Transurethral Resection of the Prostate (TURP) is a common surgical procedure used to treat urinary symptoms caused by Benign Prostatic Hyperplasia (BPH), or an enlarged prostate. As the prostate gland grows, it can squeeze the urethra, making urination difficult, frequently urgent, or incomplete. TURP involves removing excess prostate tissue through the urethra, effectively clearing the obstruction to improve urine flow. This procedure has been considered the standard surgical option for decades and remains widely utilized for men whose symptoms have not responded to medication.
Defining Successful Outcomes
Medical professionals define the success of a Transurethral Resection of the Prostate (TURP) using a combination of objective and subjective measurements. The primary subjective metric is the International Prostate Symptom Score (IPSS), a questionnaire that quantifies the severity of a patient’s urinary symptoms and their impact on daily life. A significant reduction in the IPSS score, typically a decrease of over 50%, is a key indicator of a successful outcome. The procedure’s success is also measured by an improvement in the patient’s Quality of Life (QoL) score, which assesses how bothersome the urinary symptoms are.
Objectively, success is confirmed by measuring the maximum urinary flow rate (Qmax) using a test called uroflowmetry. A successful TURP should result in a substantial increase in Qmax, often by more than 100%. Furthermore, the procedure aims to reduce the volume of urine remaining in the bladder after voiding, known as Post-Void Residual (PVR) volume. These measurable improvements in flow and symptom relief determine whether the surgery has effectively resolved the BPH-related blockage.
Statistical Success and Symptom Relief
The statistical success rate of TURP in relieving lower urinary tract symptoms is high, with an estimated 80% to 90% of patients reporting significant and lasting improvement. This makes TURP one of the most reliable surgical treatments for BPH, especially for those with moderate to severe symptoms that have failed to respond to drug therapy. Patients can expect the most dramatic improvements in obstructive symptoms like weak stream, straining to urinate, and the sensation of incomplete emptying.
Across studies, patients experience an average reduction in their IPSS score of approximately 70% following the procedure, often shifting patients from the severe symptom category to the mild category. The average increase in maximum urinary flow rate (Qmax) is substantial, typically increasing by an additional 10 to 12.6 milliliters per second. This profound improvement in flow is a direct result of the surgical removal of the obstructing prostate tissue.
The relief also extends to storage symptoms, including reduced urinary frequency, urgency, and the need to wake up at night to urinate. While these symptoms can be more complex, their severity is often reduced by roughly half within six months of the procedure. Patients whose primary issue was physical blockage typically see the fastest results, often noticing an improved urinary stream within days of catheter removal. Patients who were the most bothered by their symptoms before surgery tend to report the greatest satisfaction with the outcome.
Understanding Potential Post-Surgical Issues
While the primary goal of relieving urinary obstruction is largely successful, patients must understand the common post-operative realities. The most frequent side effect is retrograde ejaculation, where semen travels backward into the bladder during orgasm instead of exiting through the penis. This occurs because the internal sphincter at the bladder neck is opened or damaged during the procedure, affecting 65% to over 80% of men who undergo TURP. Retrograde ejaculation does not typically affect the sensation of orgasm or the ability to achieve an erection, but it causes a “dry” orgasm and can impact fertility.
Other potential issues, though less common, include urinary incontinence and erectile dysfunction. Long-term, severe urinary incontinence is rare, though temporary leakage can occur immediately following catheter removal. Permanent loss of bladder control is seen in a very small percentage of cases. Similarly, the risk of new-onset, persistent erectile dysfunction is low, typically affecting fewer than 10% of patients who had normal function before the operation.
Recovery Timeline and Long-Term Durability
The immediate recovery from a TURP procedure begins with a hospital stay, typically lasting one to two days. A urinary catheter is kept in place to drain the bladder and flush out any blood clots, and it is usually removed within 24 to 72 hours. Patients can generally return to light activities within two to four weeks, but full internal healing can take up to six weeks. During this period, it is common to experience mild burning during urination, frequent urination, and occasional blood in the urine, especially around 10 to 14 days post-surgery.
The long-term durability of TURP results is a major reason for its established reputation, with symptomatic relief often lasting 15 years or longer. However, the prostate gland naturally continues to grow, and a small percentage of men may experience the return of obstructing symptoms years later. The rate of needing a re-treatment procedure after 10 years is relatively low, typically falling in the range of 5% to 10%. This need for follow-up intervention may also be due to the development of scar tissue that narrows the urethra or bladder neck, known as a stricture.