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TURP (Transurethral Resection of the Prostate)
TURP (Transurethral Resection of the Prostate) is the gold standard endoscopic surgical treatment for Benign Prostatic Hyperplasia (BPH) — removing obstructing prostate tissue through the urethra without any incision, dramatically improving urinary flow and relieving the lower urinary tract symptoms of an enlarged prostate.
Overview
TURP uses an electrically heated resectoscope loop passed through the urethra to systematically resect the obstructing adenomatous tissue from the prostate under continuous saline irrigation and direct endoscopic vision — creating a wide channel through the prostate that allows unobstructed urinary flow. Modern bipolar TURP using saline irrigation has replaced monopolar TURP with glycine irrigation, eliminating the risk of TURP syndrome (dilutional hyponatraemia) and making the procedure safer in higher-risk patients. TURP remains the most performed urological operation worldwide for BPH, providing durable symptomatic relief and objective flow improvement superior to all medical treatments and persistent for over 10 years in most patients.
Types of Prostate Surgery for BPH
Several surgical options are available for BPH, with TURP remaining the most widely performed and evidenced procedure.
- Bipolar TURP (modern standard — saline irrigation, no TURP syndrome risk)
- HoLEP — Holmium Laser Enucleation of Prostate (for any prostate size — very durable results)
- GreenLight PVP — Photoselective Vaporisation (laser vaporisation — suitable for anticoagulated patients)
- Open Prostatectomy (Millin's retropubic — for very large prostates above 80 to 100 g)
- Rezum Water Vapour Therapy (minimally invasive office procedure for smaller prostates)
Risk Factors for Benign Prostatic Hyperplasia
BPH is an age-related condition influenced by hormonal, genetic, and metabolic factors.
- Male sex and ageing — BPH affects 50% of men by age 60 and 90% by age 85
- Family history of BPH in first-degree male relatives
- Obesity and metabolic syndrome associated with more severe BPH symptoms
- Type 2 diabetes and insulin resistance correlating with increased BPH prevalence
- Sedentary lifestyle associated with worsening lower urinary tract symptoms
- High dietary fat consumption associated with prostate growth
BPH Symptoms Requiring TURP Assessment
These lower urinary tract symptoms indicate significant bladder outflow obstruction from BPH that has failed medical management and requires urological assessment for TURP.
- Severely reduced urinary stream with poor force and calibre of voiding
- Urinary hesitancy — prolonged waiting before voiding begins
- Incomplete bladder emptying with significant post-void residual on ultrasound
- Nocturia — waking 3 or more times per night to void
- Recurrent urinary tract infections from chronic urinary retention
- Acute urinary retention requiring emergency catheterisation
- Bladder stones or haematuria from chronic retention and stasis
- BPH refractory to maximum medical therapy with alphablocker and 5-alpha reductase inhibitor
Key Benefits
Discover the advantages of choosing our turp (transurethral resection of the prostate) services.
Immediate post-catheter removal improvement in flow rate to normal levels in most patients
Durable symptomatic relief lasting 10 years or more compared to medical therapy
Eliminates recurrent urinary retention episodes requiring emergency catheterisation
Bipolar technique in saline eliminates the electrolyte disturbance of older monopolar TURP
Endoscopic procedure with no external incisions and short hospital stay of 2 to 3 days
Clinical Features
The technology, techniques and clinical approach behind our turp (transurethral resection of the prostate).
Bipolar TURP in saline irrigation eliminates the risk of TURP syndrome compared to monopolar technique
Systematic anatomical resection working lobe by lobe ensures complete adenoma removal
Verumontanum landmark preservation protects the external sphincter preventing incontinence
Individual vessel coagulation at the end of resection achieves thorough haemostasis
Three-way catheter with overnight irrigation prevents post-operative clot retention
Preparation Instructions
After TURP, drink at least 2 to 3 litres of fluid daily for 2 to 4 weeks to keep the healing prostatic cavity well-flushed. Expect blood-tinged urine for 2 to 3 weeks — this is normal as the resection site heals. Avoid heavy lifting, straining, and sexual activity for 4 to 6 weeks. Attend prostate chip histology result review at 2 to 3 weeks. Contact your urology team immediately for inability to pass urine, severe haematuria with clot retention, or high fever after discharge.
The Procedure
Step-by-step guide to what you can expect during your turp (transurethral resection of the prostate) procedure.
Pre-Operative Urodynamics and Prostate Assessment
Your urologist reviews the uroflowmetry, post-void residual ultrasound, PSA, and transrectal ultrasound prostate volume measurements to confirm the BPH is the cause of the obstruction and to plan the appropriate resection extent for your specific prostate size.
Spinal or General Anaesthesia
Spinal anaesthesia is preferred for TURP in most patients — avoiding the respiratory risks of general anaesthesia, allowing continuous neurological monitoring, and providing excellent post-operative analgesia. You remain comfortable and relaxed throughout.
Cystoscopy and Anatomical Assessment
The resectoscope is introduced through the urethra and the entire lower urinary tract is inspected — urethra, verumontanum, bladder neck, and bladder — confirming the anatomy and identifying the urethral landmarks that guide the safe limits of resection.
Systematic Prostatic Resection
Using the bipolar resection loop in continuous saline irrigation, the obstructing adenoma is systematically resected from the bladder neck to the verumontanum — working lobe by lobe until a wide, smooth resection cavity is created that allows unobstructed bladder outflow.
Haemostasis and Cavity Inspection
After completing the resection, all bleeding vessels in the prostatic fossa are individually coagulated under direct vision. The bladder is irrigated until the return fluid is clear, and a final inspection confirms the resection cavity is smooth and haemostatic.
Urethral Catheter and Irrigation Setup
A three-way urethral catheter is placed for continuous bladder irrigation overnight — diluting any post-operative bleeding and preventing clot retention. Clear urine is confirmed before the irrigation is slowed and the catheter is removed after 24 to 48 hours.
What to Expect
TURP is performed under general or spinal anaesthesia and takes 60 to 90 minutes. A bipolar resectoscope is passed through the urethra and obstructing prostate adenoma is systematically resected in chips under continuous irrigant and direct vision, creating a wide prostatic channel. A urethral catheter is placed at the end of the procedure for 24 to 48 hours. Most patients notice dramatically improved urinary flow immediately after catheter removal.
Frequently Asked Questions
Common questions about turp (transurethral resection of the prostate).
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