TURP for Enlarged Prostate: Procedure, Benefits, Risks & Recovery

An enlarged prostate, medically known as benign prostatic hyperplasia (BPH), can gradually interfere with normal urination. As the prostate grows, it can narrow the urethra and make it harder for urine to pass.

Men may experience a weak urine stream, difficulty starting urination, frequent urination, urgency, incomplete bladder emptying or repeated trips to the bathroom at night.

When medicines and lifestyle measures do not provide adequate relief, or when BPH causes significant urinary obstruction or complications, a urologist may recommend a procedure to remove or reduce the obstructing prostate tissue.

One of the most established procedures for BPH is TURP — Transurethral Resection of the Prostate.

TURP has been used for decades and remains an important surgical treatment for men with bothersome moderate-to-severe urinary symptoms caused by benign prostate obstruction. The European Association of Urology recommends bipolar or monopolar TURP for appropriately selected men, particularly those with prostate volumes of approximately 30–80 mL.

At Jyoti Hospital, Gurugram, the Urology team evaluates prostate size, urinary symptoms, IPSS score, urine flow, residual urine and overall health before deciding whether TURP or another BPH treatment is appropriate.

What Is TURP?

TURP stands for Transurethral Resection of the Prostate.

It is a minimally invasive surgical procedure used to remove prostate tissue that is blocking urine flow.

Unlike open prostate surgery, TURP does not require an incision through the abdomen.

Instead, the surgeon passes a specialised instrument through the urethra until it reaches the prostate.

The surgeon then removes the obstructing prostate tissue, creating a wider channel for urine to pass through.

Because the procedure is performed through the natural urinary passage, there is no external surgical incision.

TURP is one of the established surgical treatments for bothersome urinary symptoms caused by benign prostate obstruction.

Why Does an Enlarged Prostate Cause Urinary Problems?

The prostate surrounds part of the urethra.

As prostate tissue enlarges, it can narrow this passage.

The bladder then has to work harder to push urine through the narrowed opening.

Over time, this can result in:

• Weak urine stream
• Difficulty starting urination
• Intermittent urine flow
• Straining
• Frequent urination
• Urinary urgency
• Night-time urination
• Incomplete bladder emptying
• Urinary retention

Not every man with an enlarged prostate needs TURP. Our doctors generally consider surgery when symptoms remain troublesome despite appropriate treatment or when BPH causes complications.

When Is TURP Recommended?

Our urologist may consider TURP when:

• BPH symptoms significantly affect your quality of life.
• Medicines do not provide adequate relief.
• Symptoms continue or worsen despite medical treatment.
• You develop recurrent urinary retention.
• BPH causes recurrent urinary tract infections.
• Bladder stones develop because of obstruction.
• Significant bleeding occurs in selected cases.
• Your bladder does not empty adequately.
• There is significant bladder outlet obstruction.

TURP is generally considered for men with moderate-to-severe lower urinary tract symptoms caused by benign prostatic obstruction.

The EAU currently recommends bipolar or monopolar TURP for appropriately selected men with prostate volumes of approximately 30–80 mL. Prostate size is only one part of treatment selection, however.

Does Every Man With an Enlarged Prostate Need TURP?

No.

Many men with BPH can manage their symptoms with:

• Lifestyle changes
• Watchful waiting
• Alpha-blockers
• 5-alpha reductase inhibitors
• Other appropriate medicines

Our doctors consider TURP when the symptoms or obstruction justify an intervention.

Other procedures, including HoLEP, Rezūm, UroLift, Aquablation and other techniques, may also be appropriate depending on prostate size, anatomy, symptoms and treatment goals.

Therefore, TURP should not be considered automatically simply because the prostate is enlarged.

What Tests Are Done Before TURP?

Before recommending TURP, your urologist usually evaluates the urinary problem in detail.

Depending on your symptoms, this may include:

• IPSS Score: The International Prostate Symptom Score (IPSS) helps measure the severity of urinary symptoms and their effect on quality of life.
• Prostate Assessment: Ultrasound may help determine prostate volume and anatomy.
• Urine Testing: A urine test can identify infection or blood in the urine.
• PSA: Our doctor recommend a PSA blood test when appropriate based on your age, symptoms and prostate cancer risk assessment.
• Uroflowmetry: This test measures how quickly urine flows.
• Post-Void Residual: A bladder scan can measure how much urine remains after you urinate.
• Cystoscopy: In selected patients, cystoscopy can help evaluate the urethra, prostate and bladder.

These tests help our urologist determine whether the symptoms are actually caused by prostate obstruction and which treatment is most appropriate.

How Is TURP Performed?

TURP takes place in a hospital or surgical centre.

• Step 1: Anaesthesia– The procedure is usually performed under either:
  • Spinal anaesthesia, or
  • General anaesthesia

Your anaesthetist will discuss the appropriate option with you.

• Step 2: Inserting the Instrument– The surgeon passes a thin instrument called a resectoscope through the urethra.
  • The instrument contains a camera and specialised equipment that allows the surgeon to see the prostate and remove tissue.
• Step 3: Removing Obstructing Tissue– The surgeon removes small pieces of prostate tissue that are blocking urine flow.
  • The goal is not to remove the entire prostate.
  • Instead, the surgeon removes the obstructing portion of the prostate to create a wider urinary passage.
• Step 4: Controlling Bleeding– The surgeon controls bleeding from the treated prostate tissue during the procedure.
• Step 5: Catheter Placement– At the end of the procedure, the surgeon places a urinary catheter into the bladder.
  • The catheter allows urine to drain while the treated area begins to heal.
  • A catheter may also be used to flush the bladder if necessary.

How Long Does TURP Take?

The duration depends on:

• Prostate size
• Amount of obstructing tissue
• Surgical technique
• Patient factors

Many TURP procedures take around one hour, although the actual operating time can vary.

Our urologist can provide a more specific estimate after assessing your prostate.

What Happens Immediately After TURP?

After the procedure, you will spend some time in a recovery area.

A urinary catheter usually remains in place for a period after surgery.

You may notice:

• Blood-tinged urine
• Bladder spasms
• Mild discomfort
• Burning when urinating after catheter removal
• Increased urinary frequency or urgency
• Temporary difficulty controlling urine

These symptoms can occur during the early recovery period and generally improve as healing progresses.

Your medical team will monitor your urine output and overall condition before deciding when the catheter can be removed.

How Long Does the Catheter Stay After TURP?

The exact duration varies between patients.

Your catheter may remain in place until:

• Urine becomes sufficiently clear
• The bladder is draining properly
• You can urinate adequately after catheter removal
• Your medical team considers it safe to remove

If you have difficulty passing urine after catheter removal, the catheter may need to be replaced temporarily.

How Long Do You Stay in the Hospital After TURP?

Hospital stay depends on your recovery, urine appearance, catheter requirements and medical condition.

Many patients leave hospital within a few days. NHS guidance notes that many people go home approximately 1–4 days after TURP, although hospital protocols vary.

Our urologist will confirm when you are ready for discharge.

Benefits of TURP

TURP can provide significant improvement in urinary symptoms when prostate obstruction is responsible for the problem.

Potential benefits include:

• Better urine flow
  • Removing obstructing tissue can widen the urinary passage.
• Reduced urinary symptoms: Men may experience improvement in:
  • Weak stream
  • Straining
  • Difficulty starting urination
  • Incomplete emptying
  • Frequency
  • Urgency
• Improved bladder emptying
  • Reducing the obstruction can make it easier for the bladder to empty.
• Reduction in urinary retention
  • TURP can help men whose symptoms or complications result from significant prostate obstruction.
• Long-term symptom improvement
  • TURP has extensive clinical experience and remains an established surgical treatment for BPH. The EAU considers TURP a standard surgical option for appropriately selected men with prostate volumes of 30–80 mL.

What Are the Risks of TURP?

TURP is generally an established and effective procedure, but every operation has potential risks.

Our urologist will discuss the risks that are particularly relevant to you.

Possible complications include:

• Bleeding
• Urinary tract infection
• Temporary difficulty urinating
• Urinary retention
• Urinary urgency or frequency during recovery
• Temporary or persistent urinary incontinence
• Urethral stricture
• Bladder neck narrowing
• Erectile dysfunction
• Retrograde ejaculation
• Need for further treatment

The risk of complications varies depending on factors such as prostate size, surgical duration, age, medical conditions and medications.

What Is Retrograde Ejaculation After TURP?

Retrograde ejaculation is one of the commonly discussed sexual effects of TURP.

Normally, semen travels forward through the urethra during ejaculation.

After TURP, the bladder neck may remain open during ejaculation, causing semen to travel backward into the bladder instead.

As a result, a man may experience:

• Little or no visible semen during ejaculation
• A change in ejaculation
• Normal sexual sensation despite reduced visible semen

Retrograde ejaculation can affect fertility because sperm may not exit the penis normally.

Therefore, if future fertility is important to you, discuss this with our urologist before TURP.

Can TURP Cause Erectile Dysfunction?

Erectile dysfunction is a recognised possible complication of TURP, although it does not occur in every patient.

Your individual risk depends on several factors, including your age, existing erectile function, medical conditions and other health factors.

It is important to discuss your baseline sexual function with our urologist before surgery.

Can TURP Cause Urinary Incontinence?

Temporary urinary leakage can occur during recovery.

Most patients do not develop permanent severe urinary incontinence, but persistent incontinence is a recognised potential complication.

Pelvic floor exercises may help some men regain bladder control during recovery. Our doctor or physiotherapist can advise you about appropriate exercises.

TUR Syndrome: What Is It?

TUR syndrome is a rare complication associated primarily with certain forms of monopolar TURP.

It can occur when irrigation fluid is absorbed in significant amounts during the procedure, causing changes in fluid and electrolyte balance.

Modern surgical techniques and improved monitoring have reduced this risk considerably.

Bipolar TURP also has a more favourable perioperative safety profile compared with monopolar TURP according to current EAU guidance.

Our surgeon will select the appropriate technique based on available equipment, experience and your clinical situation.

Bipolar TURP vs Monopolar TURP

TURP can be performed using different electrical technologies.

• Monopolar TURP
  • This is the traditional form of TURP and has a long history of use.
• Bipolar TURP
  • Bipolar technology uses a different electrical circuit and allows the surgeon to use saline irrigation.

According to the EAU, bipolar TURP provides similar efficacy to monopolar TURP while having a more favourable perioperative safety profile. Both remain established surgical options.

The choice depends on equipment availability, surgeon expertise and patient factors.

TURP Recovery Timeline

Recovery varies between patients, but the process generally occurs in stages.

First few days

You may experience:

• Blood in urine
• Burning during urination
• Urinary urgency
• Frequency
• Mild pelvic discomfort
• Temporary bladder control problems

First few weeks

Urinary symptoms generally begin settling, although some irritation can persist.

You may gradually return to normal daily activities according to our doctor’s instructions.

Around 2–4 weeks

Many patients can resume many usual activities during this period, depending on their recovery.

Around 4–6 weeks

The prostate and urinary tract continue to heal.

NHS guidance notes that usual activities may resume around 2–4 weeks for some patients, while complete healing can take up to approximately 6 weeks. Heavy lifting and intense exercise are generally avoided during the early healing period.

Your own recovery may be faster or slower.

When Can You Return to Work After TURP?

The timing depends on:

• Type of work
• Physical demands
• Urinary symptoms
• Overall recovery
• Doctor’s advice

Someone with a desk-based job may return sooner than someone whose work involves heavy lifting or prolonged physical activity.

Discuss your expected return-to-work timeline with our urologist before discharge.

When Can You Exercise After TURP?

Light movement and walking are generally encouraged during recovery.

However, avoid strenuous exercise and heavy lifting until our urologist confirms that it is safe.

NHS guidance recommends avoiding heavy lifting or intense exercise for approximately six weeks after TURP.

Follow your surgeon’s specific instructions because recovery can vary.

When Can You Have Sex After TURP?

Sexual activity should generally wait until your urinary tract has recovered adequately and our doctor confirms that it is safe.

The exact timing varies between patients.

Remember that retrograde ejaculation is common after procedures that remove prostate tissue, so discuss possible changes in ejaculation and fertility before surgery.

Is Blood in Urine Normal After TURP?

Some blood in the urine is common during the early recovery period.

The urine may become clearer and then temporarily become bloodier again during healing.

NHS guidance notes that some patients may notice blood in their urine again around 10–14 days after surgery as part of the healing process.

However, heavy bleeding, large clots, inability to urinate or worsening symptoms require prompt medical assessment.

What Should You Do After TURP?

Our urologist recommend:

• Drinking adequate fluids
• Taking prescribed medicines
• Completing prescribed antibiotics when indicated
• Walking regularly
• Avoiding heavy lifting
• Avoiding strenuous exercise during early recovery
• Following catheter-care instructions if discharged with a catheter
• Performing pelvic floor exercises when advised
• Attending your follow-up appointment

Do not stop prescribed medicines or restart blood-thinning medicines without discussing them with our doctor.

What Should You Avoid After TURP?

During the early recovery period, our doctor may advise you to avoid:

• Heavy lifting
• Strenuous exercise
• Activities that significantly increase abdominal pressure
• Long periods of physical exertion
• Driving until you are medically fit and comfortable
• Sexual activity until your doctor advises that it is safe

Your specific restrictions depend on your recovery.

When Should You Contact Your Doctor After TURP?

Contact our medical team promptly if you develop:

• Increasing difficulty passing urine
• Heavy bleeding
• Large blood clots
• Fever or chills
• Severe pain
• Increasing redness or swelling
• Persistent urinary leakage
• Worsening urinary symptoms

Seek urgent medical attention if you suddenly cannot urinate, develop significant bleeding or become severely unwell.

TURP vs HoLEP: Are They the Same?

No.

Both procedures remove obstructing prostate tissue through the urinary passage, but they use different surgical techniques.

• TURP
  • Uses an electrical resection technique to remove prostate tissue in smaller pieces.
• HoLEP
  • Uses a holmium laser to separate/enucleate the obstructing prostate tissue.

HoLEP can be used across a broad range of prostate sizes and is an established alternative to TURP. The EAU strongly recommends HoLEP as an alternative to TURP or open prostatectomy for appropriately selected patients.

The choice between TURP and HoLEP depends on prostate size, anatomy, patient factors, available equipment and surgeon expertise.

TURP vs Other BPH Treatments

TURP is only one option for treating an enlarged prostate.

Depending on your prostate characteristics and treatment goals, our urologist may discuss:

• Medicines
• TURP
• HoLEP
• Rezūm
• UroLift
• Aquablation
• iTIND and other emerging techniques
• Other laser procedures

The appropriate treatment depends on the individual patient rather than simply choosing the newest procedure.

Can TURP Cure an Enlarged Prostate?

TURP removes the portion of prostate tissue causing obstruction, so it can provide long-term improvement in urinary symptoms.

However, it does not remove the entire prostate.

Residual prostate tissue remains, and prostate tissue can continue to grow over time.

Therefore, some men may eventually require additional treatment.

TURP also does not eliminate the need for appropriate prostate health monitoring.

Can TURP Prevent Prostate Cancer?

No.

TURP treats urinary obstruction caused by prostate enlargement. It is not a treatment for preventing prostate cancer.

In some cases, the removed prostate tissue is sent for laboratory examination, which can identify unexpected abnormalities.

You should continue appropriate prostate health assessments recommended by our doctor.

How Jyoti Hospital Can Help With TURP

At Jyoti Hospital, Gurugram, our Urology team evaluates men with urinary symptoms caused by an enlarged prostate and determines whether medication, TURP, laser treatment or another procedure is appropriate.

Before recommending TURP, our urologist may assess:

• IPSS score
• Prostate size
• Urine flow
• Post-void residual urine
• Urinary symptoms
• Medical history
• Current medicines
• PSA when appropriate
• Bladder function
• Overall surgical fitness

The team can then discuss the potential benefits, risks, expected recovery and alternatives.

The aim is to select a treatment that addresses the underlying obstruction while taking your urinary function, general health and personal priorities into account.

Final Thoughts

TURP is an established surgical treatment for urinary obstruction caused by an enlarged prostate.

The procedure removes obstructing prostate tissue through the urethra without an external incision. For appropriately selected men, TURP can significantly improve urine flow and lower urinary tract symptoms.

However, TURP is not automatically required for every man with BPH. Medicines, lifestyle measures, HoLEP, Rezūm, UroLift, Aquablation and other treatments may be appropriate depending on prostate size, anatomy, symptoms and individual priorities.

If our urologist recommends TURP, understanding the procedure, expected benefits, possible risks and recovery process can help you make an informed treatment decision.

If you have a weak urine stream, difficulty urinating, recurrent urinary retention or persistent BPH symptoms despite medicines, consult our urologist for an appropriate evaluation.

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FAQs

1. What is TURP?
   • TURP, or transurethral resection of the prostate, is a procedure that removes obstructing prostate tissue through the urethra to improve urine flow.
2. How long does it take to recover from TURP?
   • Many patients can resume some normal activities within a few weeks, while complete healing can take several weeks. NHS guidance states that full healing can take up to around six weeks.
3. Is TURP painful?
   • The procedure itself is performed under anaesthesia, so you should not feel the operation. Some discomfort, burning during urination and bladder irritation can occur during recovery.
4. Is TURP better than HoLEP?
   • Neither procedure is universally best for every patient. Both can effectively relieve obstruction. HoLEP can be particularly useful across a broad range of prostate sizes, while TURP remains an established standard surgical option for appropriately selected prostates.
5. Can the prostate grow again after TURP?
   • TURP removes the obstructing portion rather than the entire prostate. Remaining tissue can grow over time, and some men may eventually require additional treatment.