Surgery to treat problems passing urine (TURP)

Prostate cancer can press on the tube (urethra) that carries urine from the bladder. This can make it difficult for you to empty your bladder. Your doctor might suggest that you have an operation to remove some of the cancer so that you can pass urine more easily. This is called trans urethral resection of the prostate (TUR or TURP). 

This operation is more common in men with a non cancerous (benign) swelling of the prostate. This is called benign prostatic hypertrophy (BPH).

Surgeons can also use laser surgery to remove the prostate tissue. It works just as well as a TURP, but isn't available in every hospital.   

Before the procedure

You have the operation as an inpatient in the hospital. You stay in hospital between 1 to 3 days.

You usually have a TURP under general anaesthetic.  This means that you will be in a deep sleep for the whole operation. Some men have a spinal anaesthetic instead. This means that you have an anaesthetic injection into your spine. You are awake but can’t feel anything below the level of the injection.

During the procedure

The surgeon passes a thin tube up the urethra through your penis. The tube has a tiny camera and an eye piece. It helps the surgeon to see inside your urethra. They remove the obstruction using an instrument attached to the tube that heats up with an electric current and can cut away the abnormal areas.

The procedure usually takes 45 to 60 minutes to complete.

After the procedure

You will have a tube into your bladder (catheter) to measure how much urine you pass.

It is normal to have blood clots in your urine after this surgery. This can block the catheter. To prevent this, the nurse will pass fluid into your bladder. They drain it out through the catheter (bladder irrigation). As soon as your urine is clear, the catheter will come out.

Some men can’t pass urine when the catheter comes out. This is because of swelling where you’ve had surgery. You may have to go home with a catheter for a while. A district nurse will remove it at home.

Your doctor sends the small pieces of prostate removed to the laboratory. A specialist doctor called a pathologist looks at the samples under a microscope. 

Possible risks

Your doctors make sure the benefits of having the surgery outweigh these possible risks:

• temporary mild burning, bleeding and feeling that you have to pass urine often (frequency)
• not being able to produce semen when you ejaculate
• you may still have some problems with passing urine afterwards
• erection problems
• infection to your bladder
• bleeding, you may have to go back to theatre to stop the bleeding or get a blood transfusion

Follow up

You will have a follow up appointment 6 weeks or so after your surgery. At the appointment your doctor:

• gives you the results of the surgery and pathology report
• examines you
• asks you about how you are and if you have had any problems  

It is also your chance to ask any questions. Write down any questions you have before your appointment to help you remember what you want to ask. Taking someone with you can help you to remember what the doctor says.

How often you have follow up appointments depends on the results of your surgery. Ask your doctor how often you need to have follow up appointments and what they will involve.