Prostate cancer may block the tube that drains urine from the bladder. An operation called a transurethral resection of the prostate (TURP) can help.
Your doctor may offer you a TURP if the cancer is blocking the urethra (the tube that drains urine from the bladder). The aim of the surgery is to remove the blockage, which can help with problems passing urine (peeing).
During the procedure, a thin tube that contains a cutting instrument and a tiny camera is passed through the urethra and into the prostate. The cutting instrument is used to shave off the inner area of the prostate and unblock the urethra.
This can be done under a general anaesthetic while you are asleep. Or you may have a local anaesthetic using a spinal anaesthetic (epidural). An epidural temporarily numbs the lower part of your body using an injection of anaesthetic into the spine. You are awake, but you will not feel anything.
A TURP can also be done using a special laser. This is only done in some specialist treatment centres. Your doctor will advise you if this is suitable for you and where the treatment is available.
You will be encouraged to start moving around as soon as you can after your operation. This can help reduce the risk of complications.
After a TURP, you will usually have a drip (intravenous infusion) into a vein in your arm. This will stay in for a few hours after your operation, until you are eating and drinking again. Most men can usually go home after 3 or 4 days.
- 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.
Difficulties of having a catheter
- You may find it difficult to pee (pass urine) without the catheter at first, but this will improve.
- Some men may have urinary incontinence after a TURP, but this usually improves within a few weeks.
Your catheter at home
- 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.
- You may have bladder spasms caused by the catheter irritating your bladder. The spasms can cause urine to bypass your catheter, so you leak urine at times.
- These spasms are normal, but if they last a long time and are frequent, tell your doctor or nurse. Some men find them uncomfortable.
- A district nurse can be arranged to visit you at home to help with any problems. Once the swelling goes down, the catheter can be removed.
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. There may be another type of painkiller they can give you.
Ejaculating into the bladder
This 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.
Some men may have problems getting an erection after having a TURP (called erectile dysfunction, or ED). This depends on whether you had problems getting an erection before having this operation. Your surgeon may be able to explain more about your risk of erection problems.
Difficulties passing urine
Occasionally, a TURP can cause some long-term difficulties with passing urine.