Transurethral Resection of the Prostate

For Benign Disease

The Procedure

This operation involves the telescopic removal or incision of the obstructing, central part of the prostate with cautery and temporary insertion of a catheter for bladder irrigation.

Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. Your anaesthetist will explain the pros and cons of each type of anaesthetic to you.

The procedure takes 45-60 minutes.

At the end of the procedure a suprapubic catheter may be inserted. This is a catheter placed directly through the wall of the abdomen into the bladder.

Transurethral Resection of the Prostate
After the Procedure

There is always some bleeding from the prostate area after the operation. The urine is usually clear of blood after 48 hours, although some patients lose more blood for longer. If the loss is moderate, you may require a blood transfusion.

You will be able to eat and drink the morning after the operation although this may be allowed earlier after a spinal anaesthetic.

The catheter is generally removed after 2-4 days, following which urine can be passed in the normal way.

At first, it may be painful to pass your urine and it may come more frequently than normal. Any initial discomfort can be relieved by tablets or injections and the frequency usually improves within a few days. It is not unusual for your urine to turn bloody again for the first 24-48 hours after catheter removal. A few patients are unable to pass urine at all after the operation. If this should happen, we normally pass a catheter again to allow the bladder to regain its function before trying again without the catheter.

The average hospital stay is 3- 5 days.

Side Effects

Most procedures have a potential for side-effects and these are outlined below.

Common (greater than 1 in 10)

  • Temporary mild burning, bleeding and frequency of urination after the
  • No semen is produced during an orgasm in approximately 20%, if a
    bladder neck incision is performed, or in 75% if the prostate is fully
  • Treatment may not relieve all the prostatic symptoms.
  • Poor erections (impotence in approx 5-10%).
  • Infection of the bladder, testes or kidney requiring antibiotics.
  • Bleeding requiring return to theatre and/or blood transfusion (5%).
  • Possible need to repeat treatment later due to re-obstruction (approx
  • Injury to the urethra causing delayed scar formation.

Occasional (between 1 in 10 & 1 in 50)

  • May need self catheterisation to empty bladder fully if bladder weak.
  • Failure to pass urine after surgery requiring a new catheter.

Rare (less than 1 in 50)

  • Loss of urinary control (incontinence) which may be temporary or permanent (1%).
  • Finding unsuspected cancer in the removed tissue which may need further treatment.
  • Absorption of irrigating fluids causing confusion, heart failure (TUR syndrome).
  • Very rarely, perforation of the bladder requiring a temporary urinary catheter or open surgical repair.
Going Home

Most patients feel tired and below par for a week or two. Over this period, any urinary frequency usually settles gradually

Sexual activity can be resumed as soon as you are comfortable, usually after 3-4 weeks.

It is often helpful to start pelvic floor exercises as soon as possible after the operation since this can improve your control when you get home.

The symptoms of an overactive bladder may take 3 months to resolve whereas the flow is improved immediately.

If you need any specific information on these exercises, please contact the ward staff.

The results of any tissue removed will be available after 14 – 21 days and you and your GP will be informed of the results. You will be given the follow-up plan when you leave hospital.

Most patients require a recovery period of 2-3 weeks at home before they feel ready for work. We recommend 3-4 weeks’ rest before resuming any job, especially if it is physically strenuous and you should avoid any heavy lifting during this time. You should not drive until you feel fully recovered; two weeks is the minimum period that most patients require before resuming driving.

If you experience increasing frequency, burning or difficulty passing urine or worrying bleeding, contact Dr Rasiah’s rooms or your GP.

About 1 man in 5 experiences bleeding some 10-14 days after getting home; this is due to scabs separating from the cavity of the prostate.

Increasing your fluid intake should stop this bleeding quickly but, if it does not, you should contact Dr Rasiah’s rooms or your GP who will prescribe some antibiotics for you. In the event of severe bleeding, passage of clots or sudden difficulty in passing urine, you should contact Dr Rasiah’s rooms or go to your nearest Emergency Department for assessment and if necessary, readmission to hospital.

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