Transurethral Prostatectomy

WHAT YOU SHOULD KNOW:

• A transurethral prostatectomy is surgery that is done to remove part or all of your prostate gland. This surgery is also called transurethral resection of the prostate (TURP). TURP surgery treats benign prostatic hypertrophy (BPH). BPH is a condition where the prostate gland grows too large. The prostate is a male sex gland that helps make fluid in semen (sperm). The prostate surrounds part of the urethra. Urine is stored in the bladder, and travels from there to the outside of your body through the urethra.
  
  
• A large prostate gland can press on your urethra, causing trouble when you urinate and urinary tract infections. The urinary tract is made up of your kidneys, bladder, and urethra. After TURP, problems such as having to urinate urgently and often, and having blood in your urine may go away. You may get fewer urinary tract infections after surgery. TURP surgery may stop your prostate from growing larger. This can help prevent serious medical problems that may be caused by a large prostate gland.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• During surgery, you may bleed more than expected, and need a blood transfusion. If you have general anesthesia to make you sleep during surgery, you may have trouble breathing. Your prostate, bladder, or urethra may be damaged. After surgery, your urethra or part of your bladder may grow narrow. This can make it difficult or painful to urinate. You may feel like you need to urinate often, or have trouble controlling when you urinate. You may get blood clots in your urine that may block your urethra.
  
  
• After surgery, you may get a urinary tract infection, or an infection in the surgery area. You may have trouble getting an erection (hard penis) or ejaculating. You may get TUR syndrome, which can cause dizziness, fatigue (tiredness), stomach pain, and vomiting (throwing up). If you had a partial resection of the prostate, the part of your prostate that was not removed may grow too large. This can cause your signs and symptoms to return, and you may need to have surgery again.
  
  
• Without TURP surgery, your prostate may grow larger, and your symptoms may get worse. Urine may not be able to flow through your urethra as it should. The urine may remain in your bladder, and cause an infection. Stones may form in your bladder and kidneys, and you may have blood in your urine. These problems can damage your bladder or urethra, and over time, may cause your kidneys to stop working. If you are unable to urinate on your own, a Foley catheter may need to stay in place to drain your urine. Talk with your caregiver if you have questions or concerns about your condition, surgery, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  
  
• Pre-op care: You may be given medicine in your IV to help you feel relaxed and sleepy. The surgery area is washed, and sheets are put over the area to help keep it clean.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Anesthesia:
  
  
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
    
    
  • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

During your surgery:

Caregivers insert a resectoscope through your urethra. A resectoscope is a tube with a small camera on the end. The camera shows your prostate on a screen for caregivers while they do surgery. Your bladder may be filled with fluid during surgery. Heat that is produced by the resectoscope is used to remove part, or all, of your prostate. Heat is also used to stop bleeding in the surgery area. Fluid is used to wash away extra tissue and blood. The resectoscope is removed from your urethra. A Foley catheter (tube) is put through your urethra and into your bladder. The catheter drains urine out of your body.

After your surgery:

You are taken to a room to rest. Do not get out of bed until caregivers say it is okay. When caregivers see that you are okay, you will be taken to your room.

• Foley catheter: Keep the bag of urine below your waist. Lifting the urine bag higher will make the urine flow back into your bladder and cause an infection. Avoid pulling on the catheter, because this may cause pain and bleeding, and the catheter may come out. Do not allow the catheter tubing to kink, because this will block the flow of urine. Caregivers will remove the catheter when you no longer need it.
  
  
• Diuretic medicine: You may need diuretic medicine if you do not have enough sodium (salt) in your blood.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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