Transurethral resection of the prostate (TURP) is a surgery used to treat urinary problems due to an enlarged prostate surrounding the urethra: benign prostate hyperplasia ou BPH. The symptoms can be very cumbersome to a man and may include: dribbling, slow stream, urgency, increase frequency, urinary tract infections, etc.
A combined visual and surgical instrument (resectoscope) is inserted through the tip of the penis and into the urethra. Using the resectoscope, the excess prostate tissue that's blocking urine flow will be trimmed away.
TURP is generally considered an option for men with moderate to severe urinary problems that haven't responded well to oral medication. Traditionally, TURP has been considered the most effective treatment for an enlarged prostate.
A first assessment is done by Dr Marois at one of the clinics.
The surgery itself is performed in the only accredited private hospital in Quebec, at the Centre Métropolitain de Chirurgie.
What are the indications for a transurethral resection of the prostate (TURP)?
How is transurethral resection of the prostate (TURP) performed?
The resectoscope is inserted into the urethra into the prostate. Dr. Marois starts by observing the inside of the urethra, prostate and bladder.
The excess prostate tissue is removed or vaporized in the area surrounding the urethra. It's basically enlarging the inside of a donut hole.
A catheter is placed in the bladder to allow urine to flow and is removed when there is no more blood in the urine (usually after 24 to 48 hours). Bladder irrigation is often necessary, depending on the amount of bleeding in the urine following the operation.
If there is little bleeding and the medical condition allows, the patient can leave with his probe at the end of the day. Otherwise, a night of hospitalization is often necessary.
What are the possible risks and complications of a TURP?
Bleeding
Infection
Discomfort
Retrograde cumshot
Erectile dysfunction (rare)
Incontinence (rare)
Some men may have to undergo a second intervention (10% of men after 10 years).
What are the different types of TURP?
- It consists of resecting the tissue by means of an electric current.
- The duration of the intervention is limited to less than 45 minutes, depending on the absorption of the liquid (glycine).
- This technology is limited to prostates under 80 g to limit bleeding.
- It carries more risk of haemorrhage.
- This is the most commonly performed RTUP.
- It is performed by Dr. Marois at the Centre Métropolitain de Chirurgie.
- It consists of resecting the tissue by means of a bipolar electric current.
- The duration of the intervention is not limited by the absorption of liquid since the surgery takes place in saline water.
- This technology is less limited in the volume of the prostate and is mainly used with PlasmaButton in the case of larger prostates.
- It has less risk of bleeding.
- This is a more affordable option than laser surgery.
- It is performed by Dr Marois at the Centre Métropolitain de Chirurgie.
- It consists in vaporizing the tissue by means of a bipolar electric current.
- The duration of the intervention is not limited by the absorption of liquid since the surgery takes place in saline water.
- This technology is not limited to the volume of the prostate and can be used with PlasmaLoop in the case of larger prostates.
- The duration of the procedure is shorter than for laser surgery.
- It has less risk of bleeding.
- This is a more affordable option than laser surgery.
- A holmium laser can be used to cut (enucleate) or spray the prostate.
- Especially useful for bulky prostates over 80g.
- The duration of the procedure is longer than for laser surgery.
- It carries little risk of bleeding.
- The necessary technology is expensive and less accessible.
- A powerful green laser is used to spray the prostate.
- Spraying is said to be photoselective because the red prostate tissue selectively absorbs the green light of the laser.
- It carries little risk of bleeding.
- The intervention is of a long duration.
- The necessary technology is expensive.