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A TURP is an operation to treat urinary blockage caused by enlargement of the prostate. The procedure removes the part of the prostate gland that surrounds the urethra and causes obstruction to the urethra as a result of benign prostatic hyperplasia.

While enlargement of the prostate happens to most men, fewer than 10% will require surgery. The TURP procedure cannot be used to cure prostate cancer because it removes only the parts of the prostate closest to the urethra, while leaving the majority of the gland intact.

At the time of the procedure, an instrument known as a resectoscope is inserted into the penis, through the urethra and through to the prostate. Once positioned correctly in the prostatic portion of the urethra, the resectoscope uses an electrically activated wire loop to cut the nearby prostate tissue away. The procedure does not require an incision through the skin.

What is Benign Prostatic Hyperplasia?

Benign Prostate Hyperplasia (BPH) is a benign non-cancerous enlargement of the prostate gland and is the most common prostate problem in men aged over 50. It may also be referred to as benign prostatic hypertrophy. The prostate surrounds the urethra (the tube that urine passes through from the bladder to the penis) and as the prostate gland enlarges, it narrows the urethra making urination more difficult. This results in the following symptoms:

• Poor flow or a weak stream
• Urinary frequency (the need to urinate often)
• Urinary urgency (the need to urinate in a hurry)
• Difficulty in starting to urinate (hesitancy)
• Waking up at night to urinate (nocturia)
• Dribbling at the end of urination
• Incomplete emptying of the bladder

If these symptoms become troublesome then they can be treated with medications initially and if these fail, or are unsuccessful, then it can be treated with an operation known as a TURP (transurethral resection of the prostate).

Patient preparation for a TURP

Fasting:

This operation is performed under a general anaesthetic or a spinal anaesthetic and you will therefore be required to fast prior to the operation. You must fast for 8 hours prior to the procedure. Fasting prior to an operation includes all food and fluids. If you are a diabetic please let us know when we are booking your operation so that we can take this into consideration.

Bowels:

You do not need any specific preparation for your bowels. If you move your bowels regularly each morning then no preparation will be required. If you have troubles with bowel motions or are constipated you may require a Microlax enema, which can be purchased over the counter from a pharmacy and administered by yourself on the morning of the procedure. Please let Dr Swindle know if you have troubles with your bowels.

What to bring to hospital:

When you come to hospital you will need to bring an overnight bag with enough clothes for a hospital stay of approximately 2 nights. Please also bring all your x-ray films and your medications. Please ensure that you bring all paperwork provided to you by Dr Swindle’s rooms.

Paperwork:

When you are booked for the procedure, Dr Swindle’s office will give you a folder with paperwork. This will include an admission form, orders for nursing staff, informed financial consent, informed consent about the procedure, a summary sheet of your admission details and post operative follow up. All of your clinical details in the form of copies of the letters sent to your GP will also be enclosed.

This information will detail what time you are to present to the hospital, where to present to the hospital and the name of your anesthetist. Please bring all of this paperwork with you to hospital and give it to the nurses when you are admitted to the ward. Without this, your surgery may be cancelled.

Medications:

Many medications can thin the blood and cause excessive bleeding during surgical procedures. It is very important that you cease any blood thinning medications 7-10 days prior to the procedure. Common medications that thin the blood are Aspirin, Warfarin, Plavix (Clopidogrel) and anti-inflammatory pain medications. For a complete list of medications that may thin the blood or interfere with a surgical procedure, please refer to our information on surgery preparation and medications. Please ensure Dr Swindle is aware of all drugs, pills and medications that you take, whether on prescription or not, even if they are not on the list of medications to avoid. Do not stop any of these medications without discussion with Dr Swindle as he will advise you of the exact timing to cease any medication.