Transurethral resection of the prostate, commonly known as TURP, is a surgical procedure used to treat urinary problems caused by an enlarged prostate. This condition, known as benign prostatic hyperplasia (BPH), is quite common in older men. As the prostate gland enlarges, it can block the flow of urine from the bladder, leading to a range of uncomfortable symptoms.

TURP is considered the gold standard for treating BPH. It has been used for decades, offering relief from symptoms and improving quality of life for countless men. In this blog, we will explore how the TURP procedure is done, step by step. We will also discuss what to expect during recovery and why this procedure remains a popular choice for treating BPH.

Preparing for the TURP Procedure

Before undergoing TURP, you will need to prepare for the surgery. First, your doctor will conduct a thorough medical evaluation. This evaluation includes a physical exam, blood tests, and possibly imaging studies of the prostate. Additionally, your doctor may ask you to stop taking certain medications that could increase the risk of bleeding during surgery.

In the days leading up to the surgery, your doctor may instruct you to follow a specific diet or limit food and drink. On the day of the surgery, you will likely be asked to arrive at the hospital or surgical center a few hours before the procedure.

Anesthesia: Ensuring Comfort During Surgery

TURP is typically performed under either general anesthesia or spinal anesthesia. General anesthesia will put you to sleep during the procedure, while spinal anesthesia numbs the lower half of your body, allowing you to remain awake but pain-free.

Your anesthesiologist will discuss the best option for you, taking into account your medical history and personal preferences. Regardless of the type of anesthesia used, the goal is to ensure that you remain comfortable and free from pain throughout the surgery.

Step-by-Step: How TURP Is Performed

The TURP procedure is done through the urethra, the tube that carries urine from the bladder out of the body. This means that there is no need for an external incision, which helps reduce recovery time and the risk of complications.

Here’s a step-by-step overview of how the TURP procedure is done:

1. Insertion of the Resectoscope: The surgeon begins by inserting a specialized instrument called a resectoscope into the urethra. This instrument is about 12 inches long and contains a light, camera, and a wire loop for cutting tissue. The camera allows the surgeon to see inside the urethra and bladder on a monitor.
2. Resection of Prostate Tissue: Once the resectoscope is in place, the surgeon uses the wire loop to remove small pieces of the enlarged prostate tissue. The wire loop cuts and cauterizes the tissue, which helps to control bleeding. As the surgeon removes tissue, it is flushed into the bladder with a sterile solution.
3. Tissue Removal: After enough tissue has been removed to relieve the blockage, the surgeon flushes the bladder to remove the tissue pieces. This step ensures that the urethra and bladder are clear, allowing for normal urine flow.
4. Insertion of a Catheter: Once the procedure is complete, the surgeon inserts a catheter into the urethra to help drain urine from the bladder. The catheter is usually left in place for a few days to allow the area to heal and to prevent urinary retention.

What to Expect After TURP

After the procedure, you will be moved to a recovery area where you will be monitored as the anesthesia wears off. Most patients stay in the hospital for one to two days following the surgery. During this time, the catheter remains in place, and you may receive medication to manage pain or prevent infection.

It’s normal to experience some discomfort and blood in your urine for a few days after the procedure. However, these symptoms should gradually improve as you heal. Your doctor will provide specific instructions on how to care for the catheter and what activities to avoid during recovery.

Recovery and Aftercare

The recovery process after TURP can vary from person to person. Most men are able to return to normal activities within a few weeks. However, it’s important to follow your doctor’s advice to ensure a smooth recovery.

Here are some tips for a successful recovery:

1. Rest and Take It Easy: Avoid strenuous activities, heavy lifting, and sexual activity for several weeks after the surgery. Your body needs time to heal, and overexertion can lead to complications.
2. Stay Hydrated: Drinking plenty of fluids, particularly water, helps flush out the bladder and prevents infection. However, avoid caffeine and alcohol, as they can irritate the bladder.
3. Follow-Up Appointments: Attend all scheduled follow-up appointments with your doctor. These appointments are important for monitoring your recovery and addressing any concerns you may have.
4. Watch for Complications: While complications are rare, it’s important to be aware of potential issues. Contact your doctor if you experience heavy bleeding, severe pain, fever, or difficulty urinating.

Benefits of TURP

TURP offers several benefits for men with BPH. First and foremost, it provides significant relief from urinary symptoms. Most men experience improved urine flow, reduced frequency of urination, and better bladder control after the procedure.

In addition, TURP is a minimally invasive procedure, meaning there are no external incisions. This results in a quicker recovery time compared to open surgery. Furthermore, TURP has a high success rate, with most men enjoying long-term relief from their symptoms.

Risks and Potential Complications

Like any surgical procedure, TURP carries some risks. However, serious complications are rare. Potential risks include infection, bleeding, and issues related to anesthesia. In some cases, men may experience temporary urinary incontinence or erectile dysfunction after the procedure.

It’s important to discuss the potential risks with your doctor before deciding to undergo TURP. Your doctor can help you weigh the benefits and risks based on your specific situation.

Alternatives to TURP

While TURP is the most common procedure for treating BPH, there are alternatives. Some men may benefit from other minimally invasive procedures, such as laser surgery, transurethral microwave therapy (TUMT), or transurethral needle ablation (TUNA). These alternatives may be suitable for men who are not good candidates for TURP or who prefer a different treatment approach.

In addition, medication is an option for managing mild to moderate symptoms of BPH. However, medications may not be as effective as surgery for severe cases of BPH.

Conclusion

The TURP procedure is a highly effective treatment for relieving symptoms of an enlarged prostate. By understanding how the procedure is done, what to expect during recovery, and the benefits and risks, you can make an informed decision about your treatment options.

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