What is TURP?
Transurethral resection of the prostate (TURP) is an endoscopic surgical procedure used to treat benign prostatic hyperplasia (BPH) — non-cancerous enlargement of the prostate that restricts urine flow. A thin instrument called a resectoscope is passed through the urethra (no abdominal incisions are needed) and an electrically heated wire loop systematically removes the obstructing inner prostate tissue, chip by chip.
The removed chips are washed out with irrigation fluid. The result is a widened channel through the prostate — immediately improving urinary flow. TURP has been performed for over 60 years and remains the most widely performed surgical treatment for BPH worldwide.
Who is a candidate for TURP?
- Men with moderate to severe BPH symptoms (IPSS ≥ 8) not controlled by medication
- Men in urinary retention due to BPH
- Men with complications of BPH: bladder stones, recurrent UTIs, kidney damage from obstructed urine flow, or recurrent haematuria
- Men with prostate volumes under approximately 80 ml (larger glands may be better suited to Aquablation or laser enucleation)
- Men who prefer the most established and evidence-based surgical option
- Men for whom preserving ejaculatory function is not the primary concern
How TURP is performed
Recovery after TURP
| Timeframe | What to expect |
|---|---|
| Day 0–1 | Overnight stay. Continuous bladder irrigation via catheter. Blood-stained urine is expected and normal. Oral fluids and diet resume the same evening. |
| Day 1–3 | Catheter removed once urine runs clear. Discharge home. Frequency, urgency and burning on urination are normal initially. |
| Week 1–3 | Rest at home. Avoid strenuous activity, driving and sexual intercourse for 2–3 weeks. Drink 2 litres of fluid daily to flush the bladder. Some blood in urine can recur around day 10–14 as the scab inside the prostate heals — this is normal. |
| Week 3–6 | Most men return to desk work and light exercise. Urine flow noticeably improved. Urgency and frequency usually settling. |
| Month 2–3 | Full functional recovery. Six-week outpatient review with urine flow assessment. Symptom scores assessed. |
| Long term | TURP provides durable relief in most men. Retreatment is needed in approximately 10–15% of men within 8–10 years. Annual review recommended. |
Risks and side effects
Very common (~65–70%)
Retrograde ejaculation
Semen travels backwards into the bladder at orgasm. Permanent and expected — orgasmic sensation is preserved. The most common significant side effect of TURP. If this is a priority concern, discuss Aquablation or Rezum.
Common (temporary)
Urgency and frequency
Irritative urinary symptoms are common for 4–8 weeks after TURP as the urethra heals. Usually resolves fully. Anticholinergic medication can help during this period.
Uncommon (~1–3%)
Urinary incontinence
Stress or urge incontinence. Usually temporary. Long-term incontinence affects fewer than 1–3% of men. Pelvic floor exercises are recommended during recovery.
Uncommon (~10%)
Erectile dysfunction
Risk exists but is lower than often assumed. Most studies report rates of 5–10%. Nerve-sparing is less controlled than with robotic prostatectomy. Penile rehabilitation can be started if needed.
Uncommon (1–7%)
Urethral stricture
Scarring of the urethra can develop weeks to months after surgery, causing a progressive reduction in urine flow. Treated endoscopically (urethrotomy). More common than with Aquablation or Rezum.
Rare (<1% with bipolar)
TURP syndrome
Absorption of irrigation fluid causing low sodium levels. Very rare with modern bipolar TURP using saline irrigation. Managed in hospital with monitoring and fluid restriction.
Frequently asked questions
TURP remains the most established and evidence-backed surgical treatment for BPH — the benchmark against which newer procedures are tested. For men who want the most reliable immediate symptom improvement and are not concerned about retrograde ejaculation, TURP is an excellent choice. Aquablation and Rezum have advantages for men who prioritise sexual function preservation, and Aquablation is superior for larger prostates. The right choice depends on your individual anatomy, priorities and health — which is why a specialist consultation is essential.
TURP provides durable relief in most men. Because only the inner prostate tissue is removed, the remaining prostate can continue to grow over years. Retreatment is required in approximately 10–15% of men within 8–10 years. Results are generally more durable for TURP than for Rezum or Urolift, but similar to Aquablation.
Anticoagulants such as warfarin, apixaban, or rivaroxaban need to be paused before TURP due to bleeding risk. The interruption period depends on the specific drug and your underlying condition. For men at high thrombotic risk (recent blood clot or heart valve replacement), bridging anticoagulation may be needed. This is assessed carefully at your pre-operative appointment.
TURP causes retrograde ejaculation in approximately 65–70% of men, which makes natural conception very difficult or impossible. If you wish to have children in the future, this is a critical discussion to have before proceeding with TURP. Rezum, Aquablation, and Urolift have significantly lower rates of retrograde ejaculation and should be strongly considered if fertility is a priority.