What is BPH?

If you’re among the millions of men who live with benign prostatic hyperplasia (BPH), you’re probably looking for solutions to manage your uncomfortable symptoms.

BPH is a condition affecting the prostate gland. The prostate is part of the male reproductive system and sits underneath the bladder surrounding the urethra, which is the urine outflow tube. The gland grows or enlarges with age. As it expands, the prostate presses on the urethra and slows the flow of urine from the bladder out of the body.

As the gland enlarges, the bladder has to squeeze harder and harder to push urine out. Over time, its muscular walls thicken and weaken. Eventually, the bladder can’t empty completely, which leads to symptoms such as a weak urinary stream and a frequent need to urinate.

While lifestyle changes along with certain medications may help, your doctor might eventually recommend surgery to remove excess prostate tissue. Here’s what you can expect if you have transurethral resection of the prostate (TURP), which is the most common surgery to treat BPH.

TURP can be done while you’re under general anesthesia, which means you’re asleep. It can also be done under spinal anesthesia, which means you’re awake but won’t feel any surgical pain.

During TURP, the surgeon inserts an instrument called a resectoscope through the penis and into the urethra. This instrument contains a light and camera to help the doctor see, and an electrical loop to perform the surgery. The surgeon uses the loop to cut away the extra prostate tissue and widen the urethra.

Fluid is sent through the resectoscope to move the cut pieces of prostate tissue into the bladder. At the end of the procedure, the surgeon inserts a tube called a catheter into the bladder to remove urine and prostate tissue. Blood vessels around the prostate are sealed to prevent bleeding. The entire TURP procedure takes about 60 to 90 minutes if there are no complications.

You’ll go to a recovery room immediately after surgery. There, hospital staff will monitor your heart rate, breathing, oxygen level, and other vital signs. Once you’ve recovered enough, you’ll be taken to your hospital room.

You’ll stay in the hospital for a day or two after your surgery. If you had laser surgery, you might be able to go home the same day. You’ll get medication to manage your pain.

During this immediate post-operative period your doctors will monitor closely for post-TURP syndrome, a rare but serious condition that occurs when too much fluid is absorbed during the TURP procedure. The initial symptoms include dizziness, headache, and a slow heartbeat, and it can progress to shortness of breath, seizures, and even coma.

A catheter placed through your penis into your bladder will remove urine until your prostate heals. The catheter will stay in place for a few days after surgery. If you go home with your catheter, the nurse will show you how to clean around it with soap and water. Cleaning your catheter twice a day will prevent infection.

Your doctor will give you instructions on how to care for yourself once you get home.

Removing extra prostate tissue should help you urinate more easily and less frequently. Still, it may take a few weeks for you to recover fully. Most men who have this surgery are back to their regular activities in six to eight weeks.

While you recover, you may have:

  • an urgent need to urinate
  • trouble controlling urination
  • pain during urination
  • problems getting and keeping an erection
  • small amounts of blood in your urine

These surgery side effects should subside in time. Tell your doctor if you’re still having problems several weeks after surgery.

Your doctor will probably recommend that you rest as much as possible for a few weeks after your surgery. Take your time getting back to your routine and keep these tips in mind:

  • Don’t exercise strenuously or lift anything heavy until you get your doctor’s permission. You can do gentle or low-impact exercises once you feel up to it.
  • Drink at least 8 cups of water per day to flush out your bladder.
  • Eat foods that are high in fiber to prevent constipation.
  • Wait four to six weeks to start having sex.
  • Ask your doctor when it’s safe for you to drive.

Some side effects, like pain and blood during urination, are normal. You should see your doctor if you notice any of the following:

  • signs of infection, including fever or chills
  • pain or burning during urination that lasts for more than a few days
  • blood clots in your urine
  • very red blood in your urine
  • trouble urinating
  • redness, swelling, bleeding, or fluid draining from the surgery site
  • nausea or vomiting

Your doctor will tell you when to come in for follow-up visits. Follow your appointment schedule to make sure you’re healing well.