Transurethral Resection of the Prostate (TURP) is a common surgical procedure for an enlarged prostate gland, known as benign prostatic hyperplasia (BPH). A resectoscope is inserted through the penis into the urethra to trim excess prostate tissue obstructing urine flow. It aims to alleviate urinary symptoms and improve quality of life for those with BPH.
Measuring Surgical Success
Success is evaluated by improved urinary symptoms and urine flow. A key indicator is a reduction in International Prostate Symptom Score (IPSS), which assesses symptom severity. Patients often experience a stronger stream and less frequent urges.
Urine flow rates, measured through uroflowmetry, also indicate effectiveness. While complete symptom resolution is not always the target, TURP achieves substantial relief, with symptom improvement rates ranging from 85% to 90%. Improved quality of life, reported by the patient, further confirms success.
Factors Influencing Outcomes
Several elements can affect the outcome of TURP surgery. Patient characteristics, such as prostate gland size, play a role; larger prostates might lead to longer operating times, but they do not necessarily compromise functional outcomes or increase complication rates. The severity of BPH symptoms before surgery, including the presence of urinary retention, can also influence the postoperative course, with retention often associated with less favorable outcomes.
A patient’s overall health and the presence of other medical conditions, known as comorbidities, can impact recovery and the likelihood of complications. Surgical factors, including the surgeon’s experience and the specific technique utilized, also contribute to the procedure’s effectiveness and safety. These variables highlight why outcomes can differ among individuals.
Common Post-Surgical Considerations
Patients undergoing TURP can expect certain temporary issues during recovery. It is common to experience a burning sensation during urination for two to three weeks, and some blood in the urine may be observed intermittently for four to six weeks. Bladder cramps or spasms can also occur, for which medication may be prescribed.
Temporary urinary incontinence, where there is some loss of bladder control, might be experienced initially but typically improves as recovery progresses. Another common occurrence is retrograde ejaculation, where semen enters the bladder instead of exiting the penis during orgasm. This is not harmful but can affect fertility. These experiences are generally anticipated aspects of recovery and do not indicate a failure of the surgery.
Long-Term Outlook
The benefits of TURP are generally durable, with treatment effects often lasting 15 years or more. While the procedure provides long-lasting relief, some individuals may require further intervention over time. Reoperation rates for TURP are reported to be around 4.0% at one year, increasing to 7.7% at five years.
An Austrian nationwide study indicated an 8.3% re-TURP rate after primary TURP at eight years. The need for re-treatment can arise if symptoms recur or do not improve sufficiently over time, or due to complications such as narrowing of the urethra or bladder neck. These long-term statistics provide a comprehensive understanding of the sustained effectiveness of TURP.