T.U.R.P. FAQs 

Frequently Asked Questions page
This information is not intended to be a substitute for medical advice or treatment of prostate problems. If you suspect prostate problems, contact your health care provider.

Please see the list of common Questions and Answers regarding TURP below and click on the one(s) you want the answer to. You can also scroll down the page and browse the FAQ's. If you have a question you want on this page, please click on the envelope and describe: Click here to suggested a FAQ

1) How painful is the surgery and recovery from TURP?
2)
How long do I have to have this damn tube in me!?
3)
When and how often do I flush the catheter?
4) What about sex?
5) What are some of the other possible surgical procedures?
6) How long do I have to wait after surgery for improvements?
7) What specifically are the post-operation symptoms and problems?
8) Hey, what's the worst that could happen?!
9) What are the guidelines for the PSA prostate cancer tests?
10) How does one find a good doctor to do the TURP?
11)
What's the story on Prostate cancer?
12) What is Prostatitis, and what can I do about it?
13) Who is the author of this TURP website?
14) What the heck is the Prostate anyway?

(Links to other web site pages at bottom of this page)


FAQ Answers

1) How painful is the surgery and recovery from TURP?

The actual surgery does not have to be uncomfortable, as you should have the option to be completely unconscious if you desire. Your doctor may opt to inspect the blockage area prior to surgery for a better idea of the severity of your problem and also as an aide to how the surgery will be performed. This instrument of inspection is called a cytoscope, and should not cause you much pain, but will be quite uncomfortable during the actual examination, which thankfully, should only be a couple minutes. He/she may decide to do this after you are already unconscious for the surgery.

When you awake in the Recovery Room after the procedure, you will already have the catheter in your penis, and some pain killer medication in your blood stream via the IV.    You will probably be disorientated, but you should not be in much pain.

The initial recovery period of approx. one week will include some pain, especially if you, like me, accidentally get up while standing on your urine bag (you will only do this once - trust me)!  However, mainly it's the uncomfortableness of having the tube in your penis with the accompanying extra tube and bag, with you constantly, that is the challenge to deal with. There will be declining pain when urinating due to the urinary canal (called urethra ) distress, as well as dealing with the spastic convulsions of your bladder and prostate responding to the changes, as well as the "balloon" at the end of the catheter in your bladder.   I learned to get around my yard with the bag quite well, but I'm not recommending this to anyone.

You will be given medications for both the pain and spasms (may have to ask for spasm med if you need it), and there is more detailed information on medications in this site.
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2) How long do I have to have this damn tube in me!?

Although it may only be a few days that you have the catheter in you, it may well feel like a very long time! That is because it is unavoidably uncomfortable to have about 10 inches of tube up your penis. Your bladder does not appreciate the "balloon" that holds the catheter in either, and after it recovers from the operation may well attempt to push it out, causing you spasms. Take your spasm medication for that, but only as prescribed, or you may cause yourself other problems. I had the catheter in for 4 days, but that may have been because a weekend was involved. You may get yours out sooner, and you may well be the person taking it out. Refer to Tips page for more information on dealing with the catheter.
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3) When and how often do I flush the catheter?

You may be told that you cannot flush the catheter tubing too much, but that is not necessarily so. In fact, too much flushing can not only be unnecessary but can cause your already spastic bladder to spasm more.

You should flush if you're sure the tube in your penis is plugged, indicated by either, blood and urine coming out around the tube where it goes in your penis, or by your need to urinate yet nothing is coming out the tube (check for kinks in the tube). However, be aware that a spastic bladder can cause blood and urine to seep-out around the tube, and also prevent you from being able to relax enough to have urine flow out the tube into the bag. So make sure you are taking your medication for bladder spasms, such as B&O suppositories and you lay-down and try to relax when needing to urinate.

If you need to flush, try to get as much water up into the bladder as possible so that the maximum flushing action can occur. If necessary, use the larger center tube to inject water up into the bladder. If you try this method, make sure you clean everything before and after.
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4) What about sex?

First, when can you have it:
It's hard to find information about when you can have sex after the operation, either via the internet or in printed material.  I find this a little strange considering the location of the operation and the importance of the subject.  At any rate, as a rule-of-thumb, all other things being equal, you should be able to start safely having sex again about six to eight weeks after the operation ("sex" includes masturbation). This is based upon the TURP procedure, whereas others that are less invasive (e.g. Laser Therapy) may allow you to start sooner. In any case, you should not start if you are still urinating blood and tissue. If in doubt, call your doctor and ask.

Second, will this operation affect my sexual ability or desire:
Regardless of the procedure selected for BPH, you should not have any
physical reason to have less of a sex drive or capability of having sex, unless there was a problem with the surgery (which rarely happens).  In fact, since sexual capability is often based at least partly (some would say mostly) on your mental state, it may help you to know that you are less likely to impregnate your partner after having the treatment, due to retrograde ejaculation:

This is because the muscle valve located at the bladder that previously directed ejaculations out the penis is often destroyed in procedures like TURP, and your sperm now goes the direction of less resistance, i.e. into your bladder. The sperm is later harmlessly expelled when you urinate. This should not be considered a fool-proof method of birth control, as some sperm could, and probably does, find it's way out the more traditional path, prior to, and during ejaculation.

Whether this mentally affects your sexual performance is really a question of how you decide to think about it.   As stated above, it can be a "freeing" experience regarding the possibility of  impregnating your partner, as well as a removal of objection for having oral sex done upon you.   It can also make the sexual experience less "messy" and reduce the chances of infections for the woman due to less fluids going into her from you.  Your choice.  (Click here for a Share Page email and response on this subject)

Still concerned? Talk to your physician.
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5) What are some of the other possible surgical procedures?

As you can see below, there are many possible treatments for BPH, including Water-induced thermotherapy (WIT), Laser surgery, Sonic and radio waves, drugs, balloons and stints, etc.. You should collect information and study each method and how it applies to your situation, and then discuss the results with your doctor, before deciding on any one.

Understand that each surgeon that specializes in a procedure will attempt to convince you that their method is the best method for you to have.   Many procedures have less risks and lesser recovery periods, but then the effectiveness of the procedure to resolve your symptoms completely and long-term, may also be less. You need to weigh the risks/benefits of all the procedures against your particular situation, to come to the correct decision. See the References and Links page for more information. Best wishes.   NOTE: New procedures are constantly being created so this list is not complete by any means (i.e. I am not out there looking for them, if you discover a new one let me know)!

1) Drug Therapy: Men with moderate symptoms may have success with drugs designed to shrink the prostate by blocking production of testosterone, the hormone that stimulates prostate growth. Other drugs relieve the symptoms but do nothing about resolving the physical problem of BPH. Some men find these drugs gradually lose their effectiveness. Also they may take up to six months to take effect. However, someone only wanting relief from some moderately irritating symptoms that don't seem to be getting worse, may find drugs an effective way to accomplish this.

2) Electrovaporization: A modified version of TURP, this uses a device that produces electronic waves to vaporize the enlarged prostate.

3) Needle Ablation or TUNA: Approved by the FDA in 1996, this uses radio waves to heat and destroy the enlarged prostate through needles positioned in the prostate gland itself. Generally less effective for reducing symptoms and increasing urine flow than traditional surgical procedures (e.g. TURP).

4) Laser Therapy/PVP: A laser inserted in the urethra via a catheter heats and destroys the extra prostate tissue. There is also Photoselective Vaporization of the Prostate or PVP, that uses a laser so strong it vaporizes the tissue in a 20 to 50 minute outpatient operation.   Link to "One Man's Laser Turp Story"

5) Balloon Dilation: Using the same concept as angioplasty for the heart, a balloon is inserted in the urethra to where the restriction is and then expanded to push the prostate tissue out and widen the urinary path. Improvements may only last a few years with this technique.

6) Stents: A tiny metal coil is inserted into the restricted part of the urethra to widen it and keep it open. The body normally grows over the stent to hold it in place. Often this is used on patients with heart conditions or illnesses that preclude more risky, complicated surgery (e.g. TURP)

7) Water-induced thermotherapy (WIT): Administered through a closed-loop catheter system, through which water is heated and maintained at a constant temperature. The procedure is usually performed using only local anesthetic gel to anesthetize the penis, and is seemingly well tolerated. FDA approved. (e.g. ArgoMed)

8) TransUrethral Microwave Thermotherapy (TUMT): Uses microwave heat energy to shrink the enlarged prostate via a probe into the penis to the level of the prostate. Treatment is an outpatient procedure and takes about one hour. Patient can be sent home the same day and can resume normal activities within a day or two. This procedure does not however produce instant results; it may take up to four weeks for urinary problems to be completely resolved.

9) TransUrethral Incision of the Prostate (TUIP): Surgery via a small incision in the bladder where a few cuts are made in the sphincter muscle to release some of the tension.

10) Other Experimental Treatments: One method being tested is the use of high-frequency, high-intensity ultrasound to destroy excess prostate tissue. It is performed much the same way as the laser or microwave therapy. Find other new treatments on the References page. The Prostate Institute (whomever they are?) has a comparison table of several procedures at: Prostate Institute BPH Procedure Options
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6) How long do I have to wait after surgery for improvements?

You should notice an increase flow improvement as soon as the catheter is out. Improvements will depend on which procedure was done, the patients prostate condition at the time of surgery, current age and health, and how well the patient adheres to the recovery plan, whether other medical conditions exist (e.g. Diabetes can cause an extended period of bleeding), success of operation, etc..  Expect a lot of the symptoms that inspired you to have a treatment done in the first place, to continue for awhile.  As well as some new ones:  including occasional voiding of blood and/or tissue; bladder spasms (the bladder continuing to apply pressure even after all the urine is out); urine leakage; aches or pains when urinating, difficulty judging when you need to void; and possibly a feeling you need to have a BM every time you urinate. This surgery (i.e. TURP) is a major upset for the body and it will take some time for things to heal. The most important issue is: whether these symptoms are continuing to decrease with time.  Full recovery can take up to a year or even two in some cases.

I believe some patients also need to RETRAIN their bladder from the "bad " habits (not really "bad", it did what it needed to do) it previously followed as a result of their long term blockage due to prostate expansion.  There is a tendency for your system to continue to urinate small amounts of urine even after the operation, sort of "out of habit".   If left to itself (the bladder) to figure out the new situation, it could in some cases, take up to two years to adjust to this new experience of actually being full before sending the signal to void it's contents. This may sound a little crazy, but when I went back to work I would delay somewhat when I urinated, so that my bladder would learn that I didn't need to go as often as before the operation. It's kind of a mind game, in that you tell yourself you don't need to go right away and can hold it for awhile longer. You may actually need to forcefully tell yourself you are "not going right now"!   You of course, do not want to carry this too far, i.e. to the point you are in major discomfort or pain, or risk having a "urine accident".  Even though this may seem like it's a lot to go through, remember that you no longer have to take that daily (and probably expensive) medication, can continually increase the time between urinating, get more restful sleep, not have to always consider where the nearest bathroom is, and hopefully not have to medically deal with this part of your body again in your lifetime (See Pelvic floor muscle exercise).
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7) What specifically are the post-operation symptoms and problems?

Listed below are some of the post-op symptoms you will experience. There are probably lots of others, so send email with yours to add.

General advice on how to deal with them is listed after, and there is more information on this subject in the other questions and answers, and also in the Medications page:

 Potential Remedies and Responses
The above are all "normal" post-op symptoms, so if you want to eliminate them from your life, then you need to do something:

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8) Hey, what's the worst that could happen!?

There is also what is known as "TURP syndrome", based upon possible post-operative complications, including temporary blindness (due to irrigation fluid entering the bloodstream) which can on very rare occasion lead to seizures, coma, and even death; toxic shock (due to bacteria entering the bloodstream) and internal hemorrhage (due to blood exiting just about anywhere). It is been said to affect up to 6% of TURP patients, whereas others (mostly TURP doctors) put the percentage at much less, around 2% or less. Generally TURP syndrome, when it does occur, is temporary (usually lasting only the first 6 hours after surgery) and is treated with medication that removes excess water from the body (diuretic).

Also there is about a 0.01% probability of incontinence or impotence. There is about a one in a hundred chance that you may acquire some lasting scar tissue from the TURP that would require a minor operation to remove it.

Sometimes patients after surgery get infections, like Prostatitis (see question on this).

A small number of TURP patients require another TURP operation after about eight years.   And there maybe other problems that should be on this list that I am not aware of.
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9) What are the guidelines for the PSA prostate cancer tests?

(May 2002) This common blood-scanning test for prostate cancer which previously was performed on a yearly basis, can now safely be done less frequently for the majority who have low readings (according to a major, federal funded study on PSA testing).

About half of all men over age 50 now get a regular yearly PSA test, which scans the blood for a protein that goes up as prostate cancer develops. According to Dr. E. David Crawford of the University of Colorado, who directed the study, there is a new time-table for PSA testing:

These new guidelines are amid a much larger controversy about whether PSA screening is medically helpful and should be done at all (per Dr. Steven Woolf of Virginia Commonwealth University). Falsely positive test results can cause anxiety and lead to unnecessary biopsies. Furthermore, many men live with slow-growing prostate cancers that never cause them any problems in their life time. Finding and removing them can cause incontinence and impotence. However, new studies (Sept. 2002) show that men with prostate cancer have a 50% improvement in their survival rate if they have their prostate removed instead of doing nothing about it. There are many methods of treatment for prostate cancer and this study only focused on the prostate removal option (results for other treatments will not be available for years). This controversy underlines the importance of the patient being educated regarding the good and bad of PSA testing.

Prostate cancer is second to lung cancer as a cancer killer of men, resulting in 30,000 deaths annually.
(Daniel Q. Haney, AP Medical Editor, West Hawaii Today, May 2002)
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10) How does one find a good doctor to do the TURP?

This is a challenging task, as there is not a lot of definitive help available on individual doctor performance. To my knowledge, there are no "statistics" kept "somewhere" for the consumer/patient to look up and use as a guide. One is always better served to chose a doctor who is "board certified" in their particular specialty. This means they took a specialty-specific test and passed -- reflecting a "polished" sort of knowledge, extra initiative, and keeping on the leading edge and current with the changing environment of medicine. Kind of a feather in one's cap.

One should also get referrals from fellow patients and/or trusted and respected physicians, although this is not fool-proof, as fellow patients' reasoning is not always based on medical soundness, but on emotions. And, fellow physicians use each other for referrals, and have privileges at the same hospitals, sit on the same committees, etc., and sometimes "politics" rule the referral "game". Hospitals do have review boards that review their staff physicians, as to the quality of their care, but that is pretty much a behind closed door thing, as the hospital does not want their reputation tarnished, and if it comes to denying hospital privileges to a particular physician, it is all pretty tight-lipped, i.e. one may need to be a fly on the wall to know the real scoop!

Lastly, ask the physician how often they've done a particular procedure, do they specialize in doing this procedure, or if you can speak with some of his/her other patients who have had the same procedure done, or if he'd have it done himself, etc. Hospitals DO keep statistical records on surgeries by type/doctor/etc. and you may get to view this otherwise "inhouse" information by asking the Head of the Dept. of Surgery or the administrator of the Urology Dept. To tell the truth, the staff that works with and around the doctor really do know -- BUT, unless you have an inside track with one or more of them, they probably won't be completely honest. Although, asking if they themselves would see that doctor, or have one of their family members do so, may provide a fairly reasonably honest response.   Consider asking male friends and family who they used, as most men have to eventually deal with this prostate problem.

The National Library of Medicine maintains a consumer-friendly listing of organizations that will assist in a search for physician and facility related information at:

National Library of Medicine website

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11) What's the story on Prostate cancer?

Prostate cancer is the second leading cancer killer of men in the U.S. (lung cancer is number one). The American Cancer Society (ACS) estimates that over 189,000 new cases of prostate cancer will be discovered in the U.S. this year, and of those, 30,200 will die from the disease (that's about 16%). The death rate for prostate cancer has been dropping since the advent of early testing in the 1990's.

Prostate cancer is normally slow-growing (fast-growing versions do exist) and most men who acquire it will die WITH the cancer, rather than FROM prostate cancer. That is because since it usually grows very slow, you will probably die of old age or other causes before the prostate cancer causes you any real problems, or maybe even symptoms. However, new studies (Sept. 2002) show that men with prostate cancer have a 50% improvement in their survival rate if they have their prostate removed instead of doing nothing about it. There are many methods of treatment for prostate cancer and this study only focused on the prostate removal option (results for other treatments will not be available for years).

Today with early detection and treatment the five-year survival rate of patients is almost 100 percent if the cancer is localized (is only in the prostate gland). This would seemingly warrant men over 50 to get regular PSA prostate cancer testing -- however even this is not without its detractors (see New Guidelines for PSA Testing).

The exact cause of Prostate cancer is not currently known, however researchers have identified "risk factors" than can increase the likelihood of one getting the disease. These include: Age. After age 50 your chances of getting it increase, e.g. at age 70 you are 12 times more likely to have Prostate cancer than a 50 year old; Race. For unknown reasons, prostate cancer occurs almost 70% more in black men than in white; Nationality. Prostate cancer is most common in North America and northwestern Europe and much less common in Asia, Africa, Central and South Americas; Diet. High animal fat (meat, dairy) diets seem to increase risk, while fruits, vegetables and fiber seem to decrease risk; Family History. There seems to be a genetic factor to Prostate cancer, in that if your father or brother has the cancer, you are twice as likely to get it yourself. The risk increases with the number of relatives diagnosed with the disease.

Things you can do to help yourself: (1) You can reduce your risk by eating a diet low in fat and high in vegetables, fruits and grains. (2) Regular exercise and maintaining a healthy weight may help reduce both prostate cancer and cancer risk as a whole. (3) Antioxidant lycopene, found in tomatoes (raw, cooked or processed in sauces or ketchup), grapefruit and watermelon seems to lower prostate cancer risk by preventing damage to DNA. (4) Taking vitamin supplements may help (e.g. Vitamin E), but so far (2005) the research has brought mixed results.

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12) What is Prostatitis, and what can I do about it?

Prostatitis is not uncommon.  It's an infection of the prostate, basically.  My brother acquired it after riding his bike in one of his many triathelons.  It can be stubborn, and so a longer course of antibiotics is sometimes necessary.

There is a very good web site by the "Prostatitis Foundation", at www.prostatitis.org.  The website states that often doctors don't know the actual cause...bacterial, autoimmune, yeast infection, physical injury problem, etc., and that the causes are not completely understood and there is controversy even among the experts.
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13) Who is the author of this TURP website?

My name is John Fife and I am a 56 (2003) year old retired single man living on the Big Island of Hawaii.  I underwent a TURP many years ago and it greatly improved my life.   However, I was released from the hospital only two hours after the operation and I received little to no postop assistance.   Learning how to deal with the catheter, leakage, pain, discomfort, bleeding, sleeping, even removing the catheter, was mostly by trial and error, and with the help of a nurse friend.  I was inspired by that to try and get some patient information out there so other men did not have to go through what I did.   I am a part-time writer and also a webmaster, so it was a logical step for me to create the TURP website.   If anyone is interested in seeing a directory page of the websites I either created or support and the books I have written click here One of my other "helper" websites is free training on computer PC's: Personal Computer 101.

After the website was running I discovered that my situation was not all that uncommon.   I did not consider other countries where the patient may not even see the doctor until the day of the operation and have no access to medical support after.   During the first couple years that this website existed, most of the share email was from patients and families of third world countries.  Often the patient did not know they would have to use a catheter or how to maintain it -- some were never told they may well not be able to father children after TURP due to retrograde ejaculation!

And then there are the horror stories -- many depressed me greatly just reading them -- it was hard for me to even imagine being the one they happened to.   Many times it was due to missing or incorrect information given the patient, but also it seems there are some inept TURP doctors out there.

It has been very rewarding for me to maintain this site, as I often get compliments and thanks, and I know that it has given comfort to many
TURP patients and their family members over the years.

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14) What the heck is the Prostate anyway?

According to Webster the Prostate is:   A gland at the base of the male urethra.   There, now you know.   Its main function is to secrete and store a clear, slightly basic fluid that constitutes up to one-third of the volume of semen.  This is generally composed of simple sugars, the protein content is less than 1% and includes proteolytic enzymes, acid phosphatase, and prostate-specific antigen, zinc and citric acid.  The prostate gland surrounds the ejaculatory ducts at the base of the urethra, just below the bladder.  The urethra is the channel that carries the semen to the outside of the body through the penis.   About 10-30% of the seminal fluid is produced by the prostate gland, the rest is produced by the two seminal vesicles.   The prostate also contains some smooth muscle that helps to expel semen during ejaculation.
Diagram of Prostate area
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This information is not intended to be a substitute for medical advice or treatment of prostate problems. If you suspect prostate problems, contact your health care provider.


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