Transurethral resection of the prostate, usually called TURP, has been used to treat an enlarged prostate for many decades. It remains a standard against which newer procedures are compared. Even if you are considering a different treatment, understanding TURP helps you weigh up the options.
What TURP involves
TURP removes the inner part of the prostate that is pressing on the urethra. There are no cuts on the skin. Instead, a thin instrument called a resectoscope is passed up the urethra through the penis.
The surgeon uses an electrical loop at the tip to shave away small pieces of prostate tissue. The pieces are washed into the bladder and removed at the end. The remaining tissue is sealed to reduce bleeding.
There are two main types:
- Monopolar TURP: the traditional technique.
- Bipolar TURP: a newer version that uses saline fluid, which lowers the risk of a rare complication caused by fluid absorption.
On the day of surgery
TURP is done under general anaesthetic or a spinal anaesthetic, which numbs the lower body. The operation usually takes about an hour. Afterwards, a catheter is placed in the bladder to drain urine. Fluid may be washed through it to clear blood and prevent clots.
Most men stay in hospital for one to three days.
Recovery at home
Recovery typically involves:
- blood in the urine on and off for a few weeks, sometimes appearing again around ten to fourteen days after surgery
- some burning or urgency when passing urine
- needing to go more often at first
It helps to drink plenty of fluid, avoid constipation and avoid heavy lifting, strenuous exercise and sex for a few weeks. Most men return to light work after about two to three weeks. The NHS guide to TURP has more detail.
Results you can expect
TURP usually gives a marked improvement in flow and symptoms. Many men notice a stronger stream soon after the catheter is removed, although urgency can take a few weeks to settle. Benefits are long-lasting for most men, although a small proportion need further treatment years later.
Side effects and risks
As with any operation, there are possible effects to consider:
- Retrograde ejaculation: the most common long-term effect. Semen passes back into the bladder instead of out through the penis. It is harmless but affects fertility and the sensation of orgasm for some men.
- Erection problems: uncommon, but possible.
- Bleeding: occasionally enough to need a return to theatre or a blood transfusion.
- Infection: usually treated with antibiotics.
- Incontinence: short-term leakage is common, long-term incontinence is rare.
- Urethral narrowing: scar tissue can form in a small number of men.
How TURP compares with newer options
Newer procedures aim to match the symptom relief of TURP with fewer side effects or a quicker recovery. For example:
- Aquablation therapy uses a heat-free waterjet and is designed to preserve ejaculation in many men.
- iTind reshapes the channel without removing tissue.
- Prostate artery embolisation reduces blood supply to the gland without surgery through the urethra.
Each has its own balance of benefits and limits. Our guide to when to consider BPH surgery explains how to approach the decision, and the British Association of Urological Surgeons publishes a detailed TURP leaflet.
Is TURP right for you?
TURP suits many men with moderate to large prostates. Your urologist will consider prostate size, your symptoms, your general health and how important it is to you to preserve ejaculation. Our page on benign prostatic enlargement outlines the range of treatments.
Professor Prokar Dasgupta can explain how TURP compares with the other options at The London Clinic. Please contact the clinic to arrange a consultation.