Method of TUR-P

Transurethral Resection of the Prostate (TUR-P)

What is TUR-P?

TUR-P is the most common and oldest classical surgical method for benign prostate enlargement. Today, it is accepted as the gold standard technique in the treatment of prostate smaller than 80 ml.

What is transurethral resection of the prostate? (TUR-P Method)

It is a closed surgical treatment method that is accepted as the gold standard for prostate enlargement. General or spinal anesthesia is used for the TUR-P method. However, it is not performed with local anesthesia. In this surgery, the prostate is reached through the urethra.

A high frequency electrical current is used to cut the prostate tissue with the resectostop device. An energy system such as Monopolar, Bipolar cautery and plasmakinetics is also an endoscope method in use. It also has a camera with high image quality. Plasmakinetic energy, electrical energy, circulates between the two cutting wires of the resectoscope instrument and generates the plasma energy. This energy is used during the cutting of the tissue.

How is the TUR-P Method Performed?

In the TUR-P method, the procedure is performed under general anesthesia or spinal anesthesia. These drugs of patients who use blood thinners before the procedure are discontinued or changed in consultation with the necessary department physicians.

Urine is entered through the external urinary tract with an instrument called a resectoscope with a camera. The bladder is checked for the presence of stones or tumors. Then, the part of the urethra blocked by the prostate is cut with the help of a wire that is moved back and forth by the surgeon in the resectoscope. An electric current passes through this wire and the cutting or bleeding is stopped. After the prostate is cut enough to provide urine flow, the cut prostate tissue is first taken to the bladder and then to the outside by washing.

The bleeding vessels are touched and stopped with this wire, and the procedure is completed. At the end of the surgery, a thick catheter is inserted into the urethra. In order to prevent post-operative bleeding and clot formation, the probe is washed with serum.

What Are the Symptoms of Tur-P?

Tur-P is defined as the surgical treatment of benign prostate enlargement. The goal of the procedure is to remove the part of the prostate that is causing the symptoms. The procedure is performed through the urinary tract without the need for an incision in the lower abdomen. It is applied to men with 30-80 milliliters of prostate causing moderate or severe symptoms. The indications of the requirement include:

The need to urinate frequently

The need to strain when urinating

Waking up at night due to the need to urinate

Weakening of urine flow

Stone formation in the bladder

Intermittent urination

Delayed onset of urine output

Presence of blood in the urine

Feeling that the bladder is not fully emptied

Sudden need to urinate

Dripping for a long time despite the end of urine

Burning and tingling sensation while urinating

When Should I Consider Tur-P?

This method, which is the standard surgical treatment of benign prostate enlargement, removes the symptoms. Since it is performed directly through the urinary tract, it does not leave any incision marks. It is generally applied to people with moderate or severe symptoms. In addition, it is very suitable for men with 30-80 milliliters of prostate.

In addition, general or spinal anesthesia is applied for Tur-P. While the patient is under anesthesia, the bladder is entered through the urethra. Resestoscope is used in this. In this way, a better quality image is obtained. It is also known as a treatment method using different energy sources.

What is Tur-P Treatment?

If the patient has benign prostatic enlargement, this method is applied and the part causing the symptoms is removed. Since no incision is made, there is no scar on the patient’s body. It is an operation performed through the urinary tract. It is applied with general or spinal anesthesia. Local anesthesia is not performed in this surgery. At the same time, it has operation types that are carried out using different energy sources. These include Monopolar Tur-P, Bipolar Tur-P. One of the differences between these two methods is the use of bipolar energy in the Bipolar Tur-P method. In addition, the surrounding tissue damage is less. A catheter is placed in the bladder to drain the urine after surgery. After an average of 2 days, the catheter is taken.

Importance of Post-Operative Follow-up

On the first day of surgery, a serum is washed into the bladder to prevent clot formation in the bladder. This serum is given into the bladder through one channel of the catheter and flows into the bag from the other channel. Depending on whether there is bleeding in the urine for 1 or 2 days after the surgery, this washing serum is removed. The catheter can be removed 2-3 days after the surgery. During this period, the patients’ blood pressure, fever and blood values ​​are monitored. It varies according to the surgeon’s experience and the patient’s condition. They can be discharged 2-3 days after surgery.

Patients with fever – urinary tract infection, deteriorated blood values, patients who need blood transfusion, and patients with bleeding in the urine can be followed in the hospital. During recovery, patients have burning and bleeding in the urine and may continue for about 3 months. Sudden urge to urinate and not being able to reach the toilet can be seen. Some patients may not be able to urinate and a catheter may be required. Patients with severe bleeding, especially after straining, have also been reported.

They can start their sexual life after 4-6 weeks. It is okay for patients who have undergone endoscopic surgery, that is, without incision, to take a bath. Our patients can start sexual intercourse after about 4-6 weeks. Unfortunately, semen does not come out in 60-85% of patients (retrograde ejaculation). At orgasm, semen enters the bladder. In a meta-analysis (compilation of data from previously published articles) investigating the rates of erectile dysfunction (erectile dysfunction) after prostate surgery, no change in erectile functions was reported.

What are the Advantages of Tur-P Therapy?

The advantages of the method include its safe and widespread use. In addition, symptoms are improved optimally and for a long time. In addition, the hospital rest of the patient is very short. However, there are also some disadvantages. One of them is the risk of bleeding.

There is a very low risk of urinary incontinence and retrograde ejaculation. Urinary tract infection, which is also a low risk, is also among its disadvantages. Before the operation, the patient is examined in detail by the doctor and a treatment program is prepared accordingly. The most suitable methods for the patient are determined and thus a better system is determined.

I’ve started working as a doctor since I attended Uludağ University Faculty of Medicine. I stopped working in the hospitals in 2020 with the thought of opening my own medical clinic. At the beginning of 2022, I opened my office in Karşıyaka Mavişehir Park Yaşam Ofisleri. In our urology clinic, I deal with my patients along with my team.


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