TURP - Trans Urethral Resection for Benign Prostatic Hypertrophy
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Really, the surgical treatments for benign prostatic enlargement can be divided into treatments that channel through the prostate, and treatments that lead to some sort of cell death in the prostate, usually by heat, and subsequently the cells die, and the prostate pulls back, and you have a clear channel to pass urine.
The classic treatment is the standard Trans Urethral Resection of the Prostate (TURP).
What happens with that is we put a telescope through the eye of the penis; we cut away little chips of the prostate until you have a clear channel.
You can think of it like an apple, and us taking the apple core a little bit more out.
During this procedure we use glycine, a particular type of fluid.
We can’t use saline, the same thing we put in our drip, because it conducts electricity, and we use electrical energy to cut the prostate.
Some of this glycine can absorb into the system, and very rarely can cause a serious problem called TUR syndrome, where fluid is absorbed, and it’s like having water intoxication.
Generally with the TURP we make little chips and cut the prostate and get bleeding, and then we cauterise the vessels.
So there is a risk of transfusion, and some risk of bleeding.
Patients are usually in hospital for two to three days, they have a catheter put in afterwards, and after the procedure they have some burning and stinging which normally settles over a few weeks.
It’s really important to do this operation very carefully to prevent any tears in the capsule, the lining of the prostate, and these days we operate through a big TV screen in the theatre, so everything’s really magnified, so the side effects of this operation is decreased.
Patients do still suffer from side effects such as retrograde ejaculation, when they ejaculate the semen may go back into the bladder.
There’s a five or ten percent chance of regrowth with time, or you can get an infection or scarring of the neck of the bladder or stretching into the urethra.
One percent of cases can develop some degree of incontinence, although this is very, very rare these days with the improved techniques.
So that’s the standard Trans Urethral Resection of the Prostate - TURP.