Transurethral resection of the prostate

TURP (transurethral resection of the prostate), partial removal of the prostate through the urethra.

Preparation for the procedure

Depending on your age and state of health, and on doctor’s advice, you must undergo a few pre-operative tests. These are preferably done before you are admitted.

• A blood draw
• A urine analysis
• A thorax X-ray: X-rays of the lungs
• An ECG or electrocardiogram: a recording of the heart’s activity

Blood thinners must be stopped at least a week before the procedure.

Because you will be under anaesthetic, you will have to fast from midnight:

Type of food:	Example:	Allowed until at the latest:
Normal meal		midnight before the surgery or examination
Light meal	e.g. a sandwich or toast with jam. Deep-fried/fatty foods or meat are not included	six hours prior to the procedure or examination
Dairy products	Milk, bottle-feeding for a child, yogurt...	six hours prior to the procedure or exam
Breastfeeding		four hours prior to the procedure or examination
Drinks	As wished: water, sugar water, sports drinks, clear fruit juices without pulp (apple juice, grape juice) Maximum a cup: clear tea and coffee without milk .	Recommended: continue to drink up to two hours before the procedure or examination (Exceptions: gastrointestinal surgery. You should follow the instructions of your attending physician). No milk products

Procedure

TURP, or the partial removal of the prostate through the urethra, remains the gold standard. Although various surgical and pharmaceutical alternatives have been developed, the TURP procedure is still the standard procedure. Large studies have demonstrated that approximately 90% of men retain a positive result up to at least ten years after the surgery.

Using a scope, tissue is scraped off the prostate through the urethra to hollow out the central gland tissue, ultimately leaving only the prostate capsule. The prostate wall is left in place to allow the prostate to regrow.

You will be away from your room for four to six hours. This includes the time you will spend in the recovery room after the operation.

In consultation with the anaesthetist, you can have a general or partial anaesthetic. For a partial or spinal anaesthetic, you will receive an injection of medication near the spinal cord that numbs your lower body.

It is normal that the externally visible ejaculation is lost. Losing the external ejaculation does not mean that impotence occurs.

After the procedure

After the procedure, an IV line will remain in place for the administration of fluids and (pain relief) medication. A urinary catheter remains in place to drain urine and allow for the possibility of bladder irrigation.

You will remain in bed during the first hours after the anaesthesia. In the case of epidural anaesthesia (through a spinal jab), you must remain in bed for at least six hours. Both in case of a general anaesthetic and a spinal block, you are only allowed to drink something in the evening. You are allowed to have regular meals the following day.

Apart from blood thinners, you are allowed to take your regular medication after the procedure. The IV line and catheter will be removed pending the advice of the clinician. After the urinary catheter has been removed, it is important to drink sufficiently, that is at least 1.5 litres a day. After the urinary catheter is removed, you will be administered an antiseptic (medication to disinfect the urine). You need to continue taking this medication at home according to the prescription.

After your discharge from hospital, you may occasionally notice a bit of blood in your urine. This is a normal phenomenon and may occur up to six weeks after the procedure. It is therefore important that you drink enough to ensure sufficient irrigation of the bladder. However, if extensive clot formation still occurs the urethra may become blocked, making passing urine impossible. If this happens you must contact your GP or urologist. Contact your physician too if you develop a high fever (higher than 38°C). A light fever after the operation is normal in most circumstances.

It is advisable to avoid cycling, sex and strenuous activity until four weeks after the procedure.

Your urologist will usually ask you to come in for a check-up after the procedure. You may be given an appointment for this when you are discharged from the hospital. It is recommended to arrive for your appointment with a full bladder. This will allow for a urine test for objective verification of the result.

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Latest publication date: 13/08/2024
Supervising author: Dr Ameye Filip