Transurethral resection of the prostate (TURP)
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 prostate cancer is blocking the urethra. This is 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 and improve your symptoms.
You may have a TURP before radiotherapy. Radiotherapy can make passing urine more difficult during and after treatment.
Your doctor and nurse will talk to you about the advantages and disadvantages of having a TURP. They will explain what to expect before your operation.
A TURP can be done under a general anaesthetic. Or, you may have a spinal anaesthetic (epidural). You have an injection of anaesthetic into your spine. This temporarily numbs the lower part of your body, so you do not feel anything.
During surgery the surgeon passes a thin tube, which contains a cutting instrument and tiny camera, through the urethra into the prostate. They use the cutting instrument to shave off the inner area of the prostate and to unblock the urethra.
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.
You will be encouraged to start moving around as soon as you can after your operation. This can help reduce the risk of complications. We have more information about what to expect after surgery.
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.
You will also have a tube (catheter) to drain urine from the bladder into a bag.
Your urine will have blood in it for a while after a TURP. To stop blood clots blocking the catheter your nurse will pass fluid into the bladder which drains out through the catheter. This is called bladder irrigation. It helps to wash out your bladder. The blood will slowly clear from your urine.
Removing the catheter
When the blood has cleared, the catheter can usually be removed. You may find it difficult to pass urine at first. Sometimes the catheter needs to be put back in again. This is only until swelling caused by the surgery goes down and you can pass urine without difficulty. You may need to have the catheter in for a while after you go home.
You may find you leak some urine (incontinence) after a TURP. But this usually improves within a few weeks.
You may have pain and discomfort for a few days after your operation. You will be given painkillers to help with this. If they do not help, tell your doctor or nurse. They can give you another type of painkiller.
You can usually go home 3 or 4 days after the TURP. It will take a few weeks to recover from surgery so you will need to take it easy at first. It is important to follow the advice your doctor or nurse gives you.
If you need to go home with the catheter the nurse will show you how to look after it. When the swelling from surgery goes down, the catheter can be removed.
You may have some long term effects after a TURP operation. Your doctor or nurse can explain these.
Ejaculating into the bladder
This is called retrograde ejaculation. It is caused by damage to the nerves or muscles surrounding the neck of your bladder (where the urethra joins to the bladder). When you ejaculate, semen goes backwards into the bladder instead of through the urethra in the normal way. Your urine may look cloudy 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. Your surgeon can tell you more about your risk of erection problems.
Difficulties passing urine
Sometimes, TURP can cause some long-term difficulties with passing urine.
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 firstname.lastname@example.org
C. Parker, E. Castro, K. Fizazi, et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2020, Volume 31, Issue 9, p1119-1134. Available from www.esmo.org/guidelines/genitourinary-cancers/prostate-cancer
National Institute for Health and Care Excellence (2019) Prostate cancer: diagnosis and management (NICE guideline NG131) Available at www.nice.org.uk/guidance/ng131
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