From the Guidelines
The Transurethral Resection of the Prostate (TURP) procedure is effective in relieving urinary symptoms caused by benign prostatic hyperplasia (BPH) with a significant improvement in symptoms in most patients within days to weeks following the procedure. The TURP procedure involves the surgical removal of the prostate's inner portion via an endoscopic approach through the urethra, with no external skin incision, and is the most common active treatment for symptomatic BPH 1. Some key points to consider about the TURP procedure include:
- The procedure is usually performed under general or spinal anesthesia and requires a hospital stay 1
- The most definitive published study of TURP, the Veterans Affairs Cooperative Study, demonstrates a 1% risk of urinary incontinence and an overall decline in sexual function that was identical to the watchful waiting treatment group 1
- Other complications that have been reported in more than 5% of patients include sexual dysfunction, irritative voiding symptoms, bladder neck contracture, the need for blood transfusion, UTI, and hematuria 1
- A unique complication of TURP is TURP syndrome, a dilutional hyponatremia that occurs when irrigant solution is absorbed into the bloodstream 1 The immediate effects of the TURP procedure include improved urinary flow rate, reduced post-void residual urine volume, and decreased lower urinary tract symptoms such as frequent urination, urgency, weak stream, and nocturia. Recovery from the procedure typically requires 1-2 weeks of limited activity, with catheterization for 1-3 days post-procedure, and patients should expect some blood in the urine for several days to weeks 1. It is also important to note that patients may experience retrograde ejaculation (semen flowing backward into the bladder) as a permanent side effect in 65-75% of cases. Overall, TURP is a highly effective procedure for relieving urinary symptoms caused by BPH, with significant symptom improvement and low risk of major complications.
From the Research
Effects of the TURP Procedure
The Transurethral Resection of the Prostate (TURP) procedure is a common treatment for benign prostatic hyperplasia (BPH) and has several effects on patients, including:
- Improvement in urinary flow and reduction in symptoms 2, 3, 4
- Reduction in post-void residual urinary volume 3, 4
- Improvement in quality of life 3, 4
- Increase in peak urinary flow rate 3, 4
Adverse Events Associated with TURP
TURP is associated with several adverse events, including:
- Retrograde ejaculation 3, 4
- Erectile dysfunction 3, 4
- Urethral stenosis 4
- Urinary incontinence 4
- Clinically significant adverse events in 20% of patients 2
Comparison with Other Treatments
TURP has been compared with other treatments for BPH, including:
- Transurethral needle ablation (TUNA) 3, 4
- Medical therapy, such as alpha-blockers and 5-alpha-reductase inhibitors 2, 5, 6
- Minimally invasive procedures, such as electrovaporisation and laser prostatectomy 2
Patient Selection and Treatment Outcomes
The selection of patients for TURP and other treatments for BPH depends on several factors, including: