Transurethral Resection of the Prostate (TURP) is a surgical procedure commonly performed to alleviate urinary symptoms caused by an enlarged prostate gland, known as benign prostatic hyperplasia (BPH). The duration of the hospital stay is highly variable, so there is no single answer to whether TURP is an outpatient procedure. While same-day discharge is possible for select patients, the procedure is most often associated with a short, planned inpatient stay. This stay ensures necessary post-operative monitoring and recovery. The ultimate decision depends on the patient’s overall health and the specifics of the surgery performed.
Defining the TURP Procedure
TURP is considered the traditional standard surgical treatment for BPH, offering significant relief from obstructive urinary symptoms. The procedure is minimally invasive, utilizing a specialized instrument called a resectoscope that is inserted through the urethra to reach the prostate gland. This method eliminates the need for an external incision.
The resectoscope features a light, a camera, and an electrical wire loop used to cut away and remove the excess prostate tissue blocking the flow of urine. Modern variations, such as bipolar TURP or Transurethral Resection in Saline (TURIS), use different electrical currents and irrigating fluids, which can reduce certain risks. The goal is to widen the narrowed passage of the urethra, restoring a stronger and more complete urinary flow.
Factors Influencing Inpatient or Outpatient Status
The determination of an inpatient stay versus an outpatient procedure is largely driven by factors that influence the risk of post-operative complications, particularly bleeding. While certain techniques like bipolar TURP have been safely performed in an outpatient setting, conventional TURP often necessitates a brief hospitalization. A short hospital stay, usually one to two nights, allows the medical team to manage initial bleeding and monitor the patient for a stable recovery period.
The patient’s overall health and age are significant considerations, as those with pre-existing heart or lung conditions may require a more cautious, monitored environment. The size of the prostate gland is another important factor; a larger gland requires a more extensive resection, which increases the likelihood of post-operative bleeding and the need for prolonged monitoring. The requirement for continuous bladder irrigation (CBI) immediately following the surgery is the most direct influence on the length of stay.
Immediate Post-Procedure Monitoring and Recovery
The most immediate aspect of post-TURP care is the management of potential bleeding from the surgical site, which is why most patients require a hospital stay. A temporary urinary catheter, typically a three-way Foley catheter, is inserted immediately after the procedure to drain the bladder and facilitate irrigation. Continuous bladder irrigation (CBI) is initiated through this catheter to continuously flush the bladder with sterile fluid, preventing blood clots from forming and obstructing urine drainage.
CBI is maintained until the urine draining from the catheter is clear or only minimally blood-stained, which generally takes between 12 and 24 hours in uncomplicated cases. Once the urine is clear and stable, the irrigation is discontinued, and the catheter is usually removed 24 to 48 hours post-surgery. The patient is then observed to ensure they can urinate effectively on their own before being discharged.
Managing Recovery After Discharge
Once discharged, patients should expect a period of temporary urinary symptoms as the surgical site heals, which can take six to seven weeks. Common symptoms include mild blood in the urine, which may be intermittent for several weeks, and increased urinary frequency or urgency. Mild burning or stinging during urination is also typical, resulting from the temporary irritation of the urinary tract.
Patients must adhere to specific activity restrictions to prevent secondary bleeding, which often occurs around 10 to 14 days post-procedure when the surgical scab begins to slough off. Heavy lifting, strenuous exercise, and activities that involve straining should be avoided for at least two to four weeks. Patients must contact a medical professional immediately if they experience a high fever, the complete inability to urinate, or heavy bleeding characterized by thick blood or large blood clots.