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Transurethral Prostatectomy

AMBULATORY CARE:

What you need to know about a transurethral prostatectomy (TURP):

A TURP is surgery to remove part or all of your prostate gland. This surgery is also called transurethral resection of the prostate.

Male Reproductive System

How to prepare for a TURP:

  • Your surgeon will tell you how to prepare. You may be told not to eat or drink anything after midnight on the day of surgery. Arrange to have someone drive you home after surgery.
  • Tell your surgeon about all the medicines you currently take. He or she will tell you if you need to stop any medicine before surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • Tell your surgeon if you have heart disease or blood clotting problems.
  • You may be given medicine to shrink the size of your prostate. You may also be given antibiotics to help prevent or treat a bacterial infection. Tell your surgeon if you had an allergic reaction to antibiotics, anesthesia, or other medicine.
  • You may need blood and urine tests. You may also need a rectal exam to check the size of your prostate.

What will happen during a TURP:

  • You may be given anesthesia to make you lose feeling from the waist down, or to keep you asleep during surgery. Your surgeon will insert a resectoscope through your urethra. A resectoscope is a tube with a small monitor on the end. The monitor shows your prostate on a screen during surgery. Your bladder may be filled with fluid during surgery.
  • Heat that is produced by the resectoscope will be used to remove part, or all, of your prostate. Heat will also be 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.

What to expect after a TURP:

A Foley catheter is inserted to drain urine into a bag. Your healthcare provider will tell you how to clean around the catheter if you go home with one. You will need to clean the area 2 times a day to prevent infection. You may have feelings of urgency and difficulty controlling your urine. You may have pain when you urinate and also a small amount of blood in your urine. You may also have a problem getting an erection and keeping one.

Risks of a TURP:

  • Your prostate, bladder, or urethra may be damaged. 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 can block your urethra.
  • You may develop a urinary tract infection, or an infection in the surgery area. You may have trouble getting an erection or ejaculating. You may develop TURP syndrome, which can cause dizziness, fatigue, stomach pain, and vomiting. 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.

Seek care immediately if:

  • You have severe abdominal or back pain.
  • You are dizzy or confused.
  • You have abdominal pain, nausea, and vomiting.
  • Your heartbeat is slower than usual.

Call your doctor or urologist if:

  • You urinate little or not at all.
  • You have a fever.
  • You have new or more blood in your urine.
  • You have trouble starting to urinate, or have a weak stream of urine when you urinate.
  • You feel like you have a full bladder, even after you urinate.
  • You often wake up during the night to urinate.
  • You feel pain or pressure in your lower abdomen.
  • Your urine looks cloudy, and smells bad.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Antibiotics prevent or fight an infection caused by bacteria.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Foley catheter care:

Keep the bag below your waist. If the bag is too high, urine will flow back into your bladder. This can cause an infection. Do not pull on the catheter. This may cause pain and bleeding, and the catheter may come out. Do not let the catheter tubing kink or twist. A kink or twist will block the flow of urine.

Bladder control:

After surgery, you may leak urine and have trouble controlling when you urinate. The following can help decrease or manage urine leakage:

  • Drink fluids as directed. Fluids may help your kidneys and bladder work properly. Fluids can also decrease your chance for infections. Ask your healthcare provider which fluids are best for you and how much you should drink.
  • Do not have caffeine. Caffeine can cause problems with bladder control and increase your need to urinate.
  • Wear a pad or adult diapers, if needed. These may help to absorb leaking urine and decrease odor.
  • Do pelvic floor muscle exercises. Pelvic floor muscle exercises, also called Kegels, may help improve your bladder control. These exercises are done by tightening and relaxing your pelvic muscles. Ask how to do pelvic floor muscle exercises, and how often to do them.

Activity:

Ask when it is okay for you to return to work and activities, or to have sex.

Follow up with your surgeon or urologist as directed:

You may need to return to make sure you do not have an infection, or to have your Foley catheter removed. Write down your questions so you remember to ask them during your visits.

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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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