What Is Transurethral Resection of the Prostate or TURP?
Transurethral resection of the prostate is a surgical procedure that aims to treat urologic difficulties caused by the enlargement of the prostate gland. The doctor might insert a device known as a resectoscope through the penis tip into the urethra. It helps the doctor visualize the lining of the prostate gland so that the excess prostate tissue that obstructs the urine flow can be removed. TURP is an ideal treatment option for patients with moderate or severe urinary retention that do not show any improvements with medications. Though TURP is considered one of the most effective treatment methods for benign prostate hyperplasia, several minimally invasive procedures can be used as an alternative to TURP.
Why Is TURP Done?
TURP helps relieve the symptoms of benign prostate hyperplasia or enlargement of the prostate gland. In simple terms, it relieves the patient of the following symptoms:
- A strong urge to pass urine.
- Difficulty in starting the urine flow.
- Nocturia or passing urine frequently at night.
- Bladder fullness.
- Urinary tract infections.
- Difficulty in passing urine or no urine flow at all.
- Bladder stones.
- Presence of blood in the urine.
What Are Some of the Alternative Procedures to TURP?
Several invasive and non-invasive methods can be used as an alternative to TURP. This is because medical science has advanced, and new inventions get added daily. Some of the other procedures that can be used instead of TURP are described below:
Observation - It is commonly recommended for patients with an enlarged prostate gland but does not present with any symptoms. Hence, the doctor might ask the patient to wait and observe for a few days. This implies that the patient would not receive any treatment immediately. However, if the symptoms exacerbate, the patient might need to undergo surgery.
New Techniques - Numerous new surgical methods are available that are equally effective to TURP and have minimal side effects and quicker recovery. The newer techniques are listed below:
1. PLASMA System - The PlasmaJet system is a recent advancement in the treatment of prostate cancer. It allows the doctor to perform an atraumatic surgery and uses kinetic energy to treat the tissues through the following three actions:
- Kinetic Dissection.
- Microlayer vaporization.
- Surface sealing.
2. Holmium Laser (Light Amplification by Stimulated Emission of Radiation) Enucleation of the Prostate Gland - A Holmium laser is attached to the resectoscope to visualize and remove the excess prostate tissue.
3. Transurethral Resection or Vaporization of the Prostate (TUVP) - In this procedure, a thin instrument known as the cystoscope is inserted into the urinary bladder through the urethra. A laser is also attached to the cystoscope to remove or burn the tissues of the prostate gland that are in excess. The most significant advantage of the procedure is that it helps the doctor detect and treat prostate problems simultaneously.
4. Prostatic Urethral Lift - A prostatic urethral lift is a surgical procedure that relieves the patient of the symptoms of benign prostate hyperplasia. This procedure is mainly performed by a urologist and aims to separate the lobes of the prostate gland so that the urethra becomes wide and the patient can easily urinate. In this procedure, the doctor first inserts an instrument into the urethra and advances it forward. After the device enters the wall on the side of the prostate gland, small implants get ejected from the device on both sides of the prostate gland. These implants pull the prostate gland and the urethra to open the channel. The number of implants inserted into the urethra depends upon the prostate gland size. Some of the advantages of this procedure are listed below:
- The prostatic urethral list is an outpatient procedure, so the patient does not have to stay in the hospital for prolonged periods and can reach home the same day.
- It differs from other procedures for benign prostate hyperplasia because the patient does not need a catheter to urinate post-surgery.
- It also minimizes the risk of retrograde ejaculation (it is a condition wherein the semen flows into the urinary bladder instead of flowing outside the body).
- The procedure does not interfere with the sexual activities of the person.
5. Open Prostatectomy - Open prostatectomy is a surgical procedure wherein a part of the prostate gland is removed. It is one of the most chosen treatments for prostate cancer. Prostatectomy can be done using various methods. However, the type of procedure the doctor performs on the patient depends upon the conditions of the prostate gland. In this procedure, the doctor first makes a cut or an incision in the lower abdomen or above the pubic bone. Next, the doctor visualizes the prostate gland and dissects or separates it from the surrounding nerves and blood vessels. Finally, the incision is secured through sutures.
Why Are Other Alternative Procedures Required?
Though TURP effectively addresses prostate problems, alternative procedures are required because of the numerous risk factors associated with TURP. Some of the risks related to TURP are listed below:
- Urologic Difficulties - The patient might have difficulty passing urine for a few days after the procedure. The patient will need a catheter until the patient starts urinating normally. In contrast, the other alternative procedures, like prostatic urethral lift, do not require the patient to use a catheter.
- Urinary Tract Infections - It is the most common complication of TURP and is likely to persist until the patient uses a catheter.
- Erectile Dysfunction - Patients undergoing TURP have a higher chance of erection problems or erectile dysfunction compared to the alternative procedures.
- Profuse Bleeding - Patients with an enlarged prostate and undergoing TURP tend to suffer from blood loss after the surgery. However, the loss is not to the extent that the patient requires a blood transfusion.
- Problems in Holding the Urine - Urinary incontinence or the leakage of urine due to the loss of bladder control has been commonly observed in patients undergoing TURP.
- Dry Orgasm - Dry orgasm is one of the most common side effects of prostate surgeries, including TURP. A dry orgasm means that the semen gets ejaculated into the urinary bladder instead of getting expelled from the body through the penis.
- Low Sodium Levels in the Blood -The sodium levels lower when the body absorbs excess fluid used to wash the surgical site. Though this phenomenon rarely happens, it can result in a life-threatening condition known as transurethral resection syndrome.
Conclusion:
TURP is an invasive procedure wherein doctors remove the tissues in excess from the prostate gland to treat urologic problems. Nowadays, numerous alternative methods provide a conservative approach to treating prostate problems. However, some are in the trial stages, and nothing has been known about their long-term success rate. So, patients with prostate problems must not ignore the symptoms and consult their doctor at the earliest to learn about other procedures.
