Transurethral resection of the prostate (TURP)

The expected outcome of the TURP procedure is improved urination, less residual urine after urination, decrease in urination disorders (e.g. urination at night), better urine stream and urination time. The tissue excised during the procedure is sent for histopathology tests.

Benign prostatic hyperplasia (BPH) may be treated with an open procedure (Milin, Juvar methods) or through the urethra. We recommend the open approach when the hyperplasia is large (over 80 cm3).

Transurethral techniques include:

• electrical resection (TURP),
• transurethral ultrasound-guided laser-induced prostatectomy (TULIP), where the BPH is removed with laser,
• transurethral microwave therapy (TUMT), where microwave energy is used to reduce the size of BPH.

Two weeks before the procedure you should have the following blood tests done: full blood count, electrolyte test, coagulation test, blood type, glucose, creatinine, Hbs antigen, ANTI-HCV.

The procedure is performed under local or general anaesthesia. The decision is taken by an anaesthetist before the procedure. During the surgery the patient is placed in the lithothomy position (on the back, with legs bent at the knees and aside). During the procedure part of the prostate which obstructs urination and causes the symptoms reported by the patient is removed. It must be remembered that the prostate is not removed completely. Only a part of it is removed. After the procedure a urinary catheter is left in the urethra for 2 to 3 days.

After the catheter is removed you may feel pain and burning in the urethra and bladder. You may also experience a frequent need to urinate and see blood in your urine. You may also have urinary incontinence. These conditions are usually temporary. The electrical resection procedure is relatively safe, but in some cases there may be complications, such as intra- and post-operative bleeding, which requires blood transfusion; infection, which may be a result of hyperplasia; TURP syndrome, which may cause damage to internal organs; recto-urethral fistula; post-operative urinary tract infection; urethral stricture; urinary incontinence; erection disorders; possible failure of the treatment; disease recurrence. Some of the above complications may require a repeat surgery or an open surgery. After the procedure you may experience retrograde ejaculation. This means that during the ejaculation the semen does not emerge through the urethra, but is redirected to the bladder lumen. It is removed from the bladder during urination.
A follow-up visit 14 days after the procedure is recommended to evaluate the treatment and talk about histopathology results.