What is it?

Transurethral resection of the prostate (TURP) is a surgery used to treat urinary problems caused by an enlarged prostate. The procedure involves inserting an instrument called a resectoscope through the urethra and cutting away excess prostate tissue that is blocking the flow of urine. It is currently considered an option for men who have moderate to severe obstructive urinary symptoms that do not improve with medication, obtaining benefits and improving quality of life, such as reducing the frequency, urgency, pain when urinating, and preventing complications such as infections or retention urinary.

Why is it done?

This procedure helps reduce urinary symptoms caused by benign prostatic hyperplasia (BPH), such as: frequent and urgent need to urinate, difficulty starting urination, slow (prolonged) urination, nocturia (getting up more often to urinate), stopping and starting to urinate again, feeling like you cannot empty your bladder completely, and developing urinary tract infections.

What does the procedure consist of, and what to expect in the postoperative period?

Before surgery, you should avoid taking medications that increase the risk of bleeding such as anticoagulants such as warfarin or clopidogrel, pain relievers such as aspirin, the affected anesthesiologist usually a technique called spinal which consists of inserting a needle into the lower part of the back through the lumbar spine blocking any type of pain from the lower abdomen to the legs, which means that you will remain conscious or sedated throughout the surgery. Transurethral resection of the prostate is a minimally invasive procedure, meaning that no cut (incision) is made on the outside of the body. The procedure begins by introducing the resectoscope into the tip of the penis and it is passed through the urethra until it reaches the prostate. For the visualization of all the structures, a solution that irrigates the working channel is used, normally it is physiological 0.9%. 1.5% glycine, sterile water, which facilitates scraping or cutting at the level of the prostate tissue, converting it into small fragments that are extracted at the end of the surgery. The procedure lasts between 60 and 90 minutes with a hospital stay of 24-48 hours. Once the surgery is over you will leave with a urinary catheter that will be withdrawn between 5-7 days. A prophylactic antibiotic is used to reduce the risk of infections. Sometimes antibiotic treatment can be extended until after surgery, especially if the catheter has been in place before surgery.

What recommendations to follow for a satisfactory recovery?

After surgery, it is normal to have some discomfort or complications, such as bleeding, infection, pain when urinating. Some recommendations that can help improve recovery and prevent complications: Drink plenty of fluids, preferably water, to maintain good hydration and facilitate clot removal, avoid constipation, which can increase pressure on the prostate and cause bleeding. For this we recommend following a diet rich in fiber, such as fruits, vegetables and whole grains, and taking laxatives if necessary. Avoid lifting heavy objects, strenuous physical exertion, or sports that can cause trauma to the pelvic area, such as cycling, horseback riding, or motorcycling; these activities can delay healing and lead to bleeding or infection. Avoid sexual intercourse for at least 4 weeks, as it can cause irritation or bleeding in the urethra or prostate. In addition, it is possible that during the beginning of sexual intercourse you experience retrograde ejaculation, that is, the semen goes towards the bladder instead of out through the penis. This does not affect sexual function or fertility, but it may decrease pleasure or the sensation of orgasm.

TURP surgery is an effective and safe technique to treat urinary problems caused by prostate growth. Most men start to notice a much stronger urine flow within a few days. However, it requires following some recommendations after the intervention to promote optimal recovery. If you have any doubts or notice any warning signs, such as fever, severe pain, profuse bleeding or difficulty urinating, you should consult your doctor as soon as possible.

1. https://www.mayoclinic.org/es/tests-procedures/turp/about/pac-20384880
2. https://urologosquiron.com/reseccion-transuretral-del-prostata-rtup/
3. https://patients.uroweb.org/es/crecimiento-benigno-de-prostata/tratamientodell-crecimiento-benigno-de-prostata/reseccion-transuretral-de-la-prostata/