Transurethral resection of the prostate (TURP) is a surgical procedure frequently performed to relieve the symptoms of benign prostatic hyperplasia (BPH). This condition, common in men over the age of 50, is characterized by an abnormal increase in prostate volume, leading to urinary problems that can be severe, such as urinary retention or frequent urination. Although effective, this procedure can have a number of side effects, and it's essential to be aware of these before embarking on the procedure. This article details the specific features of TURP, its possible impacts, and the solutions adapted to improve recovery, while also considering cases requiring drug treatment or pre-operative urinalysis.
Indications for TURP surgery?
TURP is often considered when medical treatments, such as alpha-blockers or 5-alpha reductase inhibitors, are not sufficient to manage the symptoms of BPH. These symptoms include frequent urination, a feeling of incomplete bladder emptying or the presence of blood in the urine. A urinalysis is usually requested prior to surgery to rule out infection. Surgery may also be required in the event of complications such as repeated urinary tract infections, severe urinary retention or kidney damage due to advanced hypertrophy. The main aim of TURP is to restore normal urinary flow, while significantly improving the patient's quality of life.
Common side effects of TURP
Temporary difficulties with urinary control
- Urinary incontinence is one of the most common side effects following TURP. It is often caused by temporary weakness of the muscles controlling urination. However, this situation generally improves over the weeks with pelvic floor re-education exercises.
Blood in urine after surgery
- As the operated area heals, blood may appear in the urine. This phenomenon is often temporary and subsides naturally. However, persistent or heavy bleeding should be reported to a doctor as soon as possible to rule out more serious problems.
Change in ejaculation
- Retrograde ejaculation is a frequent side effect of TURP. This phenomenon, in which seminal fluid is redirected to the bladder instead of being expelled, does not affect sexual function or orgasm, but can reduce fertility.
Risk of urinary tract infections
- The temporary use of a bladder catheter after surgery increases the risk of urinary tract infections. These usually manifest themselves as pain or burning on urination, fever or abnormally colored urine. Rigorous hygiene and medical follow-up can prevent and rapidly treat these infections.
Effects of anesthesia
- Depending on whether general or spinal anesthesia is used, temporary side effects such as nausea, headaches or fatigue may occur. These symptoms generally disappear within a few days.
Bleeding in patients on anticoagulants
- For patients on anticoagulant therapy, the risk of bleeding is higher. Appropriate preoperative preparation, including adjustment of treatment regimens, is essential to limit this risk and ensure a safe operation.
A modern alternative: prostatic embolization
Prostate embolization is a less invasive treatment option, particularly suited to men who are unwilling or unable to undergo traditional surgery. The technique involves reducing the blood supply to certain parts of the prostate by blocking the small arteries that feed it. Performed under local anaesthetic and guided by medical imaging, embolization offers several advantages, including a reduced risk of complications such as urinary incontinence or retrograde ejaculation. It is particularly indicated for patients with contraindications to general anesthesia or anticoagulants. What's more, this outpatient procedure enables patients to resume their daily activities as quickly as possible.
Conclusion
Prostate planing is an effective way of relieving the symptoms of BPH, such as frequent urination or urinary retention. Although the procedure is generally safe, it can have temporary or permanent side effects. Careful preparation, including urinalysis and adjustment of anticoagulant therapy if necessary, and rigorous follow-up after the procedure help minimize risks and optimize recovery. If you are concerned by problems related to an enlarged prostate, consult a specialist to determine the treatment best suited to your needs.
