TURP surgery is an endoscopic prostate operation used to treat urinary blockage caused by an enlarged prostate. A urologist passes a telescope through the urine passage and removes the inner obstructing part of the prostate. There is no cut on the skin. TURP can improve weak urine flow, straining, incomplete emptying, repeated urinary retention and catheter dependence. For many men, the main goal is simple: to pass urine comfortably without repeated catheterisation. Recovery usually takes a few weeks. Temporary burning, frequency and mild bleeding can happen. Important risks include bleeding, infection, retrograde ejaculation and, rarely, urinary leakage or narrowing of the urine passage.

What is TURP surgery?

TURP stands for Transurethral Resection of the Prostate.

“Transurethral” means the surgery is done through the urine passage. “Resection” means removal of tissue. In TURP, the surgeon removes the inner obstructing part of the prostate that is blocking urine flow.

TURP is done for benign prostate enlargement, also called BPH or BPE. This is not prostate cancer surgery. The whole prostate is not removed. The aim is to create a wider channel so urine can flow better from the bladder.

EAU patient information describes TURP as a common surgery for benign prostate enlargement that removes part of the prostate to make urination easier.

Who may need TURP surgery?

TURP may be advised when enlarged prostate symptoms are severe, medicines are not working well enough, or complications have started.

A urologist may discuss TURP if you have:

• Very weak urine stream.
• Straining to pass urine.
• Starting and stopping during urination.
• Feeling that urine is still left inside.
• Repeated urinary retention.
• Repeated catheterisation.
• Inability to pass urine after catheter removal.
• Recurrent urine infections due to incomplete emptying.
• Bladder stones related to prostate blockage.
• Kidney swelling or kidney function changes due to long-standing obstruction.
• Bleeding from enlarged prostate after other causes are ruled out.

NICE recommends surgery for voiding symptoms mainly when symptoms are severe, or when medicines and conservative treatment are unsuccessful or unsuitable. TURP is listed as one of the surgical options for urinary symptoms presumed to be due to benign prostate enlargement.

When is TURP better than medicines?

Many men with enlarged prostate do well with medicines. Common options include alpha-blockers and 5-alpha reductase inhibitors. But medicines reduce symptoms; they do not physically remove the obstructing prostate tissue.

TURP may be more appropriate when:

• You are dependent on a catheter.
• You have repeated urinary retention.
• Your urine flow is very poor.
• Post-void residual urine is high.
• You have repeated infections or bladder stones.
• Symptoms remain troublesome despite proper medicines.
• Medicines cause side effects such as dizziness, low BP or ejaculation problems.
• The bladder is showing signs of strain from long-standing obstruction.

The decision is not based only on prostate size. A smaller prostate can sometimes obstruct badly, while a larger prostate may not always need immediate surgery. Your urologist looks at symptoms, urine flow, residual urine, PSA, ultrasound findings, kidney function, infection status, fitness for anaesthesia and your personal priorities.

Who may not be ideal for TURP?

TURP is useful for many patients, but it may not be the best option for everyone.

Your urologist may consider another approach if:

• The prostate is very large and better suited for HoLEP, enucleation or simple prostatectomy.
• You have very high bleeding risk.
• You cannot safely stop certain blood thinners.
• There is active urine infection that needs treatment first.
• Prostate cancer is suspected and needs evaluation.
• The main problem is weak bladder muscle rather than obstruction.
• You are medically unfit for anaesthesia.
• You mainly have urgency/frequency without clear blockage.

What tests are usually needed before TURP?

• Urine routine and urine culture.
• Serum creatinine to assess kidney function.
• PSA test when appropriate.
• Ultrasound KUB/prostate with post-void residual urine.
• Uroflowmetry to measure urine flow.
• ECG, chest evaluation and anaesthesia fitness.
• Blood sugar and BP assessment.
• Review of blood thinners such as aspirin, clopidogrel, warfarin, apixaban or rivaroxaban.

Cystoscopy or urodynamic testing is not needed for every patient, but may be useful if the diagnosis is unclear, previous surgery has been done, symptoms are unusual, or weak bladder muscle is suspected.

How is TURP surgery done?

TURP is usually performed under spinal anaesthesia or general anaesthesia.

The urologist passes a thin operating telescope called a resectoscope through the penis into the urethra. The bladder and prostate area are inspected. A small electric loop is used to shave the obstructing prostate tissue from inside. Bleeding points are sealed during the procedure.

The removed prostate tissue pieces are washed into the bladder and taken out at the end. These pieces are usually sent for pathology examination under a microscope.

BAUS describes TURP as a procedure done under spinal or general anaesthesia using a resectoscope with a wire loop to remove obstructing prostate tissue and seal bleeding points.

Is there any cut or stitches?

No. TURP is done through the natural urine passage. There is no abdominal cut and no skin stitches.

But TURP is still a real internal surgery. The prostate area remains raw for some time after surgery. This is why mild bleeding, burning and urinary urgency can happen during recovery.

TURP vs laser prostate surgery

TURP is a standard and time-tested operation for many men with enlarged prostate. Laser procedures such as HoLEP or laser vaporisation may be preferred in selected patients, especially those with larger prostates, higher bleeding risk or specific surgical considerations.

The best option depends on:

• Prostate size.
• Catheter dependence.
• Bleeding risk.
• Blood thinner use.
• Bladder condition.
• Available equipment.
• Surgeon experience.
• Cost and hospital setup.
• Patient priorities, including ejaculation concerns.

A good consultation should not simply say “TURP for everyone” or “laser for everyone.” The right surgery is the one that matches the patient’s anatomy, risk profile and goals.

Catheter and hospital stay after TURP

After TURP, a urinary catheter is placed through the penis into the bladder. This catheter drains urine and allows bladder irrigation if needed.

Bladder irrigation means saline wash is passed through the catheter to prevent clots from blocking it. Urine may look pink or red initially and gradually becomes clearer.

Most patients stay in hospital for about 1 to 3 days, depending on urine colour, bleeding, diabetes, heart disease, blood thinner history, preoperative catheter status and bladder strength.

The catheter is usually removed once urine is clear enough. The first few times passing urine after catheter removal may be uncomfortable, urgent or frequent. That does not automatically mean surgery has failed.

Benefits of TURP surgery

• Improving urine stream.
• Reducing straining.
• Helping the bladder empty better.
• Reducing residual urine.
• Reducing repeated retention episodes.
• Helping some catheter-dependent patients pass urine again.
• Reducing obstruction-related infections or bladder stones in selected patients.
• Improving sleep when night urination is related to poor emptying.

The stream often improves earlier than urgency and frequency. If the bladder has been irritated for years, it may need weeks to months to calm down even after the blockage is removed.

TURP recovery timeline

Recovery is slower if the patient had long-standing retention, diabetes, urine infection, a very large prostate, blood thinner use or weak bladder muscle.

What is normal after TURP?

• Mild burning while passing urine.
• Frequent urination.
• Sudden urge to pass urine.
• Mild blood in urine.
• Occasional small clots.
• Temporary leakage before reaching the toilet.
• Tiredness for a few days.
• Stronger stream but irritated bladder.

Symptoms often fluctuate. A patient may feel better for two days and then see pink urine after walking more, straining for stool or travelling. That can happen during healing.

TURP risks and side effects

Common temporary effects

• Burning urination.
• Urgency and frequency.
• Mild bleeding.
• Small clots.
• Catheter discomfort.
• Temporary leakage.
• Bladder spasms.

Important but less common risks

• Urine infection.
• Fever after surgery.
• Blood clots blocking the catheter.
• Need for bladder wash.
• Temporary inability to pass urine after catheter removal.
• Rare need for blood transfusion.
• Urethral stricture, meaning narrowing of the urine passage.
• Bladder neck narrowing.
• Need for repeat procedure in future.

Sexual side effects

The most common sexual side effect is retrograde ejaculation. Semen goes backward into the bladder during orgasm instead of coming out through the penis. It later passes harmlessly with urine.

Orgasm may still happen, but ejaculation becomes dry or reduced. This matters for men who still want children. If fertility is important, discuss it before surgery.

Erection problems are less common than ejaculation changes. Age, diabetes, BP, heart disease, smoking, anxiety and existing erection quality also affect sexual recovery.

Rare serious risks

• Significant bleeding.
• Persistent urinary incontinence.
• Severe infection.
• Anaesthesia-related complications.
• Fluid/electrolyte-related issues, especially with older monopolar techniques and prolonged surgery.

Modern bipolar TURP has reduced some fluid-related risks compared with older monopolar TURP, but safety still depends on prostate size, duration of surgery, patient fitness and surgical judgement.

Will TURP cure night urination completely?

Not always.

TURP helps night urination when the main reason is prostate obstruction and incomplete emptying. But night urination can also happen due to diabetes, excess evening fluids, tea/coffee intake, sleep disturbance, snoring or sleep apnea, leg swelling, overactive bladder, kidney issues, heart issues or certain medicines.

So, after TURP, urine flow may improve clearly, while night frequency may need separate evaluation if it persists.

Follow-up after TURP

Follow-up is important even if the stream is good.

Your urologist may check:

• Urine symptoms.
• Urine flow.
• Residual urine if needed.
• Infection symptoms.
• Bleeding recovery.
• Pathology report of prostate chips.
• Whether prostate medicines can be stopped.
• Ongoing urgency, leakage or night urination.

Some patients need temporary bladder-calming medicines after TURP, especially if they had urgency and frequency for a long time before surgery.

If you have severe prostate symptoms, repeated catheterisation, urinary retention or poor response to prostate medicines, a urologist can assess whether TURP, bipolar TURP, HoLEP, continued medicines or another option is best for you.

What to bring for consultation

• USG KUB/prostate report with post-void residual urine.
• PSA report.
• Urine routine and urine culture.
• Serum creatinine report.
• Uroflowmetry report if done.
• Current prostate medicines.
• Blood thinner and heart medicine list.
• Catheter or discharge summary if you had urinary retention.
• Diabetes, BP, heart or kidney reports.
• Previous prostate biopsy or MRI prostate reports if any.

FAQs

Related reading

• When Is Surgery Needed for Enlarged Prostate?
• Bipolar TURP Surgery Explained
• TURP vs HoLEP: Which Is Better?
• HoLEP Surgery: Procedure, Recovery and Benefits
• Catheter After TURP Surgery
• Bleeding After TURP: What Is Normal?
• Retrograde Ejaculation After Prostate Surgery
• Prostate Surgery While Taking Blood Thinners
• Prostate Surgery in Diabetic Patients
• Prostate Enlargement / BPH
• Urologist in Latur

References

• European Association of Urology Patient Information. Transurethral Resection of the Prostate for Benign Prostate Enlargement https://patients.uroweb.org/condition/benign-prostate-enlargement-bpe/surgery-for-bpe/transurethral-resection-of-the-prostate-turp
• British Association of Urological Surgeons. TURP for Benign Disease https://www.baus.org.uk/patients/information_leaflets/179/resection_of_prostate_turp_for_benign_disease
• NICE Clinical Guideline CG97. Lower Urinary Tract Symptoms in Men: Management https://www.nice.org.uk/guidance/cg97
• European Association of Urology Guidelines. Management of Non-neurogenic Male Lower Urinary Tract Symptoms https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts
• American Urological Association Guideline. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia https://www.auanet.org/guidelines-and-quality/guidelines/bph-guideline