One of the most common and proven ways to remove the prostate is transurethral resection of the prostate or TURP.

TURP is performed using spinal or general anesthesia.  A tube-like instrument called a cystoscope is inserted into the penis through the urethra and up to the prostate gland.  This tube is called a resectoscope and is about 12 inches long and 3/8 of an inch in diameter.  The tube has a light and an electrical loop to remove the tissue.

The surgeon uses this tubing to remove the obstructing tissue in pieces.  Then the irrigating fluids carry the tissue pieces to the bladder. This debris is removed by irrigation and any remaining debris is eliminated in the urine over time.

After the surgery, an electrical current is used to stop the bleeding during surgery. This is called cauterization.  You must remain in the hospital for approximately 3 days, while a catheter will be used to drain your urine. A liquid solution may be attached to the catheter to flush the area and keep the tube from becoming clogged with blood or tissue. The bleeding will gradually decrease, and the catheter will be removed within 1 – 3 days.

During the recovery period, patients are advised to

• avoid heavy lifting, driving, or operating machinery;
• drink plenty of water to flush the bladder;
• eat a balanced diet;
• use a laxative if necessary to prevent constipation and straining during bowel movements.

As this surgery is somewhat evasive, some men will not return to work for about a month.  There are some possible complications that may occur.

Blood in the urine (hematuria) is common and usually resolves by the time the patient is discharged.  However, bleeding also may result from straining or activity.  Any postsurgical bleeding should be reported to the urologist immediately.

Additionally, some individuals have initial discomfort, a sense of urgency to urinate, or short-term difficulty controlling urination. These conditions slowly improve as recovery progresses.

Another common problem may be difficulties with sexual function, as many as 30% of men have problems.  The complete recovery of sexual function may take up to 1 year.  The most common long-term side effect of prostate surgery is retrograde ejaculation or dry climax.  In this situation, the semen enters the bladder instead of being expelled through the penis, causing sterility but not affecting the man’s ability to experience sexual pleasure. This complication is not an issue for most men requiring prostate surgery.

Suggested Reading

• BPH – Diagnosis and Treatment
• How is Prostate Cancer Treated?
• How is Prostatitis Diagnosed?

Follow doctor recommendations and work to get better

Watchful Waiting

For watching waiting, the prostate is carefully monitored, but it is not treated right away.  It’s not exactly ignoring prostate cancer, but waiting to see what the next step will be.  In some cases, a man will be diagnosed with prostate cancer, but the cancer will grow so slowly that it will not affect a man over his entire lifetime.  If symptoms spread and cancer becomes more intense, there are other options that will be implemented.

Radiation Therapy

Radiation is meant to kill fast-growing cancer cells.  It can be performed externally or internally.  External radiation therapy is when a beam is sent from outside of the body toward the tumor.  It’s performed at a hospital or a treatment center.  It’s typically performed five days a week for several weeks.  It is painless, but may produce unpleasant side effects, such as tiredness, nausea, hair loss, skin soreness and loss of appetite.

Brachytherapy is a kind of internal radiation therapy where radioactive seeds or pellets are surgically implanted into the prostate with the use of needles.  An ultrasound picture guides the physician in placing the seeds or pellets.  Medication can be used to block any pain or discomfort which may be involved.

Chemotherapy

Chemotherapy is when chemicals are used to kill the cancer cells.  Chemotherapy is only implemented when the cancer has spread beyond the prostate.  It is not used in the early stages of prostate cancer.

Cryotherapy

This is a procedure in which an ultrasound probe is inserted into the rectum to produce a picture that the physician will watch on a monitor.  The physician inserts probes into the prostate through small incisions between the rectum and the scrotum.  The probes release liquid nitrogen to the prostate, freezing the tissue and killing the cancer cells.

Hormone Therapy

Prostate cancer feeds on the male hormone testosterone.  Sometimes a reduction in testosterone will slow the growth of cancer.

Luteinizing hormone-releasing hormone agonists (LH-RH agonists) are drugs that reduce the production of testosterone, but without the same side effects of estrogen.  They are often times used in conjunction with hormones called antiandrogens.

Sometimes the testicles are removed in order to prevent the production of testosterone.  This procedure is referred to as orchiectomy.

Prostate Removal

When the cancer hasn’t spread beyond the prostate, prostate removal may be an option.  It is not always a cancer cure, however, and time will have to go by before doctors can be sure.

TURP

Transurethral resection of the prostate (also known as TURP) is when only a portion of the prostate is removed.  It’s removed with an instrument that is inserted through the urethra.  The cancer is then removed when electricity is passed through the end of the instrument.

Suggested Reading

• Transurethral Resection of the Prostate (TURP)
• Prostate Health: What medications are available?