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.

Getting Ready

Before your surgery:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Tell your caregiver if you have heart disease or blood clotting problems.
  
  
• You may need blood and urine tests. You may also need a digital rectal exam to check the size of your prostate. Ask your caregiver for more information about tests that you may need. Write down the date, time, and location of each test.
  
  
• Your caregiver may give you medicine to shrink the size of your prostate. You may also be given medicine to help prevent infection. Ask your caregiver for more information about the medicine that you need to take before surgery.

The day before your surgery:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

• You may be given anesthesia medicine to make you lose feeling from the waist down, or you may be asleep during this surgery. Caregivers will 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 will be removed from your urethra. A catheter (soft tube) will be put through your urethra and into your bladder. The catheter will be left in place to drain urine out of your body and into a bag.

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. The catheter may need to stay in for 2 to 3 days after surgery, or longer if needed.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot get to surgery on time.
  
  
• You have a fever.
  
  
• Your symptoms, such as trouble urinating, get worse.
  
  
• Your urine has blood in it.

Seek Care Immediately if

• You cannot urinate, or you are urinating very little or less often than usual.
  
  
• You have severe (very bad) pain in your abdomen or back.

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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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