Transurethral Resection Of The Prostate
A transurethral resection of the prostate, abbreviated as TURP, is surgical procedure that is most often done to treat benign prostatic hyperplasia (BPH). BPH is the enlargement of the prostate gland that often occurs as a man ages. The prostate gland is located in the pelvis just below the bladder. Its main role is to secrete substances into the semen that help sperm fertilize a woman's egg.
Who is a candidate for the procedure?
The enlarged gland in a man with BPH can press against the urethra, the tube that carries urine from the bladder to the outside of the body. This pressure can interfere with a man's ability to urinate. Medications are usually prescribed to relieve these symptoms.
If the man does not want to take the medicines or if symptoms are not relieved, the healthcare provider may recommend a TURP. TURP is sometimes used when there are urinary problems caused by prostate cancer. The goal of the operation in this case is to treat the blockage, not to manage the cancer. Other treatments are needed for the cancer.
How is the procedure performed?
A TURP is done in the hospital by a urologist. A urologist is a surgeon who treats people with diseases of the kidney and urinary tract. The procedure can be performed under general or regional anesthesia. With general anesthesia, the man is given medications to put him completely to sleep, so that he feels no pain and has no awareness of the procedure. With regional anesthesia, the man is given medication to make him numb from the waist down and medication also to make him slightly drowsy.
First, the surgeon inspects the urethra and bladder with an endoscope. An endoscope is a special tube with a camera on the end which allows the surgeon to see the inside of the urinary tract. The scope is passed through the tip of the penis. It is then passed into the urethra and bladder. This is to double check that the planned operation is correct. It is also to look for any unplanned problems such as bladder tumors or stones in the bladder.
Next, an electrical loop is passed into the urethra. The loop is placed near the part of the urethra that is surrounded by the prostate. The loop is used to cut out pieces of tissue from the prostate that bulge into or block the urethra. This process is similar to coring an apple. Electricity is applied through the same loop to stop bleeding.
After the procedure is over, the pieces of the prostate that were trimmed away are removed. The tissue is sent to the lab to make sure that prostate cancer is not present. A urinary catheter is then inserted through the penis and into the bladder.