An enlarged prostate can cause numerous problems, including problem urinating and recurring urinary tract infections.  It the prostate becomes too large and starts creating problems, it may need to be removed.

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.