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Prostate is an organ which is a part of male reproductive system which is responsible for the secretion of a fluid which carries the male reproductive cell (sperm) known as semen. It is located surrounding the neck of urinary bladder (where urine is stored) from where urethra (tube that carries urine from the bladder to outside) begins. As age advances , the size of the prostate gradually increases (not every time though). After a point of time it starts obstructing the urethra. After 60 or so the size increases to such an extent that it obstructs the lumen causing problems. This condition is known as benign prostatic hyperplasia or benign enlargement of prostate.
Understanding Trans-urethral Resection of Prostate
TURP is a treatment preferred over everything else for the treatment of BPH.
In Transurethral Prostate Resection (TURP), an instrument is inserted through the urethra and excess prostate mass obliterating the way is shaved off. This is done not only for free passage of urine but also to prevent the conversion of BPH to Cancer of Prostate.
Untreated BPH can cause urinary tract infection, formation of Kidney Stones and continued loss of blood through urine hence it is best to get it treated at the earliest.
How is TURP Procedure Performed
In Transurethral prostate resection, The doctor uses a specially designed thin tube like instrument with a camera and light at the end, called resectoscope. With resectoscope we can do the procedure using the naked eye.
The resectoscope is inserted through the male urethra, the tube that carries urine from the bladder. Using a radiofrequency metal loop located on the end of the instrument the excess prostate tissue that blocks the urethra is trimmed off. This increases the size of the channel through which the urine flows. The removed prostate tissues will be sent for histopathological examination to confirm BPH.
Post operatively, the bladder is continuously washed with saline through a A tube which is used to drain urine from the bladder known as foley’s catheter to prevent clot formation. Once the urine becomes clear and free of any blood, the foley’s tube is removed.
TURP is done when the patient has severe retention of urine, caused due to obstruction of the passage of urine by the prostate gland. Not able to pass urine is very painful than one can think of and equally uncomfortable. TURP can relieve this. Moreover, if left untreated, this condition can become cancerous. Hence best treated at the earliest.
care after TURP
- No heavy lifting for 4 weeks.
- No driving for 2 weeks.
- No long trips for 3 weeks.
- No sexual activity for 6 weeks after surgery.
- Plenty of fluids. Avoid tea, coffee, and soda.
TURP is a regular operation that is done to thousands of patients every year all over the world. It is one of the excellent ways of removing the prostate using minimally invasive approach.
No this only means that you will have the prostate accessed through your own urinary tract.
If it is a very large prostate, it might bleed a bit but most prostates are done without any bleeding because the prostate is resected using an electrical current which coagulates the bleeding completely.
Usually all TURP’s are over in about 90 minutes because we do not want to irrigate the bladder for longer than that because the fluid might get into that bloodstream causing other problems.
No, there is a small risk, but this is not very large, and in units that are experienced in doing TURP’s there is hardly any risk at all. In the very old patients, there is a slightly higher risk of incontinence.
No, there is no reason why your sexuality should be affected, provided the doctors follow the right techniques. Adoption of the recommended techniques usually results in very successful prostatic surgery.
Yes. Even for cancer, a TURP is very good to avoid all the urinary symptoms that people suffer very badly with. Also a prostatic cancer unlike other cancers is a very slow growing and indolent cancer and patients are very much helped with a TURP after which they can have treatment separately, to prevent the cancer cells from growing.
Both of these are useful to treat prostatic cancer, but not for benign prostatic disease.
Yes, there are a bunch of new drugs that are quite useful for benign prostatic disease. Your doctor will only ask you to have a TURP after these drugs have been tried and have been found to be ineffective in your particular case.
Dr. Ilamparuthi Chennakrishnan
GENITO- URINARY SURGEON
M.B.B.S., M.S. (General surgery), M.Ch. (Urology), D.N.B. (GUS), F.I.C.S.