TURP
Transurethral Resection of the Prostate (TURP) is regarded as the gold standard surgical procedure for treating Benign Prostatic Hyperplasia (BPH). It is a well-established technique that has been successfully practiced for decades, offering reliable results in relieving urinary obstruction caused by prostate enlargement.
During TURP, prostate tissue is removed in small sections with the help of a resectoscope introduced through the urethra, avoiding the need for external cuts. The procedure allows controlled removal of excess tissue while minimizing complications such as strictures or incontinence.
TURP continues to be a preferred choice in most cases of BPH, though alternative modalities like Bipolar TURP, HoLEP, or PVP are also available depending on the patient’s condition.
Method
TURP uses an electrical current that passes from the resectoscope loop (active electrode) to a grounding pad on the patient, enabling precise resection of prostate tissue.
Procedure Highlights
- Time-tested and well-refined surgical approach
- Performed as a piecemeal resection of the prostate
- Better control within the prostate capsule
- Minimal instrumentation reduces risks such as stricture formation
- Possibility of TUR syndrome in rare cases due to absorption of irrigation fluid
Irrigation During TURP
Conventional TURP requires the use of non-hemolytic, hypo-osmolar irrigation fluids (like glycine). If absorbed in large amounts, it may lead to a complication called TUR syndrome, so monitoring is essential.
Advantages of TURP
- Faster recovery and effective symptom relief
- Better hemostasis with rapid coagulation
- Minimal instrumentation, lowering complication risk
- Reduced incidence of strictures and incontinence
- High success rate with long-term proven results
Limitations
- Risk of inadvertent nerve stimulation (e.g., obturator reflex)
- May interfere with cardiac pacemakers in some patients
- Intraoperative bleeding—though it can be effectively controlled
Patient Selection & Alternatives
TURP is suitable for most men with prostate enlargement. Special considerations are taken in cases of:
- Very large prostate size
- Borderline medical fitness
- Patients on blood thinners (dosage may need adjustment)
Other modalities such as Bipolar TURP, HoLEP, ThuLEP, or GreenLight PVP may be considered in patients with higher bleeding risk or specific medical conditions.