Definition:
Transurethral resection of the prostate (TURP) is a surgical procedure performed to remove the section or part of enlarged prostate gland that is blocking the urine flow through urethra. The enlarged prostate is more common in aged men known as Benign Prostatic Hyperplasia (BPH).
Why it needed?
TURP is mostly advised to patients suffering from symptoms due to enlarged prostate (BPH). The symptoms of BPH includes
- Acute urinary retention
- Recurrent urinary tract infection
- Prostate bleeding
- Kidney damage
- Increased urinary frequency, with need to urinate during night
- Slow interrupted flow and dribbling after urination.
- Has to wait long before passing urine or sudden uncontrollable urge to pass urine
Facts and figures
- Men over the age of 40 are prone to get prostate disease. BPH gradually develops with the age in about 80% of all men.
- In United states more than 30,000 men die because of prostate cancer each year
- Today TURP is considered as the “Gold Standard “ among all available treatments for BPH
- Fabian was the first person to describe about the use of intraprostatic stents for the treatment of outlet obstruction secondary to BPH in 1980
Advantages
- High success rate- surgery reduces symptoms in 88% of BPH patients.
- Most patients usually notice improvement in urine flow as soon as the catheter is removed
- Most patients are satisfied with the outcome of the surgery with the disappearance of the pain while urinating, bladder spasms etc, and can have uninterrupted and peaceful sleep at night.
Disadvantages
- After the surgery about 15-20% of patients need to go for another surgery within 10 years.
- Some patients have also report temporary urinary incontinence and impotency after the TURP operation
- Chances of semen going in to bladder instead of out through urethra, in some cases
- Transurethral resection syndrome or urethral stricture
Risk and complications associated with TURP includes
- Anesthesia or medication reaction
- Blood clots
- Breathing problems
- Post operative urinary tract infection
- Bleeding
- Scar tissue
- Damage to adjacent organ and tissue
Preoperative Preparation
- Complete physical examination
- Blood and urinalysis
- Digital rectal examination (DRE)
- Prostate-specific antigen (PSA) test
- Visit to a physician and have a list of the medicines which are to be taken or needed to be stopped before surgery
- Inform surgeon related to any habits of smoking or alcohol
- Arrangement for leave from work, help at home, help with driving, and for post operative rehabilitation
- Do not eat or drink anything after midnight the night before surgery
- Medical tourist is advised to select handicapped accessible hotel room near the hospital for post surgery recovery.
Post operative care
- After the surgery patients needs to stay in hospital for about1- 3 days. A patient will have catheter placed to pass urine for first 1-3 days, which will be removed as the urine is clear from blood.
- Patient may have pain and incontinence of urination for about 6 weeks after the surgery
Dos, Don’ts and Precautions
- Do practice good hygiene like washing hands and penis
- Take adequate rest
- Do take laxative to avoid constipation
- Drink plenty of fluids and eat high fibers food
- Avoid sexual activity for about 6 weeks after the surgery
- Avoid alcohol drink
- Don’t drive for 1-2 weeks
- Avoid strenuous activity for about 6 weeks
Most patients are fully recovered and can resume their work about 6-8 weeks post surgery
Open Prostatectomy
Open Prostatectomy is a surgical procedure performed to remove an enlarged (non cancerous ) prostate gland. It is performed when the gland is so enlarged that it can not be treated with TURP. This procedure required slightly longer stay in hospital compare to TURP. The surgery reduces the possibility of the other surgery. The surgery is contraindicated for the patient of prostate cancer.
