If
your urination problems are causing you a lot of bother, and lifestyle
changes and medication are not helping enough, then your urologist
may recommend surgery to remove the obstruction to the urinary
stream. The most common type of surgery is called Transurethral
Resection of the Prostate (TURP).
Transurethral
Resection of the Prostate (TURP)
TURP is successful in improving symptoms in about 80 per cent
of cases. In this procedure, an instrument called a resectoscope
is passed along the urethra and the tissue causing the blockage
is cut away in small slices using a heated wire). Only a part
of the prostate gland - not the whole gland is removed, in order
to relieve urinary symptoms.
You
will need to stay in hospital for usually one to two nights for
this procedure. For the first 12-24 hours after the operation,
a catheter (a narrow tube held in place by a small balloon in
the bladder) will be in place so that the urine and blood that
are in the bladder can drain away readily.
Do
not be disturbed if you see blood in urine that you pass immediately
after a TURP, as this is normal, and will disappear within a period
of a few days to 4-6 weeks. It is also possible to experience
temporary incontinence after a TURP. Should this happen, you should
have a supply of pads before you leave the hospital. It can take
up to 3 months for things to settle, and for your symptoms to
finally clear up.
Another
side-effect, which can occur in a small number of men, is the
formation of a 'stricture' or scar tissue which forms in the urethra
during healing and may impede the flow of urine. Treatment involves
surgical dilation or incision.
Transurethral Resection of the Prostate (TURP) for an enlarged
prostate does not guarantee that a person will not develop cancer
of the prostate gland at a later time, because it only removes
part of the gland. This part, surrounding the urethra, is not
where cancer usually develops.
Prostate tissue being removed with Resectoscope
Important
If you have any concerns prior to and following TURP surgery,
do not hesitate to discuss these with your urologist or doctor.
They are there to help you to make informed decisions about your
health and well being, and to advise you should you develop any
worrying symptoms after surgery.
One
side-effect of a TURP, which occurs in roughly 80 per cent of
men, is permanent retrograde (reverse) ejaculation, also called
a 'dry ejaculation'. This means that the semen is passed backward
into the bladder instead of into the urethra during an ejaculation.
An
important long term consequence of retrograde ejaculation is infertility
and you may not be able to father children naturally. Some men
may find having a 'dry orgasm' upsetting, but it usually does
not affect sexual performance or pleasure. There is no hazard
to your health from retrograde ejaculation. Most men who did not
have erection problems prior to a TURP procedure should continue
to experience no problems following it.
Impotence
(also called erectile dysfunction) following TURP can occur, but
the incidence is generally low, around 5-8 per cent. Long term
incontinence is less than 1 per cent.
Important
It is not always wise to assume that once surgery on the prostate
such as TURP has been undertaken, further operations and treatments
may not be required. The prostate gland can continue to enlarge
despite previous treatments and this may necessitate further surgery
or treatments.
