Transurethral Resection of the Prostate (TURP)

Transurethral Resection of the Prostate (TURP)

Benign prostatic hyperplasia (BPH) is very common. It will affect 50% of men between the ages of 51-60 and up to 90% of men over the age of 80.  Common symptoms include frequent urination, urgency, difficulty emptying the bladder or starting urination.  This procedure is particularly important in men when have kidney failure due to poor bladder emptying or trouble with urinary infections and/or bladder stones.  Transurethral resection of the prostate (TURP) is considered the gold standard for the surgical management of BPH. Approximately 150,000 men have this procedure each year.

It is performed under spinal or general anesthesia. The urologist inserts an instrument called a resectoscope through the penis into the urethra. This instrument uses fluid and a light source to visualize the prostate, as well as an electrical loop that is used to shave out the obstructing prostate tissue. This loop is then used to cauterize and seal any bleeding blood vessels. The resected tissue is irrigated into the bladder and then removed and sent to a pathologist to examine under a microscope. You can think of the prostate as an orange and the obstructing tissue is the inner substance of the orange. The goal is to “shave out” the substance of the orange without injuring the “orange peel” or capsule of the prostate. At the end of the procedure, a catheter is placed into the bladder and is used to continuously irrigate the bladder with fluid. It is typical for a patient to go home the following day or two. It is possible to sometimes go home the same day in some circumstances when a bipolar TURP is performed. There is no surgical incision, and the entire procedure is performed through the penis. The catheter often stays in for a few days and may be removed either at home or in the urologist’s office. When a patient goes home with a catheter, the catheter is attached to a leg bag for convenience. Instructions will be given before one leaves the hospital.