This is the most common surgical procedure for BPH, involving a special scope (known as a resectoscope) being inserted into the prostate via the urethra and an electrically heated wire loop used to cut away parts of the prostate and open up the water passage. This is very much like coring an apple out from the inside. At the end of the operation, the prostate tissue is washed out of the bladder. The operation will usually be carried out under a general anaesthetic or a spinal anaesthetic (similar to epidural anaesthetic given to pregnant women during delivery, which allows the patient to be conscious during surgery). After the operation, you will have a catheter tube for 36-48 hours to allow any blood or blood clots to be washed out of the bladder, which is usually removed after 2 days. The raw surfaces of the prostate can bleed both during and after TURP, but few men will require a blood transfusion (0.5-7%). You can expect to stay in hospital for 3 or 4 days following a TURP.
After a TURP operation, some men will experience burning when passing urine and, in some cases, an urgent need to urinate (30-40%), but this usually passes after a few weeks. There is some possibility of erectile dysfunction (impotence) after the operation, but this appears to be in a small number of men (2-3%), and some report better sexual function. In a few cases, urine leakage/incontinence (<0.5%) can result. The main change that most men (75%) see is that of retrograde ejaculation, which is when the semen is deposited into the bladder at orgasm, rather than through the penis. The semen is then washed out during the next time you pass urine. The procedure reduces fertility but does not make you infertile.
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