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TURP (transurethral resection of the prostate)

In addition to the open surgical removal of the interior of the benign enlarged prostate gland (prostate adenomectomy

), which is only rarely recommended nowadays for very large prostate glands, transurethral resection of the prostate (TURP

) has asserted itself for more than five decades. In this procedure, the prostate is operated on through the urethra, without an abdominal incision. An electric, semicircular cutting loop is inserted through a special bladder endoscope, a cystoscope, into that part of the urethra around which the prostate is located. The loop is used like an electric planer. First the urethra in that area is removed and then the obstructive prostate tissue is removed bit by bit. Patients also call this method 'planing the prostate'. The results are predominantly good: relief from the symptoms and usually a good urinary stream. The hospital stay requires 5-8 days. After the operation a catheter must be inserted for 2 - 4 days. Among experts, this operation is considered the "Gold Standard" for the treatment of benign prostate enlargement. A standard by which all other treatments are measured.

TURP is an invasive surgical procedure.

The risk factor for complications lies at approximately 18%.

The most important complications are:

Considerable blood loss
Necessitates blood transfusions in 10-15% of all cases
Damage to the internal sphincter of the bladder (bladder neck)
A high rate of retrograde ejaculation (dry orgasm)
Absorption of irrigating fluid into the blood (TUR syndrome ), which can lead to a reduction of body sodium and dangerous fluid retention in the lungs
Formation of scar tissue causing narrowing of the urethra (urethral strictures ), which has to be removed surgically
Isolated cases of loss of potency after the operation
Damage to the outer sphincter resulting in an inability to control urination; men wet themselves and have to wear diapers (incontinence ).
Follow-up operations on the prostate

Despite these possible, serious complications TURP is still considered the ‚Gold Standard' for the surgical treatment of BPH.