Transurethral Surgery
What is Transurethral Surgery?
Transurethral surgery is any surgery done through the urethra. Transurethral Resection of the Prostate (TURP) for example, refers to a procedure where parts of the prostate gland are removed through the urethra, a tube that carries urine from the bladder to the penis. The prostate is a small gland located between the penis and bladder.
TURP is commonly recommended for patients who suffer from Benign Prostatic Hyperplasia (BPH). BPH is the most common prostate problem experienced by men over the age of 50.
Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia, also known as prostate gland enlargement, is a common condition in elderly men. It gets more common as one ages. The enlarged prostate (which sits below the bladder and in front of the rectum) may put pressure on the urethra, obstructing the flow of urine from the bladder out the urethra, which, in turn, causes urinary issues. Severe BPH may prevent a patient from passing urine at all.
Why would I need a TURP procedure?
Transurethral resection of your prostate is usually recommended when you suffer moderate to severe BPH, and when more conservative forms of treatment do not suffice. You may have symptoms such as:
- Difficulty urinating
- The frequent need to urinate
- Nocturia
- Slow urination
- Voiding issues
- Urinary tract infections (UTI)
- Complications of BPH (eg; bleeding, inability to pee requiring a catheter (a tube to drain urine), bladder stones, bladder dysfunction)
Sometimes, BPH results in the blocked flow of urine. Even for patients on BPH medications, one third may eventually need surgery. As such, TURP is recommended to prevent further complications such as kidney or bladder damage or bladder stones.
How do I prepare for Transurethral Surgery?
Your urologist will first conduct a medical history and a physical examination to ensure you are in good health before the surgery. Blood tests or other tests may also be ordered.
You will be asked not to consume food and drink 8 hours before the procedure, generally after midnight.
Inform your healthcare provider if you have sensitivities or allergies to medicines, latex or anaesthesia. Based on your medical condition, specific preparation may be requested.
What happens during Transurethral Surgery?
The TURP procedure generally lasts for 60 to 90 minutes.
- General/Spinal anaesthesia is used during the procedure, so you will be put to sleep or feel numb in the lower body, and no pain is felt.
- Transurethral surgery is carried out using a resectoscope – a thin metal tube with a light, camera and loop of wire. No incisions are made, and instead, the prostate is accessed via the urethra.
- An electrical wire loop is heated and used to cut tissue of the prostate gland and seal blood vessels.
- Pieces of tissue that have been removed are then flushed away by pumping irrigating fluid into the bladder.
- The surgeon may first use an endoscope to inspect the urethra and bladder.
- After the resectoscope is removed, the surgeon will insert a catheter into your bladder to drain urine.
- The prostatic chips are then sent to the pathologist for a histological diagnosis. This determines if the prostate tissue is purely enlarged or cancerous.
How much of the prostate is removed during TURP?
Since TURP is generally done to relieve BPH symptoms by reducing pressure on the urethra, only parts of the prostate closest to the urethra are removed, leaving most of the prostate intact.
Is Transurethral Surgery painful?
As you will be put under general anaesthesia, you will not feel any pain during surgery. However, you may feel slight pain after your procedure, which will decrease in intensity for 7 – 10 days.
What to expect post-procedure
Things to note post-procedure are:
- The catheter will remain in place for a few days to help you urinate while your prostate gland heals and the swelling goes down. It will be attached to a bag of saline to wash out the small blood clots for the first to second day after surgery.
- You may also notice blood in your urine post-procedure. Drinking plenty of fluids will help flush the blood and small blood clots out of your bladder.
- You will be advised to avoid lifting heavy objects and conducting strenuous activities for the next few weeks.
- It generally takes about 3 to 4 weeks to fully recover from your procedure. You will be required to stay in hospital for 1-3 days to monitor your condition.
Can you walk after TURP surgery?
Walking may help keep your blood circulating and lower your risk of blood clots. However, only start walking when you feel able and are comfortable doing so.
Summary
Transurethral surgery or TURP is a generally safe procedure and an effective way to treat urinary symptoms caused by an enlarged prostate. For both men and women, ageing doesn’t have to come with urinary conditions that stop you from living your life to your fullest. If you suffer from BPH or other urinary concerns, book a consultation with your urologist for a proper diagnosis and treatment.
