What Is Transurethral Resection of the Prostate (TUR-P)?

Transurethral Resection of the Prostate (TUR-P) is a closed surgical treatment method that is currently considered the gold standard for the treatment of prostate enlargement. General or spinal anesthesia (waist-down anesthesia) may be used for TUR-P. It cannot be performed under local anesthesia. The urologist reaches the prostate through the urethra (urinary canal) using a resectoscope.

Resectoscope:
A type of endoscope equipped with a wire loop that uses high-frequency electrical current or another energy system such as plasmakinetic energy to cut prostate tissue. The resectoscope also contains a camera that allows the doctor to view a high-quality image of the prostate on a video monitor. During TURP, the urologist cuts away the portions of the prostate obstructing the urinary tract in small pieces, similar to shaving tissue. The removed prostate pieces fall into the bladder. At the end of the operation, the bladder is irrigated and the cut prostate pieces are removed from the body. There are various types and methods of TUR-P depending on the type and form of energy used.

Plasmakinetic Energy:
Electrical energy circulates between the two cutting wires of the resectoscope instrument, generating what is called plasma energy. This energy is used to cut tissue. During the cutting process, this energy also provides bleeding control. Unlike monopolar TUR-P, the electrical current does not circulate throughout the entire body.

Compared to conventional monopolar TUR-P, plasmakinetic energy has several advantages. It causes less damage to deep tissues (surrounding tissues) during the cutting process. Isotonic saline is used as the irrigation solution. Thanks to the use of this fluid, the risk of TUR syndrome (water intoxication) during plasmakinetic TURP surgery is minimal. There is no limitation on operation duration, so large prostates may also be operated on using this method (depending on the surgeon’s experience and skill). Bleeding is controlled better compared to monopolar TURP. It may also be performed on patients with pacemakers.

At the end of TURP surgery, a catheter is placed into the bladder. The catheter is continuously irrigated with a sterile solution to prevent blood clots from forming in the bladder. Once the bleeding stops, usually after 1–2 days, the catheter is removed. Patients are generally discharged 2–3 days after surgery.

A small amount of blood may be seen in the urine for several days. The patient may feel pain and burning during urination and may need to urinate frequently. These urinary symptoms may continue for up to one month after TURP surgery. Sexual intercourse should be avoided for 2–3 weeks after TURP surgery. After TUR-P, retrograde ejaculation may occur. This is a chronic condition in which semen flows back into the bladder instead of exiting through the urethra during orgasm.

During the First 4–6 Weeks After Surgery

• Drinking at least 2 liters of fluids daily, especially water, is beneficial.

• Do not lift objects heavier than 5 kilograms.

• Avoid heavy exercise and cycling.

• Avoid thermal baths and saunas.

• Consume fiber-rich foods and avoid constipation.

If you develop fever, are unable to urinate, experience severe bleeding, or have significant pain, you should immediately consult your urology specialist.