Transurethral Resection of the Prostate (TURP)

What is a transurethral resection of the prostate or TURP?

A transurethral resection of the prostate (TURP) is a surgical procedure that removes portions of the prostate gland through the penis. A TURP requires no external incision.

The surgeon reaches the prostate by inserting an instrument through the urethra (the narrow channel through which urine passes from the bladder out of the body). This instrument, called a resectoscope, is about 12 inches long and one-half inch in diameter. It contains a light, valves that control irrigating fluid, and an electrical loop that cuts tissue and seals blood vessels. It’s inserted through the penis and the wire loop is guided by the surgeon so it can remove the obstructing tissue one piece at a time. The pieces of tissue are carried by fluid into the bladder and flushed out at the end of the procedure.

Many common problems are associated with the prostate gland. These problems may occur in men of all ages and include:

  • Benign prostatic hyperplasia (BPH). An age-related enlargement of the prostate that isn’t malignant. BPH is the most common noncancerous prostate problem, occurring in most men by the time they reach their 60s. Symptoms are slow, interrupted, or weak urinary stream; urgency with leaking or dribbling; and frequent urination, especially at night. Although it isn’t cancer, BPH symptoms are often similar to those of prostate cancer.
  • Prostatism. This involves decreased urinary force due to obstruction of flow through the prostate gland. The most common cause of prostatism is BPH.
  • Prostatitis. Prostatitis is inflammation or infection of the prostate gland characterized by discomfort, pain, frequent or infrequent urination, and sometimes fever.
  • Prostatalgia. This involves pain in the prostate gland, also called prostatodynia. It’s frequently a symptom of prostatitis.

Cancer of the prostate is a common and serious health concern. According to the American Cancer Society, prostate cancer is the most common form of cancer in men older than age 50, and the third leading cause of death from cancer.

There are different ways to achieve the goal of removing the prostate gland. Methods of performing prostatectomy include:

  • Surgical removal includes a radical prostatectomy (RP), with either a retropubic or perineal approach. This is used to treat cancer. Radical prostatectomy is the removal of the entire prostate gland. Nerve-sparing surgical removal is important to preserve as much function as possible.
  • Transurethral resection of the prostate, or TURP, which also involves removal of part of the prostate gland, is an approach performed through the penis with an endoscope (small, flexible tube with a light and a lens on the end).
  • Cryosurgery is a less invasive procedure than surgical removal of the prostate gland. Treatment is administered using probe-like needles that are inserted in the skin between the scrotum and anus. The urologist can also use microwaves.
  • Laparoscopic surgery, done manually or by robot, is another method of removal of the prostate gland.

Credit: Hopkins Medicine