Transurethral Resection of the Prostate

(TURP)

TURP, or Transurethral Resection of the Prostate, is a surgical procedure used to alleviate the symptoms of an enlarged prostate or BPH by shaving away excess prostatic tissue using electrical energy. Once the most performed BPH procedure in the United States, TURP has declined in large part due to newer procedures that address some of TURP’s shortcomings. That said, TURPs are still performed and remain an option for patients who have severe BPH and have not seen relief from other therapies

How Does a TURP Work?

A TURP is performed in a hospital setting and under general anesthesia. First, a resectoscope is inserted into the urethra (the tube through which we pee) and threaded up to the level of the prostate.

Traditionally, monopolar electricity was used to begin shaving away prostatic tissue. Using water to irrigate the prostate, the procedure could only be performed for about 30 minutes without interruption.

Newer technology, using bipolar electrical current, uses a continuous arc of electricity to shave away excess prostatic tissue, all under direct visualization by the urologic surgeon via a tiny high-definition camera. This allows for saline irrigation of the prostate, meaning TURP is viable for longer, continuous surgeries when needed and has fewer complications than ever before. The procedure lasts approximately 60 to 90 minutes, and patients will, at times, remain in the hospital overnight for observation.

Recovery and Aftercare

Most patients experience some discomfort, but little pain after their procedure, and all will be sent home with a catheter that can be removed within a few days (please refer to post-op instructions).

Modern TURP technology has reduced the risks and considerations of the procedure; however, common risks and considerations include:

Blood in the urine will steadily improve over a month or so.
Retrograde ejaculation or a dry orgasm in almost all men. This means that semen is pushed into the bladder after orgasm. Sexual function and sensation are not otherwise affected.
Approximately 1% risk of incontinence.
Pain
Infection

As with any BPH treatment, it takes up to 3 months for the bladder to adjust to the lack of obstruction, during which patients can expect inconsistent urination.

TURP is safe and durable. However, prostatic tissue is constantly growing as we age. Most patients can expect up to 15 years of relief after the procedure, at which point they may require further treatment.

The Bottom Line

Transurethral resection of the prostate, or TURP, is no longer the most popular BPH treatment, as newer procedures address some of its downsides, like retrograde ejaculation and requiring a hospital stay. Some of these minimally invasive and convenient procedures include iTind, GreenLight Laser therapy, Optilume, Prostate Artery Embolization (PAE), Rezum, and Urolift.

For smaller and larger prostates alike, hospital-based options such as Aquablation (also a form of TURP but using high-pressure water jets) can be used to avoid retrograde ejaculation entirely since it is not a heat-based procedure. Ultimately, the decision on how to treat an enlarged prostate is dependent on the specific anatomy as well as a consultation with a qualified urologic surgeon.

Remember that any stage and severity of BPH is treatable, and you do not need to suffer any longer with the sometimes significant symptoms and lifestyle impediments associated with an enlarged prostate.