Making Difficult Scenarios Easy
August 13, 2018
We hear from a number of men about the recovery after a TURP or TransUrethral Resection of Prostate procedure. And while it may not be their first option, for some men, it is their only option.
Now to go back a few steps, a TURP is a procedure that is performed on men with an enlarged prostate or BPH. BPH, or Benign Prostatic Hypertrophy, is a common issue typically in men over the age of 50. The prostate is a male sexual organ that produces the majority of fluid in the ejaculate. As men get older, and if the genetic programming (BPH can be hereditary) switch is ‘on’ for you, you may be at risk for developing BPH over your lifetime.
Symptoms typically include urinary urgency, frequency, pushing and straining to urinate, slow urination, nighttime urination, urinary dribbling and such. Basically a long list of things that keep you from your daily life and schedule.
The most common first approach is to try a medication such as Flomax, Uroxatral, Rapaflo, or their generic cousins, Tamsulosin, Alfuzosin, or Silodosin. These medications relax the prostate and typically can improve urination by 25% or more. However, slight decreases in blood pressure (can cause dizziness in some folks) can be reported and decreased ejaculate in others may be a complaint that is noticed as well (reversible upon stopping medication).
Other medications include Finasteride or Proscar, but I have tended to reduce my usage of this medication secondary to decrease libido, erectile dysfunction or fatigue secondary to the mechanism of action, which is to block DHT, a potent form of Testosterone in the male body.
In other patients, we now offer the Urolift procedure, a revolutionary procedure which works as well or better than medical therapy, and has long-term durable results at 5 years and even longer durations based on studies. Additionally, there are no sexual side effects with this procedure, which can be done as quickly as 20 minutes in a simple outpatient procedure.
And when medications fail, or the prostate is too large to successfully treat with a Urolift procedure, there is the TURP. The TURP has been performed for decades as the gold standard for the management of an enlarged prostate. And as the leaders in men’s wellness techniques, we are proud to offer the latest TURP technology to remove the enlarged prostate tissue using saline bipolar technology designed to remove a maximum amount of prostate tissue in the most rapid amount of time with decreased bleeding.
Typically we can perform a TURP in one hour or less in an outpatient setting. A Foley catheter is placed in the bladder during the procedure. I typically perform these procedures on a Tuesday or Wednesday, with the intent of removing the catheter by Friday the same week. Typical recovery involves taking it easy for about a week after the procedure and back to full activity in 2-3 weeks. Many of my patients tell me the catheter is the worst part of the procedure (an annoyance more than anything) but my hope is that 72 hours of annoyance is worth a huge, nearly 75% decrease in urination issues for the vast majority of my patients. Some blood in the urine is also typical for a few days after the procedure, but this also resolves quite rapidly and is normal immediately after the TURP.
At the Austin Urology Institute, we use the American Urologic Association guidelines to evaluate patients with BPH, with noninvasive bladder scanning, and digital flexible scope technology (when necessary) to fully understand each patients BPH issue and tailor it to the right treatment with the least side effects.