How to Treat Transurethral Resection Of Prostate?

What is Transurethral Resection of the Prostate (TURP)?

Transurethral Resection of the Prostate (TURP) is a minimally invasive surgical procedure for benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland in individuals assigned male at birth. The prostate surrounds the urethra and, when enlarged, can obstruct normal urination, causing various urinary symptoms. TURP involves introducing a slender instrument through the urethra, equipped with an electric current or laser, to precisely remove excess prostate tissue. Notably, TURP eliminates the need for external incisions, providing an effective solution to alleviate BPH-related urinary issues and enhance overall quality of life.

Why is TURP Performed?

The prostate, a crucial component of the male reproductive system, surrounds the urethra—the conduit through which urine is expelled from the bladder. As men age, the prostate gland has a tendency to undergo hypertrophy, resulting in the compression of the urethra and subsequent urinary issues. TURP is performed with the primary objective of addressing these symptoms, such as a weak urinary stream, urgency, and incomplete bladder emptying, which are often associated with BPH.

Common indications for TURP include:

1. Urinary Symptoms: TURP is recommended for individuals grappling with distressing urinary symptoms associated with BPH, including a diminished urine stream, frequent urination, and a sense of urgency during urination.
2. Urinary Retention: In situations where complete urinary obstruction occurs, leading to an inability to urinate, TURP emerges as a crucial intervention to restore normal urinary function.
3. Recurrent Urinary Tract Infections: TURP may be considered for individuals experiencing recurrent urinary tract infections attributed to BPH-induced complications, as the procedure can alleviate the factors contributing to these infections.

How is TURP Performed?

The TURP procedure is characterized by its meticulous and minimally invasive approach, conducted through the urethra without necessitating external incisions. The procedural sequence involves several key steps:

1. Anesthesia: TURP is typically executed under either general or spinal anesthesia, ensuring the patient's comfort and effective pain management throughout the procedure.
2. Insertion of the Resectoscope: A resectoscope, a slender instrument equipped with a light source and camera, is introduced through the urethra and navigated to the prostate. The camera facilitates real-time visualization, guiding the surgeon throughout the operation.
3. Tissue Removal: Employing specialized instruments attached to the resectoscope, the surgeon excises excess prostate tissue causing the urethral obstruction—a process termed resection. This step is crucial for restoring normal urinary flow.
4. Irrigation: Continuous irrigation with a sterile solution is maintained to wash away the removed tissue, ensuring a clear field of vision for the surgeon and preventing complications such as bleeding and infection.
5. Catheter Placement: Following tissue removal, a catheter is often inserted to allow for unimpeded urine drainage while the healing process ensues, preventing postoperative urinary retention.

Treatment Solutions and Alternatives to TURP:

While TURP remains a benchmark for BPH management, alternative interventions exist, each with its unique set of considerations. The choice among these alternatives is contingent on various factors, including the severity of symptoms and the overall health of the patient. Notable alternatives include:

1. Medications: Alpha-blockers and 5-alpha reductase inhibitors represent pharmaceutical interventions aiming to manage BPH symptoms by relaxing prostate muscles and reducing glandular size. These medications provide a non-surgical avenue for symptom control.
2. Minimally Invasive Procedures: Techniques such as transurethral microwave therapy (TUMT) and laser therapy utilize heat to shrink the prostate, offering symptomatic relief with less invasiveness compared to TURP.
3. Open Prostatectomy: Reserved for cases of substantial prostatic enlargement, an open prostatectomy involves removing the central part of the prostate through an abdominal incision. While more invasive than TURP, it may be necessary for particularly large prostates.

Benefits of TURP:

1. Symptom Relief: Foremost among the benefits of TURP is the significant relief of bothersome urinary symptoms linked to BPH. By addressing the root cause of obstruction, TURP fosters an improved quality of life for individuals grappling with these symptoms.
2. Improved Urinary Flow: By excising excess prostate tissue, TURP serves to restore normal urinary flow, mitigating the need for frequent and strenuous urination. This leads to improved bladder emptying and a more efficient urinary system.
3. Prevention of Complications: TURP plays a pivotal role in averting complications such as urinary retention and recurrent urinary tract infections, which may arise from untreated BPH. The procedure contributes to the overall health and well-being of patients by addressing these potential complications.
4. Quick Recovery: Relative to more invasive procedures, TURP boasts a comparatively swift recovery period. Patients often experience rapid symptomatic improvement, allowing for a quicker return to normal daily activities.
5. Long-Term Efficacy: TURP demonstrates sustained efficacy in alleviating BPH symptoms over the long term. The benefits of the procedure endure, providing lasting relief and improvement in urinary function for many patients.