Transurethral Resection of the Prostate (TURP) is a common surgical procedure to alleviate urinary symptoms caused by an enlarged prostate. While generally effective, TURP carries potential complications. Understanding these outcomes can help individuals prepare for and manage recovery.
Understanding TURP
Transurethral Resection of the Prostate, or TURP, is a minimally invasive surgical procedure. It removes excess prostate tissue that can obstruct urine flow from the bladder. A surgeon inserts a resectoscope through the urethra, using an electrical loop or laser to precisely cut away pieces of the enlarged prostate gland. This approach avoids external incisions, leading to less pain and faster recovery. TURP is a standard treatment for benign prostatic hyperplasia (BPH).
The Most Common Complication
Retrograde ejaculation is the most frequently reported long-term complication following TURP, affecting 65% to 75% of men. This condition occurs when semen flows backward into the bladder during orgasm, rather than being expelled. It is sometimes called a “dry orgasm” due to the absence of visible ejaculate. This results from surgical removal of prostate tissue around the bladder neck, which normally closes during ejaculation. When this mechanism is disrupted, semen enters the bladder. While not harmful or painful, it can affect fertility. For some, the lack of visible semen can also lead to psychological distress or impact sexual satisfaction.
Other Potential Complications
Beyond retrograde ejaculation, other complications can arise from TURP, though they are less common. Bleeding is a frequent immediate post-operative concern, often manifesting as blood in the urine. Some men may experience heavy bleeding that necessitates a blood transfusion.
Urinary tract infections (UTIs) are another potential issue, with increased risk if a catheter remains in place for an extended period. Symptoms include fever, chills, and an increased urge to urinate. Temporary urinary incontinence is common immediately after surgery, but typically resolves. Long-term incontinence is uncommon.
Erectile dysfunction (ED) affects around 4% to 14% of patients; TURP does not negatively impact erection quality. A more severe but rare complication is TURP syndrome, occurring when excessive irrigating fluid used during surgery is absorbed into the bloodstream. This can lead to fluid overload and a dangerous drop in blood sodium levels, potentially causing confusion, dizziness, headache, nausea, seizures, or coma.
Managing Complications
Managing complications after TURP depends on the specific issue and its severity. For retrograde ejaculation, active medical treatment is not necessary as it is not physically harmful. If fertility is a concern, a doctor may discuss alternative procedures or options for sperm retrieval.
Post-operative bleeding usually subsides with rest and increased fluid intake. In instances of persistent or heavy bleeding, medical intervention might involve a procedure to identify and seal the bleeding vessels. Urinary tract infections are treated effectively with antibiotics.
Temporary urinary incontinence often improves naturally as the body recovers. Pelvic floor exercises, such as Kegels, can help strengthen bladder control muscles. For more persistent cases, medication or further surgical procedures may be considered.
TURP syndrome requires immediate medical attention, including stopping the surgical procedure. Treatment focuses on removing excess fluid with diuretics and correcting electrolyte imbalances, such such as low sodium.