Transurethral resection of the prostate

A transurethral resection of the prostate (TURP) is a surgical procedure that involves cutting away a section of the prostate gland.

It is often used to treat prostate enlargement (benign prostate hyperplasia).

A TURP may be necessary if:

• the first treatments for prostate enlargement, such as medication, fail to control symptoms - this occurs in around one in 10 men
• an enlarged prostate leads to complications - such as bladder stones or a bladder infection, because the man is unable to empty his bladder properly

Read more information about why a TURP may be necessary.

How it is performed

A TURP is performed under general or spinal anaesthesia, so you will not feel any pain during the procedure.

The surgeon will insert a thin metal wire with a loop at the end into your urethra and up against your prostate. An electrical current is then used to heat the loop, which cuts away a section of your prostate.

Read more about how a TURP is performed.

Recovery

Most men can leave hospital two to three days after surgery and resume most normal activities within one week.

However, it can take up to six weeks before you are fit enough to return to work if your job is physically strenuous.

Read more about recovering from a TURP.

Advantages

Most men who have a TURP find it improves both their symptoms and quality of life.

You should notice the symptoms that bothered you before are no longer there, or are present to a much lesser extent. For example:

• you should no longer need to strain to urinate
• you should be able to go about your normal activities without having to worry about being near a toilet
• you should be more in control of holding your urine in
• you may not need to get up in the night to urinate as much as you used to
• you should also notice you have a stronger stream of urine
• you may no longer need to wear incontinence pads if you do so already

Disadvantages

In most cases, a TURP is a safe procedure and the risk of serious complications occurring during surgery is very small.

However, many men who have had a TURP lose the ability to ejaculate semen during sex or masturbation, although they still have the physical pleasure associated with ejaculation (the climax). This is known as retrograde ejaculation, and can occur in as many as 9 out of 10 cases.

Also, many men temporarily lose the ability to control their bladder (they develop urinary incontinence), although this usually passes a few weeks after surgery. In rare cases, urinary incontinence may be persistent and need further treatment. As with all surgery there is a risk of infection and bleeding afterwards, which may need additional treatment.

Read more detailed information about the disadvantages of TURP.

Alternatives

There are a number of alternatives to a TURP. Some are not suitable for all men with prostate enlargement and may not be as effective in the long term.

They include the following.

• Holmium laser enucleation of the prostate (HOLEP) - a laser is used to separate excess tissue from the prostate into the bladder and the tissue is then removed. HOLEP causes less blood loss, involves a shorter stay in hospital and is suitable for moderate to large prostates. Access to this type of treatment is currently limited in England.
• Potassium-titanyl-phosphate (KTP) laser vaporisation of the prostate - this involves placing a small fibre optic cable into the urethra (the opening through which you pass urine) and up towards the prostate. Lasers can then be directed out of the fibre optic cable and used to burn away excess prostate tissue.

Both HOLEP and KTP laser vaporisation of the prostate may be more suitable for very large prostates, older men who are not fit, or for those using blood thinning medication such as warfarin.

Read more about the alternatives to TURP.