North Bay Ontario

TURP

Transurethral resection of prostate

Urology North

Call Us:  +1-705-995-2490

A TURP (or transurethral resection of prostate) is a endoscopic minimally invasive surgical procedure that is used to reduce the obstruction of the prostate in men who are experiencing obstructive voiding symptoms.

During a TURP your Urologist will use a cystoscope to visualize the prostate adenoma and then utilize either:

1) an electrocautery resectoscope to cut away obstructing tissue or

2) A specialized laser fiber to vaporize the obstructing tissue.

* We attempt to perform as many TURP's using the green light laser vaporization system due to the advantage of minimal bleeding and the ability for the surgery to be performed as an outpatient procedure, however, no individual case is the same and the decision of which technology to use will be made in conjunction with the patient on a case by case basis.  


The Procedure

Please arrive at the day surgery unit on time. You can expect to be at the hospital for several hours; however the surgery itself will last between 1-2 hours.

Risks

All surgical procedures have inherent risks associated with them.  Despite these risks being very low, we believe it is important that all patients who choose a surgical option are aware of the potential for unwanted outcomes.

TURP is a very safe procedure, however, the risks do include anesthetic complications such as MI, Stroke, adverse drug reaction, or even death.  Specific to the surgery, blood loss and the need for a transfusion are a real, but small risk.  Surgical failure, including the inability to void and the need for a catheter can occur. Urinary overactivity is a common side effect of this surgery that usually resolves with time. Urinary incontinence is a very rare complication that can also occur.  

When you arrive

A general anesthetic or a regional anesthetic (such as a spinal that numbs below the level of the block) will be administered by the Anesthetist. Once frozen or asleep you will be placed into a lithotomy position and a rigid camera will be gently inserted into the urethra with the aid of lubrication.  You should not experience any discomfort.  This allows visualization of the prostate adenoma and allows your Urologist to proceed with the surgery.  The adenoma will then be removed with either electrocautery or laser vaporization.  ​

After TURP

After the TURP you will be able to resume normal activities including driving within a few days.  Most patients do not complain of significant pain following the surgery, however discomfort with voiding can be expected for a few weeks.  Pain medications are rarely needed. 

Depending on the technology used, different care pathways can be expected: 

1) Traditional Electrocautery TURP

You can expect to spend 1-2 days in hospital.  Following the surgery a catheter will be in place in the bladder with 3 ports.  The first port will allow inflation of the catheter balloon.  The second port will allow the flow of sterile saline into the bladder.  The third will allow the flow of fluid out of the bladder.  This is a technique called "CBI" or "continuous bladder irrigation".  This will be continued until the urine is mostly clear of blood (pink / red colour change is normal).  Usually on day 1 or day 2 after the surgery the catheter will be removed for a "Trial of Voiding".  You will be discharged once you are able to void.  Occasionally patients remain unable to void following this surgery.  In this situation the catheter will be left in place for a further period of time, typically 1-2 weeks.

2) Green light laser vaporization 

With Green light laser vaporization you can expect to be discharged from hospital the same day as your surgery.  This is due to the ability of the Green light laser to spot bleeding.  However you will have a catheter in place to allow the passage of urine.  Pink / Red urine is normal, however the catheter should flow freely and without any significant clots.  The catheter will be left in place for 1-2 days and can then subsequently be removed at home for a "trial of voiding".  Rarely, the foley will need to be replaced if the patient in unable to void.  Sometimes, the patient experiences bladder overactivity following this technique.  Medications can be prescribed temporarily to assist with this until it resolves if necessary.  

When Should I Call my Doctor?

You should contact our office if significant bleeding or burning persists for more then a few days, if you are having a hard time passing your urine, or if you develop a fever.

Q&A

1. What is a resectoscope?

     It is a small retractable piece of surgical equipment that passes within a rigid cystoscope.  It allows for either an electrocautery loop or a laser fiber to deliver energy to the prostate to remove excessive tissue.

2. Will it hurt?

     The procedure should not be uncomfortable and is performed under either a regional or general anesthetic.  You may feel pressure, burning, or an urge to urinate, but it should not be "painful".

3. How long will it take?

     The procedure length is determined by the amount of obstruction present and the amount of tissue to be removed.  This can range from 30 minutes to 120 minutes.