Transurethral Resection of Prostate
Transurethral resection of the prostate (TURP) is a surgical procedure by which portions of the prostate gland are removed through the urethra.
Before the Procedure
You will have many visits with your doctor and tests before your surgery:
- Complete physical exam
- Visits with your doctor to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems, are being treated well
If you are a smoker, you should stop several weeks before the surgery. Your doctor or nurse can help. Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.
During the weeks before your surgery:
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and other drugs like these.
- Ask your doctor which drugs you should still take on the day of your surgery.
On the day of your surgery:
- Do not eat or drink anything after midnight the night before your surgery.
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive at the hospital.
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
- Breathing problems
- Infection, including in the surgical wound, lungs (pneumonia), or bladder or kidney
- Blood loss
- Heart attack or stroke during surgery
- Reactions to medications
Additional risks are:
- Problems with urine control (incontinence)
- Loss of sperm fertility (infertility)
- Erection problems (impotence)
- Passing the semen into the bladder instead of out through the urethra (retrograde ejaculation)
- Urethral stricture (tightening of the urinary outlet from scar tissue)
- Transurethral resection (TUR) syndrome (water buildup during surgery)
- Damage to internal organs and structures
TURP syndrome effects 2–6% of TURP patients. Symptoms may include temporary blindness due to irrigation fluid entering the bloodstream. On very rare occasions, this can lead to seizures, coma, and even death. The syndrome may also include toxic shock due to bacteria entering the bloodstream, as well as internal hemorrhage.
BPH symptoms include:
- increase in urination frequency, and the need to urinate during the night
- difficulty starting urine flow
- a slow, interrupted flow and dribbling after urinating
- sudden, strong urges to pass urine
- a sensation that the bladder is not completely empty
- pain or burning during urination
In evaluating the prostate gland for BPH, the physician usually performs a complete physical examination as well as the following procedures:
- Digital rectal examination (DRE). Recommended annually for men over the age of 50, the DRE is an examination performed by a physician who feels the prostate through the wall of the rectum. Hard or lumpy areas may indicate the presence of cancer.
- Prostate-specific antigen (PSA) test. Also recommended annually for men over the age of 50, the PSA test measures the levels of prostate-specific antigen secreted by the prostate. It is normal to observe small quantities of PSA in the blood. PSA levels vary with age, and tend to increase gradually in men over age 60. They also tend to rise as a result of infection (prostatitis), BPH, or cancer.
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