Transurethral resection of the prostate - discharge
TURP - discharge; Prostate resection - transurethral - discharge
You had transurethral resection of the prostate (TURP) surgery to treat an enlarged prostate. This article tells you how to take care of yourself at home after the procedure.
The prostate gland is an organ that surrounds the urinary urethra in men. It secretes fluid which mixes with sperm to make semen.
Not every man will have to deal with age-related issues like balding or weight gain. Whether you have these problems really depends on your health, and luck. But one problem just about every man will have to face, if he lives long enough, is an enlarged prostate. Let's talk about an enlarged prostate, also known as benign prostatic hyperplasia, or BPH. The prostate gland is part of your reproductive system, and its job is to add fluid to the sperm before ejaculation. The prostate is pretty small when you're young, but as you get older it grows and grows. Keep in mind, this growth isn't cancerous. But by design, the prostate is wrapped around the urethra, the tube that carries urine from your bladder out of your body. So as the prostate grows, it can begin to squeeze or pinch the urethra which often can make it harder for men with an enlarged prostate to urinate. If you have an enlarged prostate, the first notice that you're having trouble urinating. Instead of having a strong even flow, the urine only dribbles out like a leaky faucet; drip, drip, dribble, drip. Because you're not emptying your bladder fully each time, you keep feeling the urge to use the bathroom, even in the middle of the night. To check your prostate, your doctor or urologist will check your prostate gland by inserting a lubricated, gloved finger and feeling for any growth. Other tests may check your urine flow, and how much urine is left in your bladder after you go, as well as look for signs of an infection or prostate cancer. How is an enlarged prostate treated? Treatment often depends on how you feel. If you're not having any symptoms, your doctor may suggest just watching it, that's called watchful waiting. If you've got bothersome symptoms, medications can reduce the size of the prostate gland, and relax your bladder and prostate so you don't constantly feel the urge to go. For more serious symptoms, surgery can remove the extra prostate tissue. To help relieve the symptoms of an enlarged prostate, watch how much fluid you drink, especially before bedtime, or before going out. Minimize alcohol and caffeine, as well as over-the-counter decongestants and antihistamines. They can make your symptoms worse. Double voiding can help. After you've emptied your bladder, wait a moment and try to go again without straining or pushing. Some people take herbs like saw palmetto for an enlarged prostate. Although there's some evidence that these herbs can relieve BPH symptoms, many studies haven't found a benefit. Talk to your doctor before taking any herbal remedy, because they can cause side effects. Prostate enlargement isn't usually serious, but it can have a serious impact on your way of life, especially when you're always going to the bathroom. Remember that BPH is treatable. Work with your doctor to find the treatment that works best for you. If you've been caring for your symptoms for 2 months and not finding any relief, or you're having more serious symptoms like you're not urinating at all, or you have a fever or pain in your back or abdomen, call your doctor as soon as possible.
When You're in the Hospital
You had transurethral resection of the prostate (TURP) surgery to treat an enlarged prostate.
Your surgeon inserted a tube-like tool called a cystoscope (or endoscope) through your urethra (the tube that carries urine from the bladder out of the penis). Your surgeon used a special cutting tool to remove part of your prostate gland piece by piece.
What to Expect at Home
You can expect to start doing most of your normal activities in 3 to 6 weeks. Problems you may notice include:
- Problems with urine control or leakage after sneezing, coughing, or lifting.
- Erection problems (impotence).
- Absence of semen or decrease in volume. Semen travels up into the bladder instead of out through the urethra. This is called retrograde ejaculation. It is not harmful but can interfere with your ability to get women pregnant. It can be permanent.
- Burning or pain during urination.
- Passing blood clots.
Self-care
You should rest as often as you need to the first few weeks after surgery. But you should also do regular, short periods of movement to build up your strength. While resting, continue to do some of the bedside exercises and breathing techniques your nurse showed you.
Gradually return to your normal routine. You should not do any strenuous activity, lifting (more than 5 pounds or more than 2 kilograms), or driving for 3 to 6 weeks.
Try taking regular, short walks. Work up to longer walks to build up your strength. You can return to work when you are better and can tolerate most activities.
Drink plenty of water to help flush fluids through the bladder (8 to 10 glasses a day). Avoid coffee, soft drinks, and alcohol. They can irritate your bladder and urethra.
Eat a healthy diet with plenty of fiber. You may use a stool softener or fiber supplement to help prevent constipation, which can delay the healing process.
For the first few weeks after surgery, take only the medicines your health care provider has told you to take.
- You may need to take antibiotics to help prevent infection.
- Check with your surgeon before taking aspirin, ibuprofen (Aleve, Motrin), naproxen (Aleve, Naprosyn), acetaminophen (Tylenol), or any other drugs like these.
You may take showers. If you have a catheter, do not take baths until it is removed. Make sure your provider clears you for baths to make sure your incisions are healing well.
Avoid sexual activity for 3 to 4 weeks. Many men report a lower amount of semen during orgasm after having TURP.
Urinary Catheters
You may feel spasms in your bladder and may feel like you need to urinate while you have a urinary catheter in place. Your provider can give you medicine for these spasms. You may have urine come out around the catheter because of the bladder spams. This is normal.
You will need to make sure your indwelling catheter works right. You will also need to know how to clean the tube and the area where it attaches to your body. This will prevent infection and skin irritation. There should be urine draining and filling the bag if the catheter is working properly. Call your provider if you have not seen any urine drain in an hour.
The urine in your drainage bag may look darker red. This is normal.
After your catheter is removed:
- You may have some urine leakage (incontinence). This should get better over time. You should have close-to-normal bladder control within 3 to 6 months.
- You will learn exercises (Kegel exercises) that strengthen the muscles in your pelvis. You can do these exercises any time you are sitting or lying down.
When to Call the Doctor
Contact your provider if:
- You have pain in your belly that is not helped with your pain medicines
- It is hard to breathe
- You have a cough that does not go away
- You cannot drink or eat
- Your temperature is above 100.5°F (38°C)
- Your urine has a thick, yellow, green, or milky drainage
- You have signs of infection (burning sensation when you urinate, fever, or chills)
- Your urine stream is not as strong, or you cannot pass any urine at all
- You have pain, redness, or swelling in your legs
While you have a urinary catheter, call your provider if:
- You have pain near the catheter
- You are leaking urine
- You notice more blood in your urine
- Your catheter seems blocked and is not draining urine
- You notice grit or stones in your urine
- Your urine smells bad, or it is cloudy or a different color
References
Delongchamps NB. Surgical management of LUTS/BPH: new mini-invasive techniques. In: Morgia G, ed. Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia. Cambridge, MA: Elsevier Academic Press; 2018:chap 14.
Helo S, Welliver C, McVary KT. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 146.
Roehrborn CG, Strand DG. Benign prostatic hyperplasia: etiology, pathophysiology, epidemiology, and natural history. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 144.
Version Info
Last reviewed on: 4/1/2023
Reviewed by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
