Transurethral Resection of the Prostate (TURP) is a common surgical procedure performed to alleviate significant urinary symptoms caused by Benign Prostatic Hyperplasia (BPH), or an enlarged prostate. During the TURP procedure, excess prostate tissue is removed through a specialized instrument inserted via the urethra, which avoids external incisions. This surgical intervention effectively clears the obstruction, leading to improved urine flow and a reduction in bothersome urinary symptoms. Understanding the typical recovery path is helpful for those preparing for or recovering from the procedure.
Immediate Post-Operative Experience
The first one to two days following TURP surgery are typically spent in a hospital setting for close monitoring. Patients wake up with an indwelling urinary catheter, which drains urine from the bladder. This catheter is necessary because the surgical site in the urethra swells immediately after the procedure, preventing urine flow.
Many patients will also have continuous bladder irrigation (CBI) running through the catheter. This involves a sterile fluid continuously flushing the bladder to prevent blood clots and tissue fragments from blocking the catheter. The urine will appear pink or red initially due to bleeding, but the irrigation helps keep the urine clear enough for safe drainage.
Mild pain is expected and is managed with prescribed medication, often felt in the lower abdomen, perineum, or rectum. The presence of the catheter may also cause bladder spasms, leading to a strong, urgent sensation to urinate, which can be treated with specific medications. The catheter is generally removed after 24 to 48 hours, once the urine is sufficiently clear and the patient can urinate independently. Discharge usually follows shortly thereafter.
Recovery and Activity Restrictions at Home
The first four to six weeks following discharge require attention to physical restrictions to promote proper healing. Patients often experience fatigue during this period, and resting when tired is recommended, balanced with gentle activity like short, frequent walks. Avoiding strenuous exercise, heavy lifting (over 10 pounds), and activities that place pressure on the perineum, such as bicycle riding, is advised for up to six weeks.
Proper hydration is important to help flush the bladder and minimize the risk of blood clots. Patients should aim to drink non-irritating fluids throughout the day. Dietary management is advised to prevent constipation, as straining during a bowel movement significantly increases pelvic pressure, which can trigger bleeding. High-fiber foods and, if necessary, stool softeners help ensure easy bowel movements.
Expected Urinary and Sexual Function Changes
After the catheter is removed, it is common to experience temporary urinary symptoms as the bladder adjusts to the wider channel. Patients frequently report increased urinary urgency and frequency, along with a mild burning sensation during urination. These irritative symptoms are often a result of bladder inflammation. They usually improve over the following weeks, though they can persist for a few months.
A common and often permanent change following TURP is retrograde ejaculation, which affects a large majority of men. This occurs because the surgical removal of prostate tissue opens the bladder neck, the muscle that normally closes during orgasm. Consequently, semen travels backward into the bladder and is later passed harmlessly with urine, resulting in a “dry orgasm.” This typically does not affect the sensation of orgasm or the ability to achieve an erection.
Recognizing Potential Complications
While the healing process involves expected side effects, certain signs warrant immediate contact with the surgical team. A complete inability to urinate, known as acute urinary retention, requires prompt medical attention, as it indicates a blockage, possibly from a blood clot. Patients should also monitor for signs of a severe infection, which include a fever (typically over 101.5°F), chills, or severe, worsening pain.
A sudden and significant increase in bleeding is also a cause for concern. This is indicated by bright red urine or the passage of large, thick blood clots that do not clear up after resting and increasing fluid intake. Any severe pain that is uncontrolled by the prescribed pain medication should also be reported immediately.