Type of Surgery

Information

Doctor Certified

Last updated: 11/24/2009

Diagnosis/Preparation

BPH symptoms include:

  • increase in urination frequency, and the need to urinate during the night
  • difficulty starting urine flow
  • a slow, interrupted flow and dribbling after urinating
  • sudden, strong urges to pass urine
  • a...

    sensation that the bladder is not completely empty
  • pain or burning during urination

In evaluating the prostate gland for BPH, the physician usually performs a complete physical examination as well as the following procedures:

  • Digital rectal examination (DRE). Recommended annually for men over the age of 50, the DRE is an examination performed by a physician who feels the prostate through the wall of the rectum. Hard or lumpy areas may indicate the presence of cancer.
  • Prostate-specific antigen (PSA) test. Also recommended annually for men over the age of 50, the PSA test measures the levels of prostate-specific antigen secreted by the prostate. It is normal to observe small quantities of PSA in the blood. PSA levels vary with age, and tend to increase gradually in men over age 60. They also tend to rise as a result of infection (prostatitis), BPH, or cancer.

If the results of the DRE and PSA tests are indicative of a significant prostate disorder, the examining

physician usually refers the patient to a urologist, a physician who specializes in diseases of the urinary tract and male reproductive system. The urologist performs additional tests, including blood and urine studies, to establish a diagnosis.

To prepare for TURP, patients should:

  • Select an experienced TURP surgeon to perform the procedure.
  • Purchase a mild natural bulk-forming laxative.
  • Wear loose clothing on the morning of surgery.
  • Ask friends or family to be available for assistance after surgery.
  • Schedule a week off from work.
  • Get sufficient sleep on the night before surgery.

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A Transurethral Resection of the Prostate or TURP is a procedure to expand the dimensions of the urethra or urine outflow tract. This video shows what a urologist sees during a TURP. Note that this video shows surgery on an living human.

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An enlarged prostate can cause urinary problems due to its location around the male urethra (A). In TURP, the physician uses a cystoscope to gain access to the prostate through the urethra (B). The prostate material that has been restricting urine flow is cut off in pieces, which are washed into the bladder with water from the scope (B). (Illustration by GGS Inc.) An enlarged prostate can cause urinary problems due to its location around the male urethra (A). In TURP, the physician uses a cystoscope to gain access to the prostate through the urethra (B). The prostate material that has been restricting urine flow is cut off in pieces, which are washed into the bladder with water from the scope (B). (Illustration by GGS Inc.)




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Other Information

Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This is considered the most effective treatment for BPH. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. As with all invasive procedures, the patient should first discuss medications they are taking with their doctor, most especially blood thinners or anticoagulants, such as warfarin (Coumadin), or aspirin. These may need to be discontinued prior to surgery. Postop complications include bleeding (most common), clotting and hyponatremia (due to bladder irrigation).


From http://en.wikipedia.org/wiki/Transurethral_resection_of_the_prostate

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