T.U.R.P

TURP (Transurethral (resection) prostatectomy). Some 45,000 TURP operations are carried out each year in the UK. The TURP operation is regarded by the medical profession as the 'gold standard' treatment, we don't agree; it is 'gold plated' possibly. It can have serious side effects and repeat operations are often required. "If this treatment is the Gold Standard I would hate to have the bronze", is one comment from a medical man. Whilst this coring out of the prostate tissue can certainly help the urine flow in many cases, even the medics agree that it fails in 25% of cases. The PHA feels this figure is too low, and that many of the ex-patients are too 'nervous' to come forward and admit that the condition is unsatisfactory, and soldier on with the condition as it was, or in many circumstances, according to the letters we get, in a worse condition than before the operation.

A TURP is carried out under a general anaesthetic, or an epidural. The surgeon inserts a resectoscope down the penis until it reaches the prostate area. This instrument, as well as having a cutting device which cuts the prostate tissue also has a fibre-optic light and a telescope so that the surgeon can see what he is doing. To clear out the debris the area is washed out with glycine fluid. To check for cancer cells some of the cut tissue is examined. The overall benefit of this for the patient is problematical. A recent study of 432 patients who underwent special checks to calculate the amount of prostate tissue removed during their operation showed that in no case was more than 50% of the enlarged prostate tissue removed. That would lead one to believe that the chances of finding cancer cells by this method was 50/50. In fact it could be less than that as it can be assumed that the majority of the tissue would be cut from the centre of the gland, yet as cancer cells are 'normally' found in the outer portion of the prostate the odds could be even greater against finding early cells by this method. Indeed one figure noted indicates that only 5% of cancers are found by this method.

However lightly your friends or the medics may treat this operation be assured it is a major operation. You can expect to be in hospital for up to 5 days. Following the operation you will have a catheter in place and you will be passing blood in the urine for at least 48 hours. You will not leave the hospital until the bleeding has stopped and you are able to pass water without a catheter. Some hospitals will issue you with a list of things not to do, like not driving a car, some don't. If you do not get such instructions ask for information before you leave.

Side effects.... A side effect is something you may get; not something you will get !

  • Not really a side effect (!) but death can occur as it can during any surgical procedure.
  • During the operation you could absorb the glycine irrigant due to capsule perforation or low bladder pressure for instance, (not due to the length of the operation, as was once thought), this can cause confusion, swelling of the limbs,kidney or heart damage and death. It is called post TUR syndrome.
  • Following the operation you might be incontinent; fully or partially, you could be impotent, and you most certainly will be infertile. This latter condition is not guaranteed, so it should not be looked upon as a method of contraception.
  • If you are impotent following a TURP it is most unlikely that it is 'all in the mind'. It has been shown that perforation of the prostate capsule causes impotence and some 66% of capsules are perforated by some surgeons.
  • The big draw back. It may not work and you may be no better off. You may need to have a repeat. The PHA have letters from men who have had up to four such operations, and one man has had five.
  • We suggest that you try all other available treatments; alternative, drug and radio frequency before you 'burn your boats' with the TURP. Remember not all BPH symptoms progress from bad to worse. Often the condition may plateau out, or even improve.