It is the most common and oldest classical surgical method for benign prostate enlargement. Today, it is accepted as the gold standard technique in the treatment of prostate smaller than 80 ml.
In recent years, technology has become safer with technological developments.
The procedure is performed under general anesthesia or spinal anesthesia. These drugs of patients who use blood thinners before the procedure are discontinued or changed in consultation with the necessary department physicians.
Urine is entered through the external urinary tract with an instrument called a resectoscope with a camera. The bladder is checked for the presence of stones or tumors.
Then, the part of the urethra blocked by the prostate is cut with the help of a wire that is moved back and forth by the surgeon in the resectoscope.
Electric current passes through this wire and the cutting or bleeding is stopped. After the prostate is cut enough to provide urine flow, the cut prostate tissue is first taken to the bladder and then to the outside by washing.
The bleeding vessels are touched and stopped with this wire, and the procedure is completed. At the end of the surgery, a thick catheter is inserted into the urethra. In order to prevent post-operative bleeding-clot formation, the probe is washed with serum.
In the previous years, when devices using monopolar electric current were used, a complication of lap syndrome was seen due to the fluid used during the surgery. However, in recent years, devices using plasmakinetic or bipolar electric current have been developed. Since isotonic fluid is used in TUR-P surgeries performed with these devices, TUR syndrome is not observed.
On the first day of the surgery, a serum is washed into the bladder to prevent clot formation in the bladder. This serum is given into the bladder through one channel of the catheter and flows into the bag from the other channel. Depending on whether there is bleeding in the urine on the 1st or 2nd day after the surgery, this washing serum is removed. The catheter can be removed 2-3 days after the surgery. During this period, the patients' blood pressure, fever and blood values are monitored. They can be discharged 2-3 days after surgery, depending on the surgeon's experience and the patient's condition.
Patients with fever-urinary tract infection, deterioration in blood values, patients who need blood transfusion, and patients with bleeding in the urine can be followed up in the hospital.
After the TUR-P operation, you stay in the hospital for at least 2 days. It is recommended to hold the catheter longer in some patients and these patients can be discharged home with the catheter. In some patients, stenosis is detected in the urinary tract and this narrowing area is opened during the same procedure.
The catheters of the patients whose follow-up is uneventful are taken, and the patients who urinate can be sent home. At discharge, medications to be used at home are prescribed.
During the recovery period, patients have burning and bleeding in the urine and may continue for about 3 months. Sudden squeezing and not being able to make it to the toilet, drip leakage can be seen. Some patients may not be able to urinate and a catheter may be required. Patients with severe bleeding, especially after straining, have also been reported.
They can start their sexual life after 4-6 weeks. There is no harm in taking a bath for patients who have undergone endoscopic surgery, that is, without incision.
It is recommended that patients take plenty of fluids and consume fibrous foods. Straining, straining, heavy lifting, such as constipation can increase the risk of bleeding. Since the complaints will increase in cold weather, it is recommended to protect themselves from the cold for a few months.
Infection is suspected in the presence of high fever, cloudy, foul-smelling urine, swelling of the eggs and groin pain. In these cases, please consult your doctor.
Since prostate tissue remains in patients after TURP, this remaining tissue may enlarge and compress the urethra again in the following years. One study showed that 12.7% of patients with TURP were reoperated for prostate enlargement or bladder neck/urethral stenosis. A second TURP was needed in 8.3% of patients due to prostate enlargement.
Our patients can start sexual intercourse after about 4-6 weeks. Unfortunately, semen does not come out in 60-85% of patients (retrograde ejaculation). At orgasm, semen enters the bladder. In a meta-analysis (compilation of data from previously published articles) investigating the rates of erectile dysfunction (erectile dysfunction) after prostate surgery, no change in erectile functions was reported.
“The information on this page has been prepared to enlighten patients. Please contact our doctor to get comprehensive information about diagnosis and treatment.”
