Surgical therapy with transurethral resection of the prostate (TURP) has traditionally been the “gold standard” treatment for men with BPH. In 1986, it was estimated that TURP accounted for 24% of the professional workload for practicing urologists in the U.S. In this type of surgery, no external incision is needed. After giving anesthesia, the surgeon reaches the prostate by inserting an instrument called a resectoscope through the urethra.
The resectoscope is about 12 inches long and 1/2 inch in diameter, contains a light, valves for controlling irrigating fluid, and an electrical loop that cuts tissue and seals blood vessels. During the 60-90-minute operation, the surgeon uses the scope’s wire loop to remove the obstructing tissue one piece at a time.
The pieces of tissue are carried by the fluid into the bladder and then flushed out at the end of the operation. A TURP is used for approximately 90% of all prostate surgeries for BPH. In most patients, before TURP is performed, consideration has already been given to medical therapy. In general, TURP is reserved for very symptomatic men or those who develop complications including urinary tract infection, bladder stones, or gross hematuria as mentioned above.