TURP: a well-established procedure when BPH obstruction needs more definitive relief
TURP has been performed for decades and remains one of the most commonly recommended procedures for men whose BPH symptoms are significant or who have developed complications from obstruction. However, it also has the most side effects of all prostate treatments—5 to 10% people who get this surgery will get erectile dysfunction or urinary incontinence, and more than 50% will suffer from retrograde ejaculation. A good decision around TURP is based on whether it is the best procedure for you: how severe is the obstruction, how much residual urine is present, what is your prostate anatomy and size range, what are your medical risks, what outcomes matter most to you.
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What TURP is
TURP stands for Transurethral Resection of the Prostate. In plain language: a scope is passed through the urine passage (no external cut), the obstructing prostate tissue is removed from inside, this opens the urinary channel and improves flow. TURP is a 'tissue-removing' procedure (unlike PAE/Rezum which work via shrinkage over time). That's why symptom improvement can feel more immediate in many cases.
Who is a good candidate
TURP is often considered when: symptoms are moderate to severe and affecting quality of life, medicines are not sufficient or not tolerated, there is high residual urine, recurrent retention, or catheter dependence, recurrent infections occur due to incomplete emptying, the obstruction needs more definitive relief in a predictable timeframe, prostate size/anatomy is appropriate for TURP.
When TURP is often preferred over minimally invasive options
Some men strongly prefer minimally invasive approaches. That preference is valid—but it must match the clinical reality. TURP is often favoured when: rapid, more definitive channel opening is needed, symptom burden is high and life quality is significantly affected, residual urine is high or retention episodes are recurring, there is concern about bladder/kidney impact from obstruction.
Pre-procedure evaluation (tests that matter)
1) Urine test
Rule out infection, check hematuria concerns.
2) Ultrasound with post-void residual
High-value test that informs urgency and choice.
3) Symptom scoring and history
Nocturia, urgency, stream strength, retention episodes, catheter history, infections.
4) PSA in context
PSA is interpreted carefully; it is not a standalone cancer test.
5) Additional evaluation (selected cases)
Uroflowmetry, cystoscopy in selected cases, assessment of blood thinners and cardiovascular risk.
What happens during TURP
In general: You are given anesthesia based on clinical plan. A scope is passed through the urethra into the prostate channel. Obstructing tissue is resected/removed. A catheter is placed afterward to allow drainage and manage postoperative bleeding risk. You are monitored for urine clarity, comfort, and voiding stability.
Catheter and hospital stay
Most men should expect: a catheter for a period after TURP, a hospital stay that allows monitoring for bleeding, irrigation needs, pain control, and safe voiding. The duration depends on: amount of tissue removed, bleeding tendency, urine clarity, baseline bladder function, comorbidities.
Expected benefits and timeline
In the early days
Because TURP removes obstructing tissue directly, improvement can be relatively prompt. Burning urination can occur. Frequency/urgency can occur during healing. Mild blood in urine is common initially.
Over weeks
Many men notice: stronger urinary stream, less straining, better emptying, reduced nocturia and improved sleep. Some storage symptoms may take longer if the bladder has been overworked by obstruction for years.
Risks and side effects
TURP is common, but it is still the highest side effect surgery for an enlarged prostate. Possible risks include: bleeding (usually controlled), infection, temporary urinary irritation symptoms, urinary retention during early healing, sexual side effects (varies by individual), need for re-treatment in some cases over long time horizons, anesthesia-related risks. You should seek urgent evaluation if: fever/chills, inability to pass urine, heavy bleeding with clots, severe uncontrolled pain or weakness.
TURP vs PAE vs Rezum vs HoLEP/ThuLEP
TURP
Tissue-removing, endoscopic. Often more immediate relief. Suited to selected prostate anatomy/size.
PAE
Vascular approach, gradual shrinkage. Candidacy depends on arterial anatomy. Improvement often over weeks to months.
Rezum
Minimally invasive steam therapy. Gradual improvement; often temporary symptom flare during healing. Anatomy-dependent candidacy.
HoLEP/ThuLEP
Laser enucleation approaches. Often chosen for durable relief, including in larger prostates. Depends on surgeon expertise.
FAQs
Talk to a doctor / plan TURP
For a TURP decision review, please share: ultrasound report (prostate size + post-void residual), urine report, PSA history, symptom pattern, medications (especially blood thinners). We will guide you: whether TURP is an appropriate fit, whether PAE/Rezum/HoLEP/ThuLEP is better aligned, what recovery timeline is realistic, and what follow-up plan protects your outcome.
