Before surgery

Before the procedure, the doctor will carefully assess the medical history and conduct a physical exam to ensure overall health. The patient may need to undergo blood tests and other evaluations. It is essential to avoid eating or drinking anything for 8 hours before the procedure, usually after midnight. The patient should provide a comprehensive list of all medications, herbs, vitamins, and supplements they are taking, both prescribed and over-the-counter.

In preparation for surgery, the doctor might advise stopping medications that could increase the risk of bleeding, such as blood thinners like warfarin or clopidogrel, as well as nonprescription pain relievers like aspirin, ibuprofen, or naproxen sodium. Additionally, they may prescribe an antibiotic to prevent urinary tract infection during the procedure. A written consent form is typically signed by the patient or their family member after they have been provided with information about the surgery.

During surgery

During a TURP procedure, a thin, flexible instrument called a resectoscope is inserted through the urethra and into the prostate. The resectoscope contains a light and a small wire loop or laser at the end, which allows the surgeon to remove excess prostate tissue. The procedure is performed under general or spinal anesthesia, and the surgeon can view the prostate on a monitor to guide the removal process. As the obstructive tissue is removed, it opens up the urethra and improves urine flow.

After surgery

After the TURP procedure, the patient will likely stay in the hospital for one to two days. A urinary catheter will be in place to help with urine flow due to swelling. The catheter is usually removed after 24 to 48 hours once the swelling reduces and the patient can urinate on their own.

During recovery, the patient might experience:

• Blood in urine, which is normal immediately after the surgery. If the blood is thick like ketchup, bleeding worsens, or urine flow is blocked due to blood clots, the patient should contact the doctor immediately.
• Irritating urinary symptoms such as painful urination, urgency, or frequent need to urinate. Painful urination typically improves within six to eight weeks.

The TURP procedure typically lasts for 60 to 90 minutes.

After the TURP procedure, the doctor is likely to recommend the following:

• Drink plenty of water to flush out the bladder.
• Consume high-fiber foods to prevent constipation and straining during bowel movements. A stool softener might also be recommended.
• Wait for the doctor’s approval before resuming any blood-thinning medications.
• Avoid strenuous activities, like heavy lifting, for four to six weeks.
• Abstain from sexual activity for four to six weeks.

TURP, like any surgery, has certain risks involved, such as:

• Temporary difficulty controlling urination (incontinence)
• Urinary tract infection
• Erectile dysfunction
• Retrograde ejaculation (semen flowing backward into the bladder)
• Bleeding
• Bladder perforation