You will have a tube (catheter) to drain urine from the bladder into a bag. After a TURP, your urine will have blood in it for a while. To stop blood clots blocking the catheter, fluid is passed into the bladder and drained out through the catheter. This is called bladder irrigation. The blood will slowly clear from your urine, and then the catheter can be taken out. You may find it difficult to pass urine without the catheter at first, but this will improve. You may have urinary incontinence after a TURP, but this usually improves within a few weeks. You may need to keep the catheter in for a while after you go home. This is because swelling caused by the surgery may make it difficult for you to pass urine. The nurse will show you how to look after your catheter before you leave the hospital. They can also organise for a district nurse to visit you at home to help with any problems. When the swelling goes down, the catheter can be removed. If you go home with a catheter, you may have bladder spasms. These are caused by the catheter irritating your bladder. The spasms can cause urine to bypass your catheter, so you may leak urine at times. These spasms are normal, but if they last a long time and are frequent, tell your doctor or nurse. You may find them uncomfortable.

You may have pain and discomfort for a few days after your operation. You will be given painkillers to help with this. If the painkillers are not helping, talk to your doctor or nurse. They can give you another type of painkiller.

Ejaculating into the bladder

Ejaculating into the bladder is called retrograde ejaculation. It is caused by damage to the nerves or muscles that surround the neck of your bladder. The neck of your bladder is where the urethra joins on to the bladder. It means that during ejaculation, semen goes backwards into the bladder instead of through the urethra in the normal way. After an ejaculation, your urine may look cloudy. This is because there is semen in the bladder, but this is harmless.

You may have problems getting an erection after the TURP. This is called erectile dysfunction (ED). It might depend on whether you had problems getting an erection before the operation, or if you were on hormone therapy. Your surgeon can tell you more about your risk of erection problems.

Difficulties passing urine

Sometimes, a TURP can cause some long-term difficulties with passing urine.

Surgery for advanced prostate cancer

Some people have an operation to help with the symptoms of advanced prostate cancer. Find out about the different types of surgery that may be used.

About surgery for advanced prostate cancer

Surgery can be used to help control advanced (metastatic) prostate cancer and relieve symptoms. Surgery can be used:

instead of hormonal therapy, to reduce testosterone
if the cancer is making it difficult to pass urine (pee)
to strengthen a bone.

Surgery to remove the prostate gland (radical prostatectomy) is not used to treat advanced prostate cancer. This is because a radical prostatectomy cannot cure prostate cancer once the cancer cells have spread outside the prostate gland and nearby area.

Surgery to reduce testosterone

Some people may have surgery, instead of hormonal therapy, to reduce the amount of testosterone the body produces naturally. The operation involves removing part of the testicles. This is called a subcapsular orchidectomy.

This surgery is not reversible so the hormonal effects are permanent. It is rarely done now, as most people have hormonal therapy to reduce testosterone instead.

Surgery for problems with passing urine

Surgery can be used to help if the cancer is affecting the flow of urine through your:

ureters – the tubes that drain urine from the kidneys into the bladder
urethra – the tube that you pass urine out of the body from.

Surgery for prostate cancer that is affecting the urethra is called a transurethral resection of the prostate (TURP). Surgery for prostate cancer that is affecting the ureters will either be a percutaneous nephrostomy or JJ stent.

Transurethral resection of the prostate (TURP)

Your surgeon may offer you a transurethral resection of the prostate (TURP) if you are having difficulty passing urine (peeing). A TURP is not done to treat the cancer.

The aim of the surgery is to remove the area of prostate that is pressing on the urethra. It can help you pass urine more easily again and improve symptoms.

You may have a TURP before radiotherapy to the prostate. This is because radiotherapy can make passing urine more difficult during treatment and for a while afterwards.

We have more information about having a TURP.

Percutaneous nephrostomy or JJ stent

The tubes that drain urine from the kidneys to the bladder (ureters) may get blocked by prostate cancer. This will make it difficult to pass urine (pee). If this happens, you may be offered 1 of the following types of surgery:

Percutaneous nephrostomy – the doctor, guided by a scan, puts a tube into the kidney. The tube goes into a bag that sits outside on the skin. Urine can then drain into the bag.
JJ stent, also called a ureteric stent – this is when the doctor puts a fine tube into the ureter. This opens up the ureter so urine can flow through it.

A planned percutaneous nephrostomy can often be done under a local anaesthetic with a sedative (a drug to make you relaxed and sleepy). You usually do not need to stay in the hospital overnight.

Your cancer team can give you more information about both these types of surgery.

Surgery to strengthen a weakened bone

Prostate cancer that has spread to the bones may cause problems that need treating with surgery.

If you are at risk of a broken bone, your doctor may advise surgery to repair or strengthen the bone to help prevent it from breaking in the future.

What happens after surgery?

Going home after surgery

Before you leave hospital after surgery for advanced prostate cancer, your hospital doctor will send a letter to your GP. This is called a discharge summary. It is usually sent electronically so that your GP gets it within 24 hours of your discharge. You are usually given a copy to take home with you. It will explain what type of surgery you had, any medication you are taking and about your follow-up care.

If you need a district or community nurse, the ward nurses will organise this before you go home. You should also be given 24-hour telephone numbers for your hospital team in case you need to contact them.

Your surgeon or specialist nurse can give you advice on when you can start doing things such as driving or returning to work.

Going home from hospital

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line for free on 0808 808 00 00.
Chat to our specialists online.
Visit our prostate cancer forum to connect with people who have been affected by prostate cancer, share your experience, and ask your questions.

References

Below is a sample of the sources used in our prostate cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk

Prostate cancer: diagnosis and management. NICE guideline [NG131] Published: 09 May 2019 Last updated: 15 December 2021 (accessed October 2024) https://www.nice.org.uk/guidance/ng131

Parker, C. et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, Volume 31, Issue 9, 1119–1134 (accessed October 2024) https://www.annalsofoncology.org/article/S0923-7534(20)39898-7/fulltext#articleInformation

Cancer Information Development team

Author

Dr Ursula McGovern

Reviewer

Consultant Medical Oncologist & Honorary Associate Professor

University College Hospitals, London

Date reviewed

Reviewed: 01 February 2025

Next review: 01 February 2028

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.