- You have tried multiple medications, and continue to have significant problems urinating.
- You have been taking several medications, and no longer like taking medications, or don’t want continue having to pay for monthly medications when a TURP would likely take care of most symptoms, without the need for medication.
- Your symptoms are so severe, that you are no longer effectively emptying your bladder (feeling of incomplete bladder emptying). We have the latest ultrasound tools at our office to scan your bladder after urination. High residuals (lots of urine left in your bladder after urinating) are a bad sign that your bladder is getting tired of pushing to urinate. Surgery is usually highly recommended.
Throughout a man’s life, his prostate may become larger and begin to cause problems as he ages.
Dr. Shaw starts off with a simple questionnaire to understand your symptoms. Sometimes, the solution is simple, with a few dietary and lifestyle adjustments.
For others with more moderate symptoms, it still may be as easy as take a small tablet in the evening to shrink or relax the prostate. Symptomatic relief can be as fast as overnight for some.
For others with a significantly enlarged prostate that squeezes the urine tube, much like stepping on a garden hose, surgery may be required. But rest easy, the surgery is much easier than it was just a few years ago! The advance of lasers and other techniques often makes this an outpatient surgery.
Who needs a TURP?
What is a TURP?
No incisions! That’s the good part. The entire procedure is done under general anesthesia (asleep) via the urethra (penis). We now utilize state-of-the-art high definition cameras to visualize the prostate. We then use either plasma-vaporization or lasers to basically remove the obstructing tissue of the prostate that squeezes the urethra as it passes through the bladder.
The best way to think of the prostate is an orange, that sits under the bladder. The urethra passes like a straw, right down the middle of the prostate (orange) into the urethra. When younger, the prostate is responsible for secretion of ejaculate. It has nothing, however to do with sexual desire, erections, testosterone, or sperm (from testicles). As one ages, the prostate (orange) grows, and squeezes the urethra (straw) that goes the middle of it. When medicines can no longer relax the prostate to allow urine to pass freely, surgery (TURP) can easily remove much of the blocking/obstructing prostate tissue (pulp of the orange) to allow for a much better urinary flow.
TURP is usually performed in the hospital or outpatient surgical center, and takes approximately 1 hour.
What about the different types of TURP procedure?
How long should the procedure last?
What are common side effects?
There may be some changes in ejaculation. Because the prostate cavity is enlarged after surgery, semen or ejaculate can not only go forward, as it usually does, it can ‘hiccup’ back into the bladder, where it is urinated out after ejaculation. For many people, ejaculation is not affected, whereas other patients may simply note a reduction or loss of ejaculate volume. Again erections are not affected, just ejaculate. Orgasms are not affected.
What about my medications?
The night before your procedure, you may eat and drink as usual. However, do not take anything by mouth after 12:00 midnight the night before. Wear comfortable, loose-fitting clothing like a jogging suit on the day of your procedure. Bring a list of all the prescription and nonprescription medications that you take regularly with you on the day of the procedure.
Please plan to arrive two hours prior to your treatment.
The TURP usually takes approximately 1 hour, and Dr. Shaw will come and speak to your family afterwards.
Upon wakening from the procedure, you will have a catheter draining your bladder. We have yet to meet a man who likes having a catheter, but relax, the catheter typically will remain for 48 hours and then be removed in the clinic.
It is common for the catheter to drain pink or red urine. Just as Kool-Aid can turn water red with just a small amount of coloring, just a small amount of blood turns the urine red. If there are clots, or more significant blood in the urine, Dr. Shaw may opt to keep you in the hospital overnight and discharge you in the morning.
You will be given full instructions from our nurse on how to manage, and drain the foley catheter bag when it gets full.
It is not unusual to have a sensation of wanting to urinate, or to have bladder spasms after surgery. This usually goes away within 1-2 days. You may occasionally notice a small amount of urine leak around the catheter, and this is normal.
Definitely rest up for a day or two after a TURP. Drink at least 6-8 glasses of water to wash out your system. Within a day or two, your urine will begin to clear up and look normal.
For pain, Advil®, Motrin® or prescription Toradol® work great – depend upon your doctor’s advice. Never take a medication without clearing it with your doctor first. These are non-narcotic, so you don’t get sleepy, constipated or have other issues; however they are great anti-inflammatories. Take them on a regular basis the first 2-3 days after the procedure. For pain not relieved by these medications, use the prescription Tylenol with Codeine or Vicodin that was prescribed for you. We may also occasionally give you a few days of bladder spasm medication.
Do not take blood thinners or aspirin products for one week or as directed by your physician.
Diet and Fluid
Increase your intake of fluids, particularly water – 24 to 48 ounces over your usual daily fluid intake is typically recommended during the first two weeks of your recovery.