Patient Information Sheet
Transurethral resection of the Prostate gland (TURP)
The prostate gland:
The prostate gland is about the size of a walnut that is found only in men. It is situated just below the bladder and surrounds the urethra, the canal through which urine is passed out of the body.
Enlarged prostate:
An enlarged prostate, known as benign prostate hyperplasia or BPH, is caused by an overgrowth of prostate cells. This enlargement causes constriction or narrowing of the urethra, the canal that urine is passed from the bladder out of the body. This, in turn, leads in difficulties in emptying the bladder and passing urine.
The symptoms include:
Hesitancy (difficulty in starting to pass urine or stop and start)
- Poor flow/ stream of urination
- The need to strain to pass urine
- The feeling that you haven’t emptied your bladder after urinating
- Frequent trips to the toilet, including having to get up a few times at night to pass small amounts.
- Urgency to pass urine.
Treatment:
Medications may improve symptoms for a time but for a majority of men, an operation will be necessary to treat the problem.
Preparation for the operation:
Few tests may be required before the operation depending on your age and general health. These may be carried out the day before your operation or on the morning of your operation.
These may include:
- Blood tests
- A urine check
- Chest x-ray
- Electrocardiogram(ECG) which is a non-invasive heart tracing
The Operation
Transurethral resection of the prostate gland (TURP) is the most common operation for an enlarged an enlarged prostate.
The operation itself is performed using a long telescopic instrument which is passed through the penis into the bladder. The doctor can visualise the enlarged prostate and remove the prostatic tissue in piece meal. This will allow urine to be passed with less difficulty.
Problems and risks associated with the operation
As with all operation, having an anaesthetic is associated with certain risks. The anaesthetist working with your doctor will discuss the most suitable type of anaesthetic for you.
Common risks associated with anaesthetic include:
Chest infections, caused by a build-up of secretions in the lungs (especially in smokers)
Clots in the legs due to lack of movement, these can travel to the lungs and are potentially very serious.
Other people are more at risk of complications related to their heart at time of surgery, including heart attacks, irregular heart rhythms and strokes.
Bleeding from the operated site is common and usually doesn’t present any long term problems. However, in a small number of cases, a second procedure may be required to stop the bleeding. Excessive bleeding can cause you blood count to drop and you may require a blood transfusion.
Occasionally, when the urinary catheter is removed, you may not pass urine in the normal way. A new urinary catheter may need to be passed, and rarely, a further procedure may be required to remove more of the prostate.
The bladder returns to normal, you may experience some temporary problems controlling the flow of urine; incontinence is rare in the long term.
The urethra, the canal that urine is passed through can also narrow due to scarring around the operation site; this is known as a “stricture”: This is unusual but would require an operation to rectify it.
Infection of the urinary system occurs in almost 1 in 200 cases, but can be treated effectively with a course of antibiotics.
Due to the close proximity of the prostate to the rectum (the back passage), it can be injured during the operation. This is very rare but would necessitate another operation either immediately or at a later date.
What to expect after the operation
At the end of the operation, the doctor inserts a tube through the penis into the bladder to drain urine, this is called a urinary catheter. This allows the operated site to heal. There may be some bleeding into the bladder causing your urine to have a reddish colour, do not be alarmed this will settle down in time.
You may have large bags of clear fluid attached to the urinary catheter, these are known as irrigation fluids and help flush out the bladder of blood and clots which could other wise obstruct the flow of urine into the tube.
You will also have intravenous fluids, commonly known as “a drip” to help flush out the bladder. Once these are stopped, it is important to drink plenty of fluids, at least 6 to 8 large glasses a day.
The urinary catheter is usually removed after 2 to 3 days after the operation. You can usually go home once you are passing urine again without too much difficulty.
Helpful hints at home
Some discomfort and bleeding on passing urine is common for the first few weeks. It is important to keep drinking lots of fluids, at least 6 to 8 large glasses a day. You should try to stop drinking around 8pm to avoid having to get up too often a night.
Eat a will-balanced diet with plenty of fruit and vegetables, and high in fibre.
Constipation should be avoided, as the straining associated with it can cause damage to the operation area. If you have suffered from constipation, you should mention this to the doctor or nurse who can recommend suitable laxatives for you to take.
It is recommended that you avoid sexual intercourse for a minimum of 6 weeks after this operation; the fluid that normally leaves the penis during sexual intercourse will instead pass back into the bladder and leave the body next time you pass urine. Pregnancy is extremely unlikely after this operation.
If your job does not require strenuous activity or heavy lifting, you may return to work after 3 weeks resuming you feel well enough. Other wise, you should wait 6 weeks before returning to work.
Gentle exercise is encouraged, regular should walks, golf or cycling is not advised for 3 weeks.
Finally, it is important to take any medications including pain killers as instructed by you doctor.
If you have any other concerns following your discharge, please contact;
Mr Syed Jaffry’s office: 091 720065
Between 9-5pm
Mother Teresa Unit at the Galway Clinic, Phone: 091 – 785324
After 5 pm
Compiled by: Marie Connolly, Sister
MTU
Mr. Syed. Jaffrey
Consultant Urological Surgeon
June 2006
