The most common surgery for BPH is called "transurethral resection of the prostate" or TURP. During the procedure, surgeons remove the excess prostate tissue through the urethra.
Transurethral Resection of the Prostate (TURP)
TURP is the most common type of surgery used to treat BPH. Surgeons perform most TURP procedures when the patient is under general anesthesia and unconscious or asleep.
How does the procedure work?
After anesthesia, a surgeon will insert a tool called a resectoscope into the urethra. Once the surgeon has positioned the resectoscope, they will use it to cut away abnormal prostate tissues and seal broken blood vessels. Finally, the surgeon will insert a long plastic tube called a catheter into the urethra and flush destroyed prostate tissues into the bladder where they are excreted through urine.
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Most TURP surgeries take between 1 and 2 hours and require several hours recovery under continuous monitoring. The catheter is usually kept in place for 2 to 3 days after TURP surgeries and removed when the bladder has been completely flushed.
At first, the urethra and surrounding area will be inflamed, and it will be difficult to urinate. The catheter and flushing process can also be uncomfortable and cause bladder cramping.
The urethra and lower abdominal area will be tender, red, and swollen for a few weeks after surgery, which can interfere with urination. Most people also feel very weak and tire easily for several weeks.
Common side effects of TURP surgeries include:
- difficulty completely emptying the bladder
- urinary leakage
- sudden urge to urinate
- discomfort during urination
- small dribbles or clots of blood in the urine
The minor side effects associated with TURP surgeries usually go away as the urethra and prostate tissues become less inflamed, usually within a few weeks.
Complications and risks
As with any medical procedure, especially those involving anesthesia, the surgery for BPH is associated with some medical complications.
Rare but possible risks associated with TURP procedures include:
- excessive bleeding
- urinary tract infections and problems
- prostate regrowth or scarring
- Erectile dysfunction
- a split stream of urine caused by urethral narrowing
- chronic inflammation of the prostate
In rare cases, post-TURP syndrome occurs. This is where too much of the fluid used for surgical flushing is absorbed by the body, leading to major electrolyte, fluid, and blood imbalances.
Early signs of post-TURP syndrome include nausea, dizziness, restlessness, abdominal pain, and tightness in the chest
Signs of severe post-TURP syndrome include confusion, difficulty breathing, blurred vision and seizure.
Though rare, post-TURP syndrome can be fatal if it is not treated early enough.
It is usually safe to return to basic everyday activities 1 to 2 weeks after TURP procedures, and safe to return to strenuous activities after 1 to 2 months.
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