Trans Urethral Resection of Prostate (TURP)

The prostate gland is an organ that surrounds the urinary urethra in men. It secretes fluid that mixes with the sperm to make semen. An enlarged prostate gland compresses the urethra, causing problems with urination. Prostate enlargement is caused by prostate gland overgrowth (benign prostatic hypertrophy or hyperplasia) or in some cases, prostate cancer. With an anesthetic (general anesthetic or spinal), a special kind of telescope, called a resectoscope is inserted through the urethra into the prostate. The resectosope is used to remove the blocking portions of the prostate. Transurethral resection of the prostate (TURP) is the most common type of surgical procedure for benign prostatic hyperplasia (BPH). TURP is typically successful at removing the symptoms of an enlarged prostate.

Are there other options?

BPH can be treated several ways. Medication can work well, but if it doesn't, surgery may be needed. Although a TURP operation is common, there are other options, including special heat, laser and microwave devices. Make sure to talk with your doctor about your options.

Why does a TURP need to be done?

BPH can cause problems with urination, such as difficulty starting to urinate or awakening several times during the night to go to the bathroom. BPH can even cause bladder infections and kidney problems.

While BPH is a benign condition, the symptoms associated with BPH can be similar to the symptoms of prostatic cancer. Sometimes a prostate biopsy is needed to distinguish between the two conditions.

There are several medications that can treat BPH. As men get older, their BPH can get worse and medicine may no longer work.

A TURP operation is usually done for severe BPH. This helps to correct the problems with urination.

How is a TURP performed?

A small fiber-optic scope is passed through the urethra, the opening from which urine flows. Medications can be used to numb this area to prevent pain or discomfort.
Tools are used to remove the inside of the prostate. This helps to improve your urine flow. Everything is done inside your urethra, so you won't get any cuts or scars.
After the surgery, you may see small amounts of blood in your urine. This is normal, and the blood will disappear in several days.

The operation

A TURP is usually performed under a general anaesthetic so that you are asleep and feel no pain throughout the procedure. However, the operation can be done under spinal anaesthesia, so that you are awake but feel no pain when it is carried out. Typically, no food and drink is allowed for about six hours before a general anaesthetic.

A TURP usually involves a hospital stay of around four days. The operation itself takes about an hour.

Once the anaesthetic has taken effect, the surgeon inserts a thin, tube-like telescope (a resectoscope) into the urethra.

The resectoscope includes a camera and specially adapted surgical instruments. This allows the surgeon to see the prostate clearly. A wire loop attachment carrying an electric current is used to "chip away" at the prostate. The same instrument, with a different type of electric current, is used to stem any bleeding.

During the operation, the bladder is flushed with a sterile solution to remove the chippings of prostate tissue. A catheter (a thin flexible tube) is then inserted through the urethra into the bladder.

Complications

Complications are unexpected problems that can occur during or after the operation. Most people are not affected. The complications of this operation include excessive bleeding, a urinary tract infection or an unexpected reaction to the anaesthetic. It is also possible for too much water to be absorbed from the fluid used to flush the bladder during the operation. This can temporarily upset the balance of salts in the blood, which can be harmful, particularly for people who already have heart or kidney problems. The condition is sometimes known as TURP syndrome.

On rare occasions it is possible to develop a blood clot (known as a deep vein thrombosis or DVT) in the veins of the leg. This clot can break off and travel to the lungs to cause a blockage. In the majority of cases, this is treatable, but it can be a dangerous condition. People having surgery are routinely given medicines or compression stockings to wear during the operation to help prevent a DVT.

Trans Urethral Resection of Bladder Tumor (TURBT)

Bladder tumor is a common disorder in Iranian People. Typically it causes blood in urine (hematuria).  It is especially common in old cigarette smoking men. If you observe any blood in your urine please consult as early as possible with an urologist.

Bladder tumor is diagnosed through cystoscopic examination that can be done as outpatient procedure. For definite diagnosis bladder tumor should be resected and sent for pathologic examination. Trans urethral resection as explained above is standard method for diagnosis and also treatment (small superficial tumors) of bladder tumor.

TURBT is performed similar to TURP that mentioned previously.