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TURP generally takes 60 to 90 minutes. You'll be given either a spinal anesthetic, which allows you to be awake during the procedure but unable to feel pain in the surgical area, or a general anesthetic, which will put you to sleep. The doctor may also give you a dose of antibiotics to prevent infection.
During the procedure
Once the anesthetic is working, a combined visual and surgical instrument (resectoscope) is inserted into the tip of your penis and extended through your urethra and into the prostate area. By accessing the prostate through your penis, your doctor won't need to make any cuts (incisions) on the outside of your body. The resectoscope is about 12 inches (30.5 centimeters) long and 1/2 inch (1 centimeter) in diameter. It has a light, valves for controlling irrigating fluid, and an electrical loop to cut tissue and seal blood vessels.
The doctor will use the resectoscope to trim tissue from the inside of your prostate gland, one small piece at a time. As small pieces of tissue are cut from inside your prostate, irrigating fluid carries them into your bladder. They're removed at the end of the operation.
BPH usually isn't a symptom of prostate cancer, and it doesn't increase your risk of prostate cancer. But your doctor may recommend the prostate tissue from your procedure be sent to a lab to check for hidden cancer cells.
After the procedure
After surgery, you'll need to stay in the hospital for one to two days. Talk to your doctor about what you can expect, and any precautions you need to take after you go home.
- You'll have a catheter in place that enters through the tip of your penis and goes into your bladder to drain your urine into a collection bag. The catheter is generally left in place for four to seven days, until you're able to urinate on your own. In some cases, a catheter is needed for a longer period of time — especially if you have a relatively large prostate. You may urinate around the catheter, which is normal because your bladder may try and squeeze out more urine than the catheter can accommodate.
- Urination may be painful, or you may have a sense of urgency as urine passes over the surgical area. You may also need to urinate frequently. Painful urination generally improves in one to four weeks.
- Expect some blood in your urine right after surgery. If you have clots or so much blood in your urine that you can't see through it, contact your doctor.
These steps can help you recover after your procedure.
- Drink plenty of water to flush out the bladder.
- Avoid constipation and straining during a bowel movement. Eat fiber-containing foods and avoid foods that can cause constipation. Ask your doctor if you should take a laxative if you do become constipated.
- Don't take blood-thinning medications until your doctor says it's OK.
- Don't do any strenuous activity, such as heavy lifting, for four to six weeks or until your doctor says it's OK.
- Don't have sex. You'll likely be able to resume sexual activity in about four to six weeks.
- Don't drive until your doctor says it's OK. Generally, you can drive once your catheter is removed and you're no longer taking prescription pain medications.
- Guideline on the management of benign prostatic hyperplasia (BPH). Linthicum, MD. American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph. Accessed Jan. 27, 2011.
- Prostate enlargement: Benign prostatic hyperplasia. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement. Accessed Feb. 11, 2011.
- Cunningham GR, et al. Surgical and other invasive therapies of benign prostatic hyperplasia. http://www.uptodate.com/home/index.html. Accessed Jan. 2, 2011.
- Thiel DD, et al. Electroresection and open surgery. Urologic Clinics of North America. 2009;36:461.
- Matlaga BR, et al. Surgery for benign prostatic hypertrophy. In: Graham SD, et al. Glenn's Urologic Surgery. 7th ed. Philadelphia, Pa.: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2010:166.
- Smith RD, et al. Transurethral resection of the prostate revisited and updated. Current Opinion in Urology. 2011;21:36.
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