Transurethral Resection of the Prostate (TURP)

Lithotripsy :: Chemotherapy :: Radiotherapy
Hormone therapy :: Brachytherapy :: Surgery TURP :: Laparoscopic Surgery

Prostate Surgery

Transurethral resection of the prostate gland is carried out primarily to relieve obstruction. It is not the type of operation that is usually carried out in the treatment of prostate cancer. In a great majority of cases,you will be given a spinal anaesthetic. This involves the placement of a needle into your lower back and after the injection of anaesthetic drugs; you will be completely numb from the waist down.Your anaesthetist will discuss this further with you.

The operation is performed by passing a telescopic instrument in through the eye of the penis and down the urethra into the area of the prostate. The internal lining of the bladder is also routinely inspected. A special electric knife is used to cut pieces of the prostate out and these pieces can then be flushed out. At the end of the procedure, a catheter (a plastic tube that drains urine from the bladder) is placed and usually kept in place for one to three days after the surgery.

Whilst the catheter is in place, irrigating fluid can be instilled at the same time as the urine drains into a bag. The nurses will change the irrigating fluid and bag at regular intervals.

The operation takes on average around 45-60 minutes to perform and the usual length of stay in hospital is in the vicinity of 2-3 days.

Risks of Surgery

There is a very high success rate associated with TURP, however like any surgery, there are still risks that need to be considered. The risks of having significant bleeding is very small and it is very uncommon for anybody to require a blood transfusion.There is a small risk of developing an infection in the urine, although this risk is minimised by the routine administration of antibiotics at the time of surgery. There is a tiny risk of being rendered incontinent, which means that you would not have any control over your urine at all. This is fortunately a rare complication (less than 0.5%) and even in this unlikely event, treatment is available. There is an approximately an 8-10% chance that you will lose your ability to have a penile erection and again in this event, there are very effective treatments available.

A relatively common side effect of the surgery is what is known as retrograde ejaculation - this refers to the absence of any fluid when you have a sexual orgasm.

Post-Operative Instructions

1. Drink plenty of fluids, between 2-3 litres per day, and increase further if your urine becomes deeply red (like claret).
   
   
2. Continue your usual activities but:
   1. No strenuous exercises eg. lifting laundry basket/shopping basket, suitcases.
      No lawn mowing. No gardening.
      
      
   2. No excessive bending eg. squatting to garden.
      
      
3. Walking and swimming is good for you.
   
   
4. No sexual intercourse for 4-6 weeks.
   
   
5. Continue the pelvic floor exercises for 3-4 weeks, at least 3 times per day.
   
   
6. Maintain your usual bowel habits; eat fresh fruit, roughage. Take a softening laxative if your motion is hard.
   
   
7. You may experience some urgency to pass urine and some dribbling for a few weeks surgery. This should settle spontaneously.
   
   
8. Blood may be present in your urine first thing in the morning, which usually clears within 2 weeks of surgery. If fresh bleeding with clots does occur and does not clear within 24 hours, contact your doctor.
   
9. On about the 10th-14th day after your operation some patients pass blood and clots - this is quite normal, don't worry unless it becomes excessive or you are having trouble passing urine.
   
   
10. Contact Dr. Justin Vass if you have any concerns

** When you next visit Dr. Justin Vass, check if you are to continue to follow these guidelines.