Turp trans urethral prostatectomy

TURP- Trans Urethral Prostatectomy


TURP AKA Trans Urethral Prostatectomy is a procedure that is surgically removes the enlarged portion or section of the prostate gland. The Benign Prostatic Hyperplasia or enlarged prostate mostly affects aged men.

Why it needed?

TURP is recommended when the patient has symptoms like

  • Urine tract infection or acute retention
  • Prostate bleeding
  • Damage of the kidneys
  • Increased frequency of urinating especially at night
  • Slow flow or dribbling after urinating
  • The patient either has an uncontrollable urge or cannot urinate easily.

Facts and figures

  • While 80% of men develop BHP gradually; prostate diseases are more common in men who are 40 and above.
  • As per statistics, every year, close to 30,000 men in the United States die due to prostate cancer.
  • Amongst the various treatments available for BHP, TURP in today’s world is considered as Gold Standards
  • Fabian first described the use of intraporstatic stents during the 1980’s. This is one of the secondary treatments to BHP for people suffering with outlet obstruction.

Advantages

  • The BHP surgery has a high success rate. Post the surgery, close to 88% of patients has reduced symptoms.
  • After the removal of the catheter, most patients will notice their urine flow has improved
  • The pain for most patients reduces after the surgery. This makes it easier for them to pass urine and sleep peacefully at night.

Disadvantages

  • 10 years post the first surgery, close to 15-20% opt for another one.
  •  After a TRUP operation, some patients develop fertility issues and temporary problems with urinating.
  • In some cases, it has been reported that instead of the semen going out through the urethra, it goes into the bladder.
  • Patients tend to develop urethral stricture or transurethral reaction syndrome

Complications and Risks

  • Reaction to medicines or anesthesia
  • Blood clots or bleeding
  • Breathing problems
  • UTI or urine traction infection post operation
  • Tissue scarring
  • Damage to adjacent tissues or organs

Pre-operative preparation

  • Complete physical, blood and urine examination
  • DRE or Digital examination of the rectal
  • PSA or Prostate-specific antigen test
  • Physician visit to obtain the list of medicines that have to be stopped or taken before the surgery
  • Letting the surgeon know if you drink or smoke
  • Arrange for a person to come along with you to drive you back
  • Fasting post midnight before the day of the surgery
  • Medical tourists will have to book a hotel room close to the hospital preferably in the ground floor.

Post operative care

  • The patient may have to stay back for 1-3 days post the surgery. A catheter will be placed during this time until there is no blood traces found in the urine.
  • Post the surgery, the first 6 weeks, a patient will have urination problems or discomfort like pain

Precautions, Do’s, and Don’ts

  • Good hygiene practices like washing the penis or hands regularly
  • Proper rest
  • to prevent constipation, laxatives are advisable
  • Diet should consist of high fiber foods and lots of fluid
  • Post the surgery The patient should not indulge into sexual activity at least for 6 weeks.
  • No drinks
  • for the first two weeks, it is advisable not to drive
  • For 6 weeks, the patient should avoid strenuous activities
  • Proper recovery post the surgery will take close to 6-8 weeks

 Open Prostatectomy

If there is an enlarged prostate which cannot be treated by TURP, then the surgeon would recommend open prostatectomy. This is a surgical procedure which requires hospital stay and reduces the chances of another surgery. If in the case of prostate cancer, this surgery is contraindicated.