Transurethral resection of the prostate (TURP)

Transurethral resection of the prostate (TURP) is a surgical procedure commonly used to treat benign prostatic hyperplasia (BPH), a condition where the prostate gland enlarges and causes urinary symptoms. During a TURP, a urologist uses a special instrument to remove excess prostate tissue that is blocking the urethra, thus improving urinary flow.

When is the Surgery needed?
TURP is primarily indicated for the treatment of benign prostatic hyperplasia, a non-cancerous enlargement of the prostate gland. As men age, the prostate gland often undergoes hypertrophy, leading to various urinary symptoms. These symptoms can include urinary hesitancy, weak urine flow, frequent urination, nocturia (frequent nighttime urination), and a sensation of incomplete bladder emptying. When these symptoms become bothersome or significantly affect a patient's quality of life, TURP may be recommended.

The Surgical Technique
TURP is typically performed under either general or regional anesthesia, depending on the patient's medical condition and the surgeon's preference. The procedure is minimally invasive, as it involves accessing the prostate gland through the urethra, eliminating the need for external incisions.

The key instrument used during TURP is the resectoscope. This thin, tube-like device contains a light source, a camera, and a cutting loop. The resectoscope is inserted through the urethra, allowing the surgeon to visualize the prostate gland's interior on a monitor. The surgeon then carefully trims away excess prostate tissue using the cutting loop, thereby relieving the urinary obstruction.

The removed tissue is sent for histopathological examination to ensure that it is indeed benign and not indicative of prostate cancer. This step is crucial for ruling out malignancy, as BPH symptoms can sometimes overlap with those of prostate cancer.

Potential Complications
While TURP is generally considered safe and effective, like any surgical procedure, it carries potential risks and complications. Some common complications associated with TURP include:

• Bleeding: It's not uncommon to experience some blood in the urine after TURP. This typically resolves within a few days, but in rare cases, significant bleeding may require additional intervention.
• Urinary Retention: Some patients may experience temporary difficulty urinating immediately after the procedure. A catheter is often placed to relieve this issue and is usually removed within a few days.
• Infection: Although rare, urinary tract infections can occur post-TURP. Patients are often prescribed antibiotics to prevent this complication.
• Erectile Dysfunction: TURP may lead to erectile dysfunction in some cases, but this is more common in patients who had pre-existing erectile difficulties.
• Retrograde Ejaculation: TURP can disrupt the normal ejaculation process, causing semen to flow backward into the bladder instead of exiting the urethra. While this doesn't pose a significant health risk, it can affect fertility.
• Stricture Formation: In a small number of cases, scar tissue (strictures) may develop in the urethra, leading to urinary blockage.
• Incontinence: Temporary urinary incontinence can occur after TURP but is usually short-lived.

Post-Operative Care
Following a TURP procedure, patients are closely monitored during their hospital stay. They are typically encouraged to drink plenty of fluids to help flush the bladder and reduce the risk of blood clots. Pain medication and antibiotics may be prescribed as needed. Most patients can resume normal activities within a few weeks, but strenuous activities should be avoided during the initial recovery period.

Regular follow-up appointments with the urologist are essential to monitor progress and address any concerns. It's crucial for patients to promptly report any signs of infection, excessive bleeding, or worsening urinary symptoms.

Outlook
Transurethral resection of the prostate (TURP) is a well-established surgical procedure for managing benign prostatic hyperplasia. While it comes with potential risks and complications, it has proven to be highly effective in alleviating bothersome urinary symptoms and improving the quality of life for countless men. Patients considering TURP should discuss the procedure thoroughly with their healthcare provider, weighing the potential benefits against the risks, to make an informed decision about their treatment plan.