+91 7704033027
+91 522 2732020
The prostate gland surrounds the urethra and is located immediately below the neck of the urinary bladder. All Men have prostate gland that keeps increasing in size with age. Most of the men who present with the symptoms of poor/interrupted flow, sense of incomplete evacuation and other urinary problems have enlarged prostate as the cause. The diagnosis of enlarged prostate is done with digital rectal examination, ultrasound and uroflowmetry. Treatment of enlarged prostate consists of medical or surgical means. Transurethral Resection of the Prostate (TURP) is a surgical procedure to remove excessive growth of the prostate gland, resulting from Benign Prostatic Hyperplasia (BPH).
TURP is an invasive procedure to remove the overgrowth of prostate tissue. Despite the more recent development of less-invasive treatments, TURP is still considered the “gold standard” of prostate surgery options and the preferred treatment for BPH. It is performed by a urologist in a hospital under spinal anesthesia. A resectoscope (an instrument much like a cystoscope with the advantages of a microscope, light, irrigation capability, and a wire loop) or a spring-action cutting tool, is inserted into the urethra to access the enlarged prostate gland. The electricity generated through the cutting tool removes small pieces of tissue until the urethra is no longer restricted. To control bleeding, the vessels are cauterized by the wire loop and the bladder and urethra are irrigated with a saline solution. A urinary catheter is put in place for the purpose of resting the bladder and prostate, keeping the urethra open if swelling develops, and to empty the bladder of blood to avoid clotting. The procedure takes about 45 to 60 minutes. The patient is kept under HDU observation for 6 hours and then shifted to the room. Patient is allowed to take a light meal on the eve of the surgery. Catheter traction is released on the first post-operative day. Patient is ambulated and orally allowed next day.
TURP has several advantages over the newer technologies. They include:
Visual, hands-on access to the prostate
Immediate removal of excess tissue
Can be coupled with other procedures, e.g., removing small bladder stones
Longevity of use with supportive data on overall efficiency, safety, and success rates
Traditionally taught in medical schools so doctors have extensive experience
Commonly, there is a two-night hospital stay for observation and flushing of the catheter. There would be a light blood tinge in the urine bag because of the oozing from the resected prostate surface. The colour of the urine in the urine bag is made transparent by encouraging patients to drink excess fluids and taking adequate bed rest in the immediate post-operative period. The catheter is removed on the third post-operative day and patient is discharged after confirming satisfactory voiding. At the time of discharge, precautions are recommended for the purpose of healing, comfort, and preventing damage to the treated area. Patients will require home rest for 2 weeks and should drink large quantities of water to flush out the bladder to prevent a urinary tract infection. No straining, lifting or pushing heavy items should occur in the initial 2-3 weeks. A significant improvement in recovery is seen after the catheter has been removed and, while some of the pre-operative symptoms may continue, they will slowly decrease over a period of 2-8 weeks. Majority reversal of prior symptoms may take a month. Patients are called for re-assessment at 1-month period and a uroflowmetry test is specifically performed to confirm satisfactory voiding pattern. Any specific medicines to address post-operative symptoms are prescribed.