| | |  | | © Reed Group | | | Transurethral resection of the prostate (TURP) is a surgical procedure in which portions of the prostate gland are removed through a tiny microscope inserted through the urethra (transurethral endoscopy).
The prostate gland is normally about the size and shape of a walnut and surrounds the male urethra, the tube that carries urine from the bladder to the penis. In benign prostatic hypertrophy (BPH), the prostate gland enlarges, leading to compression of the urethra.
Typical symptoms include hesitancy, incomplete voiding, increased frequency, dribbling, a strong and sudden urge to urinate, urination at night, a weak stream of urine, or blood in the urine (hematuria). In severe cases, there may be urinary retention, hydronephrosis, urinary tract infections, bladder stones or any combination of these conditions.
BPH can be diagnosed by rectal exam or ultrasonography. Today, BPH is treated with medication and TURP is used only in cases where medication has failed or can not be used. TURP is the most common surgical procedure used to treat BPH; the goal is to remove the tissue causing the obstruction with minimal damage to the surrounding areas. Prostate removal through an open incision in the abdomen is done only in cases where a second procedure on the bladder is necessary or the prostate is very large.
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Source: Medical Disability Advisor
| TURP is performed only where medication has failed or can not be used. It is contraindicated in men with myasthenia gravis, multiple sclerosis and Parkinson's disease who have external sphincter dysfunction and/or severe bladder hypotonia. Unstable coronary status, uncorrectable bleeding disorders, and active urinary tract infections are relative contraindications. |
Source: Medical Disability Advisor
| TURP is usually performed in the operating room under spinal anesthesia (only the lower part of the body is anesthetized). The individual is positioned on his back with his legs in stirrups. A lubricated scope (resectoscope) is passed through the tip of the penis into the urethra to the prostate. The resectoscope is like a miniature telescope and contains a light, controls for the irrigating fluid, and an electrocautery loop that cuts tissue and seals blood vessels. The excess prostate tissue is cut away, carried by the irrigating fluid into the bladder, then flushed out and sent to a pathologist. At the end of surgery, a urinary catheter is inserted into the urethra and left in place overnight. Most individuals leave the hospital the next day. There is minimal pain associated with this procedure. |
Source: Medical Disability Advisor
| TURP is a very effective treatment for BPH. Almost 90% of individuals experience relief of their urinary symptoms and improved urine flow, with the improvement often lasting for 10 to 15 years ("Benign Prostatic Hyperplasia"). Some symptoms of BPH return in approximately 10% of patients 5 years following TURP, such as inability to urinate and urine retention in the bladder (Smith). |
Source: Medical Disability Advisor
| Common complications from TURP include postoperative bleeding, clot retention, and urinary tract infection. Surgical risk increases with time in surgery, prostate size, and irrigation volume. Approximately 2% of patients experience TUR syndrome, an electrolyte imbalance that occurs when the solution used for irrigation during surgery is absorbed into the bloodstream. This leads to low sodium levels (hyponatremia) and seizures. Other surgical complications include infection, incontinence (loss of bladder control), narrowing of the urethra, retrograde ejaculation and impotence. Up to 71% of patients experience retrograde ejaculation, where semen flows into the bladder instead of out through the penis (Leslie). The reported frequency of impotence after TURP ranges from 3% to 35% (Leslie). |
Source: Medical Disability Advisor
| If the individual is being treated with medications, easy access to restroom facilities may be necessary. For those who undergo the surgical procedure, no restrictions are expected after they return to work. |
Source: Medical Disability Advisor
| Cited "Benign Prostatic Hyperplasia." HealthCentral.com. HealthCentral.com. 1 Mar. 2005 <http://www.healthcentral.com/mhc/top/000381.cfm>.Leslie, Stephen W. "Transurethral Resection of the Prostate." eMedicine. Eds. Martha K. Terris, et al. 31 Jan. 2005. Medscape. 3 May 2005 <http://emedicine.com/med/topic3071.htm>. Smith, Terrance L. "Transurethral Resection of the Prostate (TURP) for Benign Prostatic Hyperplasia." Information Therapy. 26 May. 2004. 1 Mar. 2005 <http://www.informationtherapy.org/kbase/topic/detail/surgical/hw60259/detail.htm>. |
Source: Medical Disability Advisor