The Transurethral Resection of the Prostate (TURP) is a common surgical procedure performed to alleviate severe urinary symptoms caused by an enlarged prostate (benign prostatic hyperplasia or BPH). During the procedure, excess prostate tissue blocking the flow of urine is removed using an instrument inserted through the urethra. This creates a clear channel for urination but leaves a sensitive, internal surgical wound within the prostate capsule and bladder neck area. Therefore, abstinence from all sexual activity is a mandatory part of the post-operative recovery protocol to ensure proper healing.
Immediate Risks of Physical Strain
The primary reason to avoid sexual activity immediately following a TURP is the significant risk of post-operative bleeding at the surgical site. The resection procedure removes tissue, leaving a large, raw surface inside the prostatic urethra that subsequently develops a protective scab. Ejaculation and the physical strain associated with sexual activity cause involuntary, rhythmic contractions of the pelvic floor muscles, including the pubococcygeus muscle. These intense muscle movements can place mechanical stress on the newly formed scab, potentially causing it to dislodge prematurely.
The physical exertion and emotional excitement of sexual arousal also lead to a temporary increase in heart rate and systemic blood pressure. This rise in blood pressure elevates the force of blood flow within the small vessels that supply the healing area. If the scab is forcefully dislodged by either muscle contraction or elevated blood pressure, it can lead to a secondary hemorrhage. This bleeding can be severe, potentially causing significant blood loss or forming blood clots within the bladder that obstruct the urethra and require emergency medical intervention.
Physical trauma or hyperstimulation to the delicate internal tissues can severely disrupt wound healing. The internal wound requires a stable environment to regenerate the epithelial lining and form strong scar tissue. Introducing friction or intense pressure can cause microtrauma, delaying the overall recovery timeline and risking complications.
Preventing Infection and Complications
Beyond the mechanical risks of physical strain, abstaining from sexual activity is a hygienic safeguard against severe post-operative infections. The urethra and bladder are temporarily highly vulnerable following the surgical removal of prostate tissue. During the procedure, and often for a short time after, a urinary catheter is placed, which inherently introduces a small risk of bacterial colonization.
Introducing foreign bacteria from external sources, such as during sexual intercourse, significantly raises the risk of developing a complicated urinary tract infection (UTI). A UTI in this context can quickly progress to involve the prostate bed or even the epididymis, leading to a painful condition called epididymitis. The post-operative inflammation and temporary disruption of the body’s natural barriers make the urinary tract an easier target for infectious agents.
Avoiding activity also minimizes irritation to the sensitive bladder neck and the newly opened prostatic urethra. Inflammation and swelling in this area can impede the smooth flow of urine, potentially causing painful voiding symptoms or even urinary retention. By keeping the area undisturbed, patients reduce the risk of introducing pathogens and promote a calmer, less inflamed state that facilitates optimal biological healing.
Establishing the Safe Waiting Period
The safe waiting period for resuming sexual activity is a critical question for many patients, and the timeline is based on the biological phases of internal wound healing. Generally, urologists advise patients to abstain from all forms of sexual activity for a period of four to six weeks following the TURP procedure. This range accounts for the average time required for the internal prostate wound to heal and for the initial scabs to pass safely.
The restriction on “sexual activity” extends to anything that results in orgasm or significant pelvic floor muscle contraction. This includes intercourse, masturbation, and any other activity that could cause hyperstimulation or physical trauma to the healing area. The most telling sign that the body is progressing through the healing process is the appearance and cessation of blood or small scabs in the urine, which typically occurs around one to two weeks post-surgery.
The four-to-six-week guideline is an estimate; the ultimate decision rests with a medical professional. Patients must receive explicit clearance from their urologist before reintroducing sexual activity. Resuming activity before clearance risks reversing healing progress and causing serious complications.
Long-Term Sexual Function Changes
Once the temporary abstinence period concludes and the surgical site is fully healed, patients should be aware of a common, permanent change to their sexual function. The most frequent long-term consequence of TURP is retrograde ejaculation, which occurs in the majority of men who undergo the procedure. This happens because tissue removal widens the bladder neck, the muscular opening that normally closes during orgasm to prevent semen from flowing backward.
With the bladder neck widened, semen is rerouted into the bladder during ejaculation instead of being expelled through the urethra. This results in a “dry orgasm,” where the sensation of climax is preserved, but little to no fluid is released externally. The semen is then harmlessly passed out of the body later when the patient urinates.
The sensation and pleasure of orgasm are typically preserved, as the nerves responsible for this feeling are not affected by the TURP procedure. The procedure is generally not associated with a decline in the ability to achieve or maintain an erection, unlike more extensive prostate surgeries. While a small percentage of men may report a temporary decline in erectile function, TURP is considered “erection-sparing.”