience certain warning signs that could indicate serious complications requiring prompt medical attention. While most TURP recoveries proceed smoothly, knowing when to seek help ensures any problems are addressed quickly.

Emergency situations that require immediate medical care include complete inability to urinate, heavy bleeding that doesn't stop, severe pain not controlled by prescribed medications, or signs of serious infection. These symptoms, while uncommon, need urgent evaluation and treatment.

Contact your healthcare provider right away if you experience any of these concerning symptoms:

• Inability to urinate despite removing the catheter
• Heavy bleeding with large blood clots that persist
• Fever above 101°F (38.3°C) with chills or shaking
• Severe abdominal or pelvic pain that worsens over time
• Nausea, vomiting, or confusion that develops suddenly
• Burning sensation during urination that becomes increasingly severe
• Swelling in your legs, abdomen, or around your surgical area

For routine follow-up care, you'll typically see your urologist within 1-2 weeks after surgery, then again at 6-8 weeks to assess your healing progress and symptom improvement. These appointments are important for monitoring your recovery and addressing any concerns you might have.