Prostate Surgery (TURP) for Enlarged Prostate
A telescopic operation that removes the overgrown inner part of the prostate through the urine passage — with no cut on the body — so that urine flows freely again, night-time trips to the toilet fall and the bladder empties properly.
About 45–90 minutes
2–3 days
Spinal, lower body numbed
About 1–2 weeks
Overview
It usually starts slowly: getting up two or three times a night to pass urine, waiting at the toilet for the stream to start, a weak flow that stops and starts, and the feeling that the bladder is never quite empty. Many men accept this as part of growing older. Some only seek help when they suddenly cannot pass urine at all and need a catheter in emergency.
The prostate is a walnut-sized gland below the bladder that surrounds the urethra, the tube carrying urine out of the body. After the age of about 50, it slowly enlarges in most men. This benign prostatic hyperplasia (BPH) is not cancer, but the enlarged gland squeezes the urethra like a clamp on a hose pipe, and the bladder has to work harder to push urine past it.
TURP (transurethral resection of the prostate) removes the part of the prostate that is causing the blockage. A thin telescope called a resectoscope is passed through the urethra — there is no cut on the skin — and a fine electric loop shaves away the overgrown tissue from the inside, a little like coring an apple, while sealing bleeding vessels at the same time. The outer shell of the prostate is left in place.
Most men with BPH are first treated with tablets, and many do well on them for years. TURP is advised when symptoms stay troublesome despite medicines, or when complications such as urine retention, repeated infections, bladder stones or kidney strain develop. At SKS Hospital, TURP is performed by our urology team with anaesthesia, ICU, blood bank and 24×7 emergency support on the same campus.
Why it's done
TURP is considered when an enlarged prostate is causing symptoms or complications that medicines cannot control. Common reasons include:
- Troublesome urinary symptoms — weak stream, frequency, urgency and waking at night — despite the right medicines
- Sudden inability to pass urine (acute retention), especially if a trial without catheter has failed
- Chronic retention — a bladder that stays partly full after passing urine
- Repeated urine infections or bladder stones caused by incomplete emptying
- Recurrent bleeding in the urine from enlarged prostate veins
- Back pressure on the kidneys causing swelling or rising creatinine
Is it right for you?
Usually a good fit
- Symptoms clearly caused by BPH, confirmed by examination, ultrasound, uroflowmetry and PSA
- A small to moderately enlarged prostate, usually up to about 80 grams on ultrasound
- You would prefer a lasting solution to lifelong tablets, or tablets have caused side effects
- You are fit for spinal anaesthesia after heart, lung and sugar checks
May not be suitable
- A raised PSA or a hard prostate on examination that has not yet been checked for cancer — this is evaluated first
- A weak bladder muscle, where tests (urodynamics) show the bladder itself cannot squeeze well — removing the blockage may not help much
- A very large prostate, often above 80–100 grams, where other operations may be more suitable
- An untreated urine infection or blood thinners that cannot safely be paused, until these are managed
Types and techniques
Standard TURP
The most widely performed operation for BPH. The overgrown inner part of the prostate is removed in small pieces through the urethra, and all the tissue is sent to the laboratory for examination. It suits most men with small to moderately enlarged prostates.
Monopolar or bipolar TURP
TURP can be performed with monopolar or bipolar electric energy. Bipolar TURP uses saline solution to wash the area, which avoids a rare problem of fluid absorption (TUR syndrome) and allows slightly longer operations. Your urologist will explain which technique is planned for you.
Incision of the prostate (TUIP)
For small prostates, often under about 30 grams, one or two small cuts are made in the prostate and bladder neck through the telescope instead of removing tissue. It takes less time and is less likely to affect ejaculation, but may need repeating more often.
Very large prostates
When the prostate is very large, removing it through the urethra can take too long to be safe. An operation to remove the inner prostate through the abdomen (simple prostatectomy), done by keyhole or open surgery, may be discussed instead.
Preparing for the procedure
- Ultrasound of the kidneys, bladder and prostate with prostate size and urine left after voiding, uroflowmetry to measure the stream, a PSA blood test and urine culture
- Blood tests for blood count, kidney function, sugar and clotting, along with an ECG, chest X-ray and an anaesthesia check-up — and a heart check if you have heart disease
- Aspirin, clopidogrel, warfarin or newer blood thinners may need pausing — only on the advice of your urologist and the doctor who prescribed them
- Any urine infection is treated with antibiotics first; if you already have a catheter, it is changed and the urine tested before surgery
- Do not eat for about 6 hours before the operation; keep your blood sugar and blood pressure well controlled in the days before
- Bring your reports, list of medicines and one family member who can stay with you for the first night
The procedure, step by step
Spinal anaesthesia
An injection in the lower back numbs you from the waist down, so you feel no pain but remain awake; a mild sedative can help you relax or sleep. A dose of antibiotic is given through the drip, and you lie on your back with your legs supported.
Looking inside
The urologist passes the resectoscope through the urethra and examines the urethra, the prostate and the inside of the bladder on a screen, checking for stones, narrowing or anything unusual.
Removing the blockage
A fine wire loop carrying electric current shaves away the overgrown prostate tissue in small strips, creating a wide channel for urine. The same current seals bleeding vessels. The tissue pieces are washed out and sent for examination. The operation usually takes 45–90 minutes, depending on the size of the prostate.
Catheter and bladder wash
A soft catheter is placed through the urethra into the bladder. For the first day or so, sterile fluid is run gently through it to wash out blood and prevent clots, so the urine in the bag looks pink or red at first and gradually clears.
Benefits and risks
Benefits
- A stronger urine stream, less straining and fewer night-time trips to the toilet for most men
- Freedom from the catheter for most men who had urine retention
- A long-lasting result — only a small proportion of men need further prostate treatment over many years
- No cut on the skin, and all removed tissue is checked in the laboratory
Possible risks
- Retrograde ejaculation — semen flows back into the bladder instead of out, so there is little or no fluid at climax. This happens in most men after TURP, is harmless to health, but reduces fertility
- Burning, frequency and urgency for a few weeks, and blood in the urine that can recur around 10–14 days after surgery
- Bleeding needing a blood transfusion, or a urine infection, in a small number of men
- Narrowing of the urethra or bladder neck later on in a few men in 100, which may need a further minor procedure
- Rarely, long-term urine leakage or new erection problems; TUR syndrome from fluid absorption is rare
Recovery timeline
Days 1 to 3 in hospital
The bladder wash is stopped once the urine clears, usually within a day. The catheter is typically removed after 1–3 days, and you go home once you can pass urine comfortably. Walk around the ward and drink plenty of fluids.
The first two weeks
Burning, urgency and some leaking are common while the area heals. Drink around 2–3 litres of fluid a day unless advised otherwise, avoid constipation and straining, and avoid lifting heavy weights. Most men can return to light work in 1–2 weeks.
Around 10 to 14 days
When the healing scab inside comes away, the urine may turn pink again for a day or two. This is common — drink more water and rest. Come back at once if the bleeding is heavy, has clots, or you cannot pass urine.
Weeks 4 to 12
Sexual activity can usually resume after about 4 weeks, and heavy lifting, cycling and strenuous exercise after 4–6 weeks. Urinary symptoms keep improving over about 3 months. We review the laboratory report of the removed tissue with you at the follow-up visit.
When to call your doctor
- Being unable to pass urine, or a catheter that stops draining — call +91 86799 11029 or come to emergency
- Heavy bleeding in the urine, passing clots, or urine that stays dark red despite drinking more water
- Fever above 100.4°F (38°C), shivering or chills
- Severe pain or swelling in the lower abdomen
- Confusion, drowsiness or breathlessness
Call us on +91 86799 11029 or come straight to our 24×7 emergency department.
Alternatives
Watchful waiting and lifestyle changes
For mild symptoms, reducing tea, coffee and fluids in the evening, avoiding alcohol, treating constipation and double voiding (passing urine again after a minute) may be enough, with regular review of symptoms and kidney function.
Medicines
Alpha-blockers such as tamsulosin relax the prostate and improve flow within days. 5-alpha-reductase inhibitors such as finasteride slowly shrink a larger prostate over 6–12 months. Many men combine both. Side effects can include dizziness and changes in ejaculation.
Catheter for men unfit for surgery
For men who are too unwell for an operation, a long-term catheter or self-catheterisation a few times a day can relieve retention safely. Our team teaches the patient and family how to care for it.
This page explains Prostate Surgery (TURP) for Enlarged Prostate in general terms. Your doctor will advise what is right for you after examining you and reviewing your reports. Please read our medical disclaimer.
Ask about your options, the cost and your insurance before you decide. We are empanelled with major insurers and TPAs.
Your care team
Urology Department
Prostate surgery at SKS Hospital is carried out by our urology team with trained theatre nurses and anaesthetists, supported by the laboratory, ICU, blood bank and 24×7 emergency department on the same campus on NH-19 (old NH-2), Mathura.
From the first OPD visit and tests to surgery, catheter removal and follow-up, the same team stays with you — and explains each step to you and your family in simple language, including what to expect for urination and sexual health afterwards.
Other departments involved
Related procedures
Kidney Stone Treatment (URS / PCNL)
Removal of kidney and ureteric stones with URS, RIRS laser, PCNL or ESWL, without a large surgical cut.
Hernia Repair
Open or keyhole repair of groin hernias, which can develop or worsen with years of straining to pass urine.
Dialysis
Blood purification for kidney failure, supervised by our nephrologists, with scheduled sessions and emergency dialysis on the same campus.
Cystoscopy
A thin telescope passed into the bladder to find the cause of blood in urine, infections or blockage, and treat some problems.
PSA Blood Test
A simple blood test that helps assess prostate enlargement and the need for further checks for prostate cancer in men over 50.
Uroflowmetry
A test in which you pass urine into a special machine that measures the strength and pattern of your stream.
Frequently Asked Questions
Common questions patients and families ask us about prostate surgery (TURP).
Is TURP a major operation?
TURP is done entirely through the urethra, so there is no cut on the skin. It still needs spinal anaesthesia and a hospital stay of 2–3 days, and the inside of the prostate takes a few weeks to heal, so it is treated as a significant operation with careful preparation.
Is enlarged prostate the same as prostate cancer?
No. BPH is a non-cancerous enlargement that is very common with age. Prostate cancer is a separate condition, although both can occur together. This is why we check PSA before surgery, and why all tissue removed during TURP is examined in the laboratory.
Will TURP affect my sex life?
Most men who have normal erections before surgery keep them afterwards. However, most men have retrograde ejaculation, where little or no semen comes out at climax. The sensation of orgasm is usually unchanged. If you still wish to father children, discuss this with your urologist before surgery.
How long will I have a catheter?
Usually 1–3 days after surgery. If you had long-standing retention with a stretched bladder, the catheter may be kept longer while the bladder recovers. Your team will teach you how to care for it if you go home with one.
Will I leak urine after surgery?
Some urgency or leaking in the first few weeks is common while the area heals and usually improves steadily. Pelvic floor exercises help. Long-term leakage is rare.
Can the prostate grow back after TURP?
The outer part of the prostate remains and can slowly enlarge again over many years. Only a small proportion of men need further treatment. A yearly check-up with your urologist is advised.
Am I too old for TURP?
Age alone is not a barrier. Many men in their 70s and 80s have TURP safely under spinal anaesthesia. What matters more is your heart, lung and kidney health, which we check carefully beforehand with the physician and anaesthetist.
What should I do if I suddenly cannot pass urine?
Sudden inability to pass urine with a painful, full bladder is an emergency. Call +91 86799 11029 or come to our emergency department straight away, where a catheter can be placed to relieve the blockage before further treatment is planned.
How much does prostate surgery cost, and is it covered by insurance?
The cost depends on the prostate size, the technique and the length of stay. Our team gives a written estimate before a planned operation. SKS Hospital is empanelled with major insurers and TPAs, and TURP is usually covered — our insurance desk helps with pre-authorisation.
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