This is probably the most common surgical procedure for BPH. It involves a special instrument (called a resectoscope) being inserted into the prostate via the urethra. An electrically heated wire loop is used to trim-off the parts of the prostate squeezing the urethra so opening up the water-pipe to help urine flow. 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 generally lasts up to an hour and will usually be carried out under a general anaesthetic or sometimes with a spinal anaesthetic so you will be numb from the waist down but still awake. After the operation, you will have a catheter for 36-48 hours to allow any blood or blood clots to be washed out of the bladder (a catheter is a thin flexible tube that is inserted into the bladder and drains urine into a bag for further information see caring-for-your-indwelling-catheter-at-home) . It is usually removed after 2 days, but occasionally some men go home with a catheter. You may have to stay in hospital for a couple of days after having a TURP. Most men find that they need around 2 weeks off work but this may increase if they have a very strenuous job.

Potential Side-effects

Blood in your urine
After the operation it is quite usual to see some blood or small blood clots in your urine especially around 7-10days and this may last a few days. If you have difficulty passing urine, pass large blood clots or have a lot of discomfort then you should get in touch with your GP. Very few men will require a blood transfusion (less than 1%).

Passing urine
Some men will experience a burning feeling when passing urine and, in some cases, an urgent need to pass urine (30-40%), but this usually passes after a few weeks. Some men find they need to pass urine more frequently for a few weeks after the operation. In a few cases, urine leakage/incontinence (<0.5%) can result. Spotlight on incontinence .

Difficulties with erections
There is some possibility of erectile dysfunction (inability to get or maintain an erection) after the operation, but this seems to affect only a small number of men (2-3%). Spotlight on ED

Retrograde ejaculation
Most men who have a TURP will experience retrograde ejaculation or dry orgasm. This means that at the point of orgasm you will not ejaculate because the semen has passed backwards into your bladder rather than down the penis. This won’t do any harm and will pass out in your urine the next time you go to the toilet but it will make your urine look cloudy. Although it’s quite common to leak a little urine at the time of ejaculation as the muscles relax. The procedure reduces fertility but does not make you infertile so you should not rely on this as a method of contraception.

Infection
Sometimes a urinary tract infection occurs and you would most likely be given antibiotics if this happens.

Most side-effects and symptoms settle down over 3-4 weeks after a TURP, although some urinary symptoms such as frequency and urgency may take a bit longer. Retrograde ejaculation is usually permanent when it occurs.

For further information see Spotlight on treatment for an enlarged prostate