Enlarged Prostate Treatment
TURP (Transurethral Resection of the Prostate)
When an enlarged prostate is large enough, obstructive enough, or symptomatic enough that lesser measures won't do, TURP remains the benchmark. It has been performed for decades, the results are well documented, and for men with significant obstruction it delivers the most substantial and reliable improvement in flow of any option. Texas Regional Urology's board-certified urologists perform TURP at Houston's leading hospital systems, with follow-up care at our offices in The Woodlands, Tomball, and Kingwood.
How TURP Works
What Is TURP?
TURP removes the portion of the prostate that is obstructing urine flow — not the entire gland. A resectoscope is passed through the urethra, and the surgeon removes the obstructing tissue from the inside using an electrical loop or laser energy, then seals the small blood vessels as the work proceeds.
There is no external incision. The channel through the prostate is widened directly, which is why the improvement in flow is typically greater and more immediate than with minimally invasive alternatives.
The removed tissue is sent to pathology. This is a meaningful secondary benefit: TURP occasionally reveals prostate cancer that was not suspected beforehand.
TURP is sometimes called the gold standard for BPH surgery, and that reputation is earned on outcomes. The trade-off is that it requires anesthesia, a catheter, and a real recovery period, and it carries a high rate of retrograde ejaculation.
There is no external incision. The channel through the prostate is widened directly, which is why the improvement in flow is typically greater and more immediate than with minimally invasive alternatives.
The removed tissue is sent to pathology. This is a meaningful secondary benefit: TURP occasionally reveals prostate cancer that was not suspected beforehand.
TURP is sometimes called the gold standard for BPH surgery, and that reputation is earned on outcomes. The trade-off is that it requires anesthesia, a catheter, and a real recovery period, and it carries a high rate of retrograde ejaculation.
Why It's Still the Benchmark
Benefits of TURP
The Most Substantial Flow Improvement
TURP typically produces greater improvement in urinary flow and symptom scores than any minimally invasive alternative.
Durable Results
The great majority of men treated with TURP never require another BPH procedure.
Effective for Large Prostates
Where minimally invasive options have size or anatomy limits, TURP handles larger glands and complex anatomy.
Immediate Relief of Obstruction
Because the obstructing tissue is physically removed, relief does not depend on waiting for the body to reabsorb anything.
Tissue Sent for Pathology
The resected tissue is examined, occasionally identifying unsuspected prostate cancer.
Who Qualifies
Am I A Candidate?
TURP is generally recommended for men with moderate to severe symptoms who have not responded adequately to medication, and for men with complications of obstruction — urinary retention, recurrent infections, bladder stones, blood in the urine from the prostate, or kidney impairment from back pressure. It is also appropriate for men who want the most definitive result available.
You need to be healthy enough for anesthesia, and your urologist will review your heart and lung health, your medications, and particularly any blood thinners. Men whose primary concern is preserving ejaculation should discuss UroLift or Rezum first, since retrograde ejaculation after TURP is common rather than rare. Men with very large prostates may be better served by a different surgical approach, which your urologist will discuss.
You need to be healthy enough for anesthesia, and your urologist will review your heart and lung health, your medications, and particularly any blood thinners. Men whose primary concern is preserving ejaculation should discuss UroLift or Rezum first, since retrograde ejaculation after TURP is common rather than rare. Men with very large prostates may be better served by a different surgical approach, which your urologist will discuss.
Recovery Time
What to Expect
Before Surgery
You'll have a pre-operative evaluation including labs, a urine culture, and a medication review. Blood thinners typically need to be stopped in advance, and you'll receive fasting instructions.
The Day of Surgery
TURP is performed under general or spinal anesthesia and typically takes about an hour, depending on prostate size. A catheter is placed at the end of the procedure, often with continuous irrigation to keep the bladder clear of blood.
In the Hospital
Most men stay one night. The irrigation is discontinued once the urine clears, and the catheter usually comes out before discharge or shortly after.
The First Two Weeks
Expect burning, urgency, frequency, and intermittent blood in the urine. Some men experience temporary leakage. Drink plenty of fluids, avoid straining, and avoid heavy lifting and strenuous activity.
Weeks Three Through Six
Symptoms settle progressively. Most men return to desk work within two weeks and to full activity, including exercise and sexual activity, around four to six weeks — your surgeon will give you specific clearance.
Longer Term
Flow improvement is usually apparent immediately and continues to refine as irritative symptoms resolve over the first couple of months.
Risks & Side Effects
Side Effects
Retrograde Ejaculation
This is the most common lasting effect and it occurs in the majority of men. Semen travels backward into the bladder rather than out, producing a dry orgasm. Sensation is preserved, but fertility is affected — discuss this before surgery if you may want children.
Bleeding
Blood in the urine is expected for days to weeks and occasionally intermittently for longer. Significant bleeding requiring transfusion is uncommon.
Temporary Urinary Symptoms
Burning, urgency, frequency, and sometimes leakage are common early and resolve for most men.
Erectile Dysfunction
New erectile dysfunction after TURP is uncommon but possible, and men should understand the risk before proceeding.
Urethral Stricture and Bladder Neck Contracture
Scarring can narrow the channel later, occasionally requiring an additional procedure.
Other Risks
Infection, urinary retention after catheter removal, and the risks associated with anesthesia. Your surgeon will review all of these in detail.
Answers to your TURP Questions
Frequently Asked Questions
No — only the obstructing inner tissue.
TURP removes the portion pressing on the urethra while the outer prostate remains. That distinguishes it entirely from prostatectomy for cancer.
Most men experience retrograde ejaculation.
Semen travels into the bladder instead of out, producing a dry orgasm with sensation preserved. If ejaculation matters to you, discuss UroLift or Rezum before choosing TURP.
Usually one to three days.
The catheter stays until the urine runs clear, often coming out before you leave the hospital. Some men go home with it briefly.
Rarely — results are durable.
The great majority of men never need a second BPH procedure after TURP. Retreatment rates are lower than for minimally invasive options.
More effective, but more recovery and side effects.
TURP produces the greatest flow improvement and the most durable result, but requires anesthesia and commonly causes retrograde ejaculation. The minimally invasive options trade some effectiveness for an easier recovery and better preservation of ejaculation.
Usually around four to six weeks.
Your surgeon will clear you once healing is adequate, typically at the four-to-six-week mark. Expect retrograde ejaculation when you resume.
Medication not doing enough?
Schedule a Consultation
If your symptoms have progressed past what pills can manage, we'll talk honestly about whether TURP is the right step — and about the alternatives, including their trade-offs.
