Transurethral resection of the prostate in saline (TURis) is an endoscopic surgical procedure which involves removing, through the urethra, part of the prostate gland.
It is a minimally invasive treatment for benign prostatic hyperplasia.
One advantage of this procedure over classical transurethral resection of the prostate (TURP) is reduced blood loss and consequently earlier discharge from the hospital following surgery.
Transurethral resection of the prostate is the treatment of choice for symptoms caused by benign prostatic hyperplasia.
It is recommended for patients in whom:
- Symptoms fail to improve on treatment with medication
- Urinary retention is experienced more than once
- Recurrent urinary tract infections occur
- Calculi (stones) develop in the bladder
- Urinary incontinence develops due to overfilling of the bladder
- Hematuria (blood in the urine) occurs
- Renal function deteriorates due to increased urine amounts in the bladder
Transurethral resection of the prostate is recommended for patients with a prostate volume less than 80 mL.
On admission to the hospital you will be required to stop taking any anticoagulant (blood thinning) medication and will instead receive medication by injection into the abdomen. A pre-operative assessment is then performed which will include:
- Urine tests
- Blood tests
- Chest X-ray
- Cardiac assessment
How TURis is performed
The transurethral resection of the prostate can be performed under general or epidural anesthesia.
The patient is placed in supine position with the feet supported in stirrups (as used in gynaecological examinations).
Following thorough antiseptic cleansing of the area, an endoscopic instrument is inserted through the urethra, which allows the surgeon to examine the bladder and prostate gland.
Using electricity and heat, the enlarged section of the prostate is removed and the area is cauterized to stop any bleeding.
On completion of the procedure, a catheter is put in place which allows continuous flushing out of the bladder with saline solution.
The patient remains in hospital for 3 to 4 days, and is discharged once the catheter is removed.
After the procedure
During the first days following transurethral resection of the prostate, blood may appear in the urine, which necessitates the continuation of flushing out using the catheter.
On removing the catheter, (normally 3 to 4 days after the procedure), a bladder-prostate ultrasound scan is performed, and urine volume following urination is measured.
At discharge you will be given instructions on:
- Drinking plenty of fluids (at least 2 liters per day)
- Avoiding coffee and alcoholic drinks
- Avoiding lifting heavy weights or doing strenuous exercise for one month
- Antibiotic medication you need to take
- Resuming any anticoagulant (blood-thinning medication) you may have been taking prior to the procedure
Most patients do not suffer any notable problems following the procedure.
A significant percentage of patients do, however, suffer from retrograde ejaculation or ‘dry orgasm’, where the semen is directed backwards into the bladder during ejaculation.