What is a TURP?

Transurethral resection of the prostate or TURP is the surgical removal of a part of the prostate gland and this is one of the options available for helping relieve symptoms of an enlarged prostate or other benign prostate disease.

What are Prostate gland and a Urethra?

The prostate gland is a small gland in the male reproductive system, and it helps make semen. The urethra is the tube that connects the bladder, through the prostate gland, to the Penis and it is used to pass urine as well as for releasing seminal fluid.  

Common Prostate problems

The three most commonly occurring prostate problems

1. Inflammation or prostatitis
2. Non-cancerous enlargement of the middle part of the prostate – called benign prostatic hyperplasia also abbreviated as BPH
3. Cancer of the prostate which mostly occurs at the back of the prostate, sometimes it also occurs in the area where the prostate is enlarged due to BPH.

Prostate size and blockage of the urethra

If the inner part of the prostate gland obstructs the urethra during urination, this irritates the bladder and cause urinary symptoms.

Urinary symptoms may include

• Problems with starting urination
• Reduced urine flow
• Frequent urination, particularly at night
• Urgency and possible urgency incontinence (when you lose control of your bladder)
• Passing drops of urine involuntarily after you think you’ve finished
• Blood in the urine – although this can never be assumed to be due to the prostate until other causes have been excluded.

The actual size of the prostate does not appear to determine whether there is a blockage. Some men with large prostates never develop obstruction, but some men with small prostates can have severe bladder obstruction, which causes difficulty with urinating.

Around one in three men over the age of 50 years have some urinary symptoms. In most cases, these symptoms are due to a blockage caused by an enlarged prostate; there could also be other underlying reasons for the same though.

TURP procedure

Transurethral resection of the prostate or TURP is sometimes referred to as a ‘rebore’. It involves inserting a slender instrument through the urethra to the prostate and removing prostate tissue back through the urethra. Only the middle part of the prostate is removed to remove the blockage and allow easy passage of urine. TURP is used most often for non-cancerous blockage but may also be used in some cases of prostate cancer. This is the most common form of surgery for BPH.

TURP post-operative nursing care strategies 

Following the process of TransUrethral Resection of the Prostate (TURP), you remain in the hospital for one or two days.

You will have a urinary catheter in place due to inflammation that blocks urine flow. The catheter is left in place for 24 to 48 hours until the inflammation decreases, and you are ready to urinate on your own.

You may also notice

• Blood in your urine – It is normal to see blood directly after the operation. But if the blood into your urine is thick such as ketchup, contact your physician, bleeding seems to be worsening or your urine flow is obstructed. Urine flow can be blocked by blood clots.
• Irritating sinus symptoms – Urination may be debilitating, or you may have a feeling of urgency or frequent need to urinate. Painful urination improves in six to eight months.

Your doctor is likely to recommend to you

• Drink plenty of water to flush toxins out of the bladder.
• Eat high-fiber diet to prevent constipation and straining during a bowel movement. Your physician might also suggest stool softeners to avoid strain.
• Wait before you restart taking any blood-thinning drugs till you receive clearance from your doctor.
• Avoid strenuous activity, such as heavy lifting, for four to six months or until your doctor gives a go ahead.
• Hold on for sex for four to six weeks.
• Avoid driving before your catheter is removed and till you have stopped taking prescription pain drugs.

Speak to your Physician

• Cannot heal
• Notice bright red blood or an increase in urine Infection which does not become lesser even after drinking plenty of fluids and resting for 24 hours
• Running a temperature over 100.4 degrees Fahrenheit

After the catheter is removed, things to anticipate

• Prior to going home, your catheter will be removed. Once it is removed, you may notice several new symptoms
• The requirement to pass urine is much more frequent and is lesser than every 2 hours
• A burning feeling when you pass urine
• The need to pass urine
• You can end up leaking urine and might not have the capacity to make it to the bathroom in time
• You may pass blood in your urine
• For approximately 10 – 14 days following surgery, you might have an interval of bleeding that might consist of passing bits of prostate tissue into your urine. When the heavy bleeding continues longer than 24 hours, please get in touch with the nurse expert

Complications between the TURP Operation

Like any surgical procedure, particularly those requiring anaesthesia, the operation for TURP is associated with a few issues as follows:

• Excessive bleeding
• Urinary Tract ailments / Infection
• retrograde ejaculation, in which semen flows backward into the bladder during orgasm
• Chronic sinus problems, especially incontinence
• Prostate augmentation or discoloration, with roughly 10 percent of patients needing additional surgery within 5 years
• Impotence or erectile dysfunction
• A split flow of urine brought on by urethral narrowing
• Chronic prostatitis or inflammation of prostate
• Allergic or abnormal response to anaesthesia

Below are the strategies to decrease the possibility of complications which would then require TURP post-operative nursing care.

• Staying hydrated
• Eating a healthy, balanced diet
• Avoiding sexual intercourse for between 1 and 2 months
• Avoiding heavy lifting for 1 to 2 months
• Restricting exercises which place a strain on the groin or lower abdominal region
• Preventing stimulants, such as alcohol, caffeine, and smoking
• Restrict usage of over-the-counter drugs which could bring about dehydration, like decongestants and antihistamines

Are there any exercises I should perform under my TURP post-operative care for easing recovery?

Yes, you should perform Kegel or Pelvic floor exercises

How do I locate the right muscles?

In order to help strengthen the pelvic floor muscles, it is important to make sure you are exercising the right muscles. It may take you a few tries to find your pelvic muscles, and it is ok to take your time but ensure you have found the right muscles to exercise.

There are several ways that you can find your pelvic floor muscles.

• Method 1 – Try to stop and start your urine stream while you stand in front of your urinal to urinate. Try to do these two or three times.
• Method 2 – Imagine that someone walks in to your bathroom while you are urinating, and you need to stop your urine flow. Try to stop your urine flow. The muscles you use to stop your urine flow, are your pelvic floor muscles. These are the muscles you want to strengthen.

How to perform Kegel exercise?

Now that you have located your pelvic floor muscles, you can exercise them even when you do not have to urinate (pee) by following the following simple steps:

• Tighten and hold your pelvic floor muscles for five seconds
• Relax your pelvic muscles.
• You have just done one Kegel exercise.
• You should plan to do 10 to 20 Kegel exercises three to four times each day.

Another way to tighten your pelvic floor muscles is to:

• Squeeze the muscles in anus like when holding a bowel movement.
• Relax pelvic floor muscles after each attempt.
• Repeat this exercise 10 to 20 times.

When you do Kegel exercises, remember

• Do not hold your breath.
• Do not push down. Squeeze your muscles together tightly and imagine that you are trying to lift this muscle up.
• Do not tighten the muscles in your stomach, buttocks, or thighs.
• Relax your pelvic floor muscles between each squeeze.

As that the patient recovery is ensured by our TURP post-operative nursing care which is a vital element of the curing process. Post-operative care for individuals might be required for a short term or long term.

From the warmth of your own home, a patient is much better off esp. in event of long-term nursing care. Aiding this kind of care is our care in-home services. Included in service, our group of nurses and other caregivers as needed. They would come to visit you and offer the required care.

Therefore, if you require home care for your patient, look no further and reach out to us at Care24.