Surgery for advanced prostate cancer

Some men may have surgery to remove their testicles (an orchidectomy). The aim of removing the testicles is to reduce the levels of testosterone in the body, so this is discussed in the section about hormonal therapies|.

Make sure that you have discussed any operation fully with your doctor beforehand. It’s important that you understand what it involves, including the chances of success, the likely side effects, and whether there are other treatment options that may be more appropriate to your particular circumstances.  

Benefits of a TURP Can help relieve symptoms that occur when passing urine.

Risks of a TURP There is a small risk of urinary incontinence. Some men have problems getting an erection after a TURP.

Trans-urethral resection of the prostate (TURP) Back to top

A TURP is carried out if part of the tumour is blocking the tube that drains urine from the bladder (the urethra). A tube which contains a miniature microscope is passed through the urethra, into the prostate. A cutting instrument attached to the tube is then used to shave the inner area of the prostate to remove the blockage.

This can be done under a general anaesthetic or with an epidural. An epidural temporarily numbs the lower body by injecting an anaesthetic into the spine, so that you can’t feel anything even though you are awake.

A TURP can’t remove all of the cancer cells and is only used to relieve problems with passing urine.

After your TURP

After your operation you will probably be up and about the next day. You will usually have a drip giving fluid into your vein. This will be taken out as soon as you are drinking normally. A tube (catheter) will drain fluid from your bladder into a collecting bag. It is usual for the urine to contain blood.

Bladder irrigation may be used to stop blood clots from blocking the catheter. Fluid is passed into the bladder and drained out through the catheter. The blood will gradually clear from your urine and the catheter can be taken out. At first you may find it difficult to pass urine without the catheter, but this should become easier. Some men find that they have some incontinence of urine following this procedure. It can also cause some long-term difficulty in passing urine.

Most men are able to go home after three or four days. Occasionally you may need to keep the catheter in for a while after you go home. If this is the case, the nurse will show you how to look after your catheter before you leave hospital, and arrangements can be made for a district nurse to visit you at home to help with any problems.

You may have pain and discomfort for a few days after your operation. You will be given painkillers, which are usually very effective. If you continue to feel pain it’s important to let the doctor or nurse looking after you know as soon as possible so that a more effective painkiller can be found.

Following a TURP about 1 in 5 men may have retrograde ejaculation. This means that during ejaculation semen goes backward into the bladder, instead of forward through the urethra, so your urine may look cloudy after sex. This is harmless.

Care after an operation Back to top

If you think that you might have any difficulties coping at home after your operation, let your nurse or social worker know when you are admitted to hospital so that help can be arranged. As well as being able to offer practical advice, many social workers are also trained counsellors who can offer valuable support to you and your family, both in hospital and at home. If you would like to talk to a social worker, ask your nurse or doctor to arrange it for you.

Before you leave hospital you will be given an appointment to attend an outpatient clinic for your post-operative check-up. This is a good time to discuss any problems you may have.