Prostate Resection (TURP)

Transurethral resection of the prostate (TURP) is a surgical procedure for men that is used to treat urinary problems caused by an enlarged prostate. This common condition causes pressure on the bladder and urethra, resulting in difficulty with passing urine.

Prostate problems are common in men 50 years and older. Most can be treated successfully without harming sexual function.

Causes of an Enlarged Prostate

The exact cause of an enlarged prostate (benign prostate hyperplasia or BPH) is still not entirely clear, although it generally occurs due to an increase in the number of cells in your prostate gland that are thought to be caused by hormonal changes as you get older.

An enlarged prostate is uncommon in men aged under the age of 45, but by the age of 60; 4 out of 10 men are affected, and by the age of 90; 9 out of 10 men have an enlarged prostate.  A TURP procedure is usually recommended when prostate enlargement causes irritating symptoms and does not respond to treatment with medication.

Symptoms

The level of symptoms in people who have prostate gland enlargement varies, but symptoms tend to worsen over time.  Common symptoms of an enlarged prostate include:

• Problems when starting to urinate
• A weak urine flow or stopping and starting
• Having to strain to pass urine
• Waking up frequently during the night to urinate
• A sudden urge to urinate
• Being unable to empty your bladder entirely
• Other symptoms include:
• Urinary tract infection
• Inability to urinate
• Blood in the urine

The size of your prostate does not control the severity of your symptoms.  Some men with marginally enlarged prostates can have significant symptoms, whilst others with much enlarged prostates may only have slight symptoms.

Diagnosis

Your doctor will start by asking detailed questions about your symptoms and will likely perform a rectal examination to ensure there are no nodules, as well as to evaluate the size of the prostate.  The initial exam is likely to include:

• Digital rectal exam
• Urine test
• Blood test
• Prostate-specific antigen (PSA) blood test

Doctors don’t generally treat an enlarged prostate unless the symptoms are bothersome or causing infections.  If necessary, your doctor may give you a particular medication to treat it.  Certain medications relax parts of the prostate and bladder to improve urine flow, whilst other medications reduce the size of the prostate.  If medication fails to improve the symptoms, you may need surgery.

Treatment

If medications do not not relieve your symptoms or you have a reaction to them, your doctor may suggest you have a TURP procedure.

A TURP procedure is a minimally invasive surgery, lasting approximately 1-2 hours.  A lighted scope is inserted into your urethra, until it reaches your prostate.  The surgeon then heats a loop of wire with an electric current and uses it to cut away the section of your prostate which is causing discomfort and irritation.  A thin tube (a catheter) is then inserted into your urethra to pump fluid into the bladder and flush away pieces of prostate that have been removed.

You will be given either a general or spinal anaesthesia before surgery so you do not feel any pain whilst the surgery is being carried out.

TURP surgery generally relieves symptoms fairly quickly, and most men have a stronger urine flow soon after the procedure.  Your doctor will discuss with you what will happen before, during and after your operation; this is your opportunity to ask any questions you have so that you have a full understanding of the procedure you are about to undergo.

Recovery

You should expect to be in hospital from 1 – 3 nights when you undergo TURP surgery, depending on your rate of recovery.  When you are ready to leave hospital, you will need to arrange for someone to drive you home.  When in recovery, if you need pain relief after your procedure, you can take over-the-counter painkillers, such as paracetamol or ibuprofen.

It can take between 4-8 weeks to fully recover from your procedure, and most people wait 2-3 weeks before going back to work.  It is always best to follow the advice given by your doctor.  To support your recovery, your doctor may suggest that you do pelvic floor exercises.  These exercises can help you to control your urine flow and stop any leakage.  You will be given direction from the hospital on how to do them and how often.  It is recommended that you do not undertake any strenuous activity for approximately 4 weeks post-surgery.

Complications

As with any procedure, there are some risks associated with transurethral resection of the prostate.  In most cases, it is a safe procedure and the risk of serious complications is very small. Possible complications can include:

Retrograde Ejaculation

Many men who undergo a TURP lose the ability to ejaculate semen during sex or masturbation, although they will still enjoy the physical pleasure linked with ejaculation. This can affect up to 7 out of 10 men.

Urinary Incontinence

Many men also temporarily lose their ability to control their bladder, however it usually passes within a few weeks. There are rare cases though where further treatment may be required.  

Erectile Dysfunction

Not being able to get an erection can happen in 1 out of 10 men. This is more likely to be connected to symptoms experienced before the surgery, rather than initiated by the a TURP procedure.

TURP Syndrome

This is a rare but possible serious risk associated with a TURP. It occurs when the fluid used to flush your bladder during your procedure gets into your bloodstream. It can cause breathing difficulties, confusion and sickness. It can affect up to 2 in 100 men, but is becoming much fewer as a different fluid is generally used these days.

Need Help?

At One Healthcare we can book you in to see a specialist Urology surgeon, usually within 48 hours, for an initial consultation.  Prostate resection is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Prostate Resection (TURP) treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

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