Transurethral resection of the prostate (TURP)
Transurethral Resection of the Prostate (TURP) is a common surgical procedure performed to treat benign prostatic hyperplasia (BPH), a condition where the prostate gland enlarges, causing urinary problems. TURP involves removing a portion of the prostate to alleviate urinary obstruction and improve urinary flow. In this comprehensive explanation, we will explore the significance of TURP, the procedure itself, its indications, preoperative and postoperative care, potential complications, and its role in enhancing the quality of life for individuals with BPH. Additionally, I will provide you with five medical references for further reading.
I. Introduction:
The prostate is a walnut-sized gland that surrounds the urethra, a tube that carries urine from the bladder through the penis. As men age, the prostate gland can undergo hyperplasia, leading to an enlargement of the gland, known as benign prostatic hyperplasia (BPH). This condition can cause urinary symptoms such as frequent urination, weak urinary stream, and difficulty emptying the bladder.
Transurethral Resection of the Prostate (TURP) is a surgical procedure designed to alleviate these symptoms by removing a portion of the enlarged prostate, thereby restoring proper urinary flow and relieving obstruction. TURP is one of the most common and effective treatments for BPH.
II. Significance of Transurethral Resection of the Prostate (TURP):
TURP holds significant medical importance for several reasons:
Symptom Relief: It effectively relieves bothersome urinary symptoms caused by BPH, improving the patient’s quality of life.
Urinary Function Improvement: By removing obstructive prostate tissue, TURP restores proper urinary flow and helps patients empty their bladders more efficiently.
Alternative to Medication: TURP can be an excellent option for individuals who do not respond to or tolerate medications used to manage BPH.
Long-Term Success: TURP typically provides long-lasting relief from BPH symptoms, reducing the need for repeat procedures.
Minimally Invasive: TURP is performed through the urethra, avoiding the need for external incisions, leading to shorter recovery times.
III. Transurethral Resection of the Prostate (TURP) Procedure:
A TURP procedure typically follows these key steps:
Preoperative Planning:
Patient Evaluation: A comprehensive evaluation of the patient’s medical history, urinary symptoms, and prostate size is conducted to determine the appropriateness of TURP.
Informed Consent: The surgical procedure, potential risks, benefits, and expected outcomes are explained to the patient. Informed consent is obtained.
Choice of Anesthesia: TURP can be performed under various types of anesthesia, including general, spinal, or regional anesthesia, depending on the patient’s condition and preference.
Surgery:
Positioning: The patient is typically positioned on their back with their legs elevated in stirrups, allowing access to the urinary tract.
Urethral Insertion: A cystoscope, a thin tube with a camera, is inserted through the urethra into the bladder to visualize the prostate.
Prostate Resection: A specialized instrument called a resectoscope is inserted through the cystoscope to remove excess prostate tissue. The resectoscope includes a wire loop that cuts away the tissue.
Tissue Removal: The removed prostate tissue is flushed into the bladder and periodically removed through the cystoscope.
Bladder Drainage: A catheter is inserted to drain urine from the bladder and provide continuous bladder irrigation to remove any blood or tissue fragments.
Assessment: The surgeon evaluates the bladder, ensuring that all obstructing tissue is removed.
Postoperative Care:
Recovery: After the procedure, the patient is closely monitored in a recovery area until they are fully awake and their vital signs are stable.
Catheterization: The catheter remains in place for a specific duration to facilitate bladder drainage and continuous irrigation. Its removal is usually determined by the surgeon based on the patient’s progress.
Pain Management: Pain and discomfort are managed with pain-relief medications as needed.
Follow-Up Appointments: Regular follow-up appointments are scheduled to monitor the patient’s urinary function and ensure a successful recovery.
IV. Indications for Transurethral Resection of the Prostate (TURP):
TURP is indicated for patients with significant BPH-related urinary symptoms, including:
Urinary Retention: Patients who have difficulty emptying their bladders due to prostate enlargement.
Frequent Urination: Those experiencing the need to urinate frequently, especially at night (nocturia).
Weak Urinary Stream: A weak urinary stream caused by obstructive prostate tissue.
Incomplete Emptying: Difficulty fully emptying the bladder, leading to residual urine.
Recurrent Urinary Tract Infections: Frequent urinary tract infections related to BPH.
V. Preoperative and Postoperative Care:
Effective preoperative and postoperative care are essential for the success of a TURP procedure:
Preoperative Care:
Patient Evaluation: A comprehensive evaluation of the patient’s medical history, urinary symptoms, and prostate size is conducted to determine the appropriateness of TURP.
Informed Consent: The surgical procedure, potential risks, benefits, and expected outcomes are explained to the patient. Informed consent is obtained.
Choice of Anesthesia: The choice of anesthesia, whether general, spinal, or regional, is discussed with the patient, considering their condition and preferences.
Postoperative Care:
Recovery: After the procedure, the patient is closely monitored in a recovery area until they are fully awake and their vital signs are stable.
Catheterization: The catheter remains in place for a specific duration to facilitate bladder drainage and continuous irrigation. The timing of catheter removal is determined by the surgeon.
Pain Management: Pain and discomfort are managed with pain-relief medications as needed.
Follow-Up Appointments: Regular follow-up appointments are scheduled to monitor the patient’s urinary function, evaluate the success of the procedure, and address any concerns or questions.
VI. Potential Complications:
TURP, while generally safe and effective, carries potential complications:
Bleeding: Some bleeding during and after the procedure is common, but excessive bleeding may require intervention.
Infection: Infection of the urinary tract or the surgical site is possible, but it is generally rare.
Bladder Injury: In rare cases, injury to the bladder can occur during the procedure.
Erectile Dysfunction: TURP may lead to temporary or permanent erectile dysfunction in some patients.
Urinary Incontinence: Some patients may experience temporary or permanent urinary incontinence.
VII. Role in Enhancing Quality of Life:
TURP plays a vital role in enhancing the quality of life for individuals with BPH:
Symptom Relief: By alleviating urinary symptoms, TURP improves the patient’s overall quality of life and allows for better sleep and daily activities.
Improved Urinary Function: Patients experience better urinary flow, reduced frequency of urination, and improved bladder emptying.
Reduced Medication Dependency: TURP reduces the need for BPH medications and their potential side effects.
Long-Term Efficacy: The procedure provides long-lasting symptom relief, reducing the need for repeat interventions.
Restored Confidence: Patients often regain confidence and independence, as they no longer need to plan their activities around frequent urination.
VIII. Medical References:
For further reading on Transurethral Resection of the Prostate (TURP), including its indications, preoperative and postoperative care, potential complications, and its role in enhancing the quality of life for individuals with BPH, the following medical references are valuable sources:
Transurethral Resection of the Prostate (TURP): Indications, Techniques, and Outcomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4564654/
Surgical Treatment of Benign Prostatic Hyperplasia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389144/
Transurethral Resection of the Prostate (TURP): A Step-by-Step Guide: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922437/
Transurethral Resection of the Prostate for the Treatment of Benign Prostatic Hyperplasia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858155/
Transurethral Resection of the Prostate (TURP): An Overview: https://pubmed.ncbi.nlm.nih.gov/28393180/
These references provide comprehensive information on TURP, covering its applications, procedures, safety considerations, and its role in enhancing the quality of life for individuals with BPH.
Medical Aids that cover Transurethral Resection of the Prostate (TURP) in South Africa
🔎 Provider | ▶️ Covers TURP | ⏩ Top Plan Covering TURP |
🥇 Bestmed | ✅ Yes | Pace 2 |
🥈 Bonitas | ✅ Yes | BonClassic |
🥉 Cape Medical | ✅ Yes | HealthPact Select |
🏅 CompCare | ✅ Yes | DYNAMIX |
🎖️ Discovery Health | ✅ Yes | Discovery Health Classic Delta Core |
🏆 FedHealth | ✅ Yes | FlexiFED 3 |
🥇 Genesis | ✅ Yes | Med 200 |
🥈 Sizwe Hosmed | ✅ Yes | Platinum Enhanced |
🥉 KeyHealth | ✅ Yes | Gold |
🏅 Makoti Medical | ✅ Yes | Primary Option |
🎖️ Medihelp | ✅ Yes | MedElite |
🏆 Medimed | ✅ Yes | Alpha |
🥇 MedShield | ✅ Yes | MediPlus Prime |
🥈 Momentum | ✅ Yes | Incentive |
🥉 Suremed | ✅ Yes | Challenger |
🏅 Thebemed | ✅ Yes | Energy |