Transurethral resection (TUR) of the prostate

Sometimes men need surgery to remove the part of a prostate cancer that is pressing on the tube that carries urine from the bladder (the urethra). If anything presses on the urethra this can make it difficult for you to empty your bladder properly. Your doctor may suggest an operation to take away some of the cancer so that you can pass urine more easily again. This operation does not cure the cancer. But it can relieve symptoms caused by the cancer pressing on your urethra.

This operation is also often used for men who have a non cancerous (benign) swelling of the prostate gland called benign prostatic hypertrophy (BPH). Here we are just describing its use as a treatment for prostate cancer. This type of surgery is called a TUR or TURP, which stands for transurethral resection of the prostate.

A TURP is carried out by passing a thin tube up the urethra through your penis. The tube has a tiny camera and an eyepiece, so that the surgeon can see inside your urethra. They remove the blockage using an instrument attached to the tube that can cut away the abnormal areas. Afterwards you usually need to stay in hospital for about 2 or 3 nights.

You usually have a TURP under a general anaesthetic, but for some men, it is done with a spinal anaesthetic. A spinal anaesthetic means you are awake, but can't feel anything below the level of the anaesthetic injection into your spine. Your doctor will suggest a spinal anaesthetic if there are reasons why you shouldn't have a general anaesthetic, for example if your lungs are not as healthy as they might be.

You recover more quickly if you can start moving around as soon as possible. You'll probably be up and about within 24 hours.

You may have a drip (intravenous infusion) to maintain your body fluids. It will be taken out as soon as you are drinking normally again. It is important to drink plenty of fluids.

You may also have a tube (catheter) into your bladder to drain your urine into a collecting bag. After this surgery, it is quite normal to have blood clots forming in your urine. To prevent the blood clots blocking this catheter, fluid is passed into your bladder and drained out through the catheter (bladder irrigation). The blood in your urine will slowly clear and then the catheter will be taken out. This is normally about 2 or 3 days after your surgery. 

You must tell your nurse as soon as you pass urine after your catheter has been removed. Sometimes, men can't pass urine when their catheter first comes out. This may be because there is still swelling around the neck of the bladder and the prostate after your surgery. If you can't pass urine, you will probably have the catheter put back in and you can try again without it in a day or so.

Sometimes you may need to have the catheter in for a while after you go home. Before you leave hospital your nurse will show you how to look after your catheter. They can also arrange for a district nurse to visit you at home to help with any problems.

There is general information about the side effects of surgery in the Cancers in general section.

Before you leave hospital your nurse will give you an appointment for the outpatient clinic for a check up. The appointment is a good time to discuss any problems you may have after your operation. It is usually 6 weeks after your surgery.

Most men go home within 3 days or so of their TURP. If you think you might have problems coping at home, let your nurse or social worker know when you are first admitted so that they can arrange help.

You may have some pain or discomfort for a few days after your operation. But you will have painkillers to control it. Remember that if you still have pain, tell the doctor or nurse looking after you as soon as possible. Your painkillers can be changed, as different drugs suit different people.

Recently, a type of laser surgery has been used to remove prostate tissue. This procedure uses a holmium laser or thulium laser. It seems to work as well as a traditional TURP, and appears to cause fewer complications. This is still quite a new technique, and is not available in all hospitals.