Neha Vapiwala, MD
Last Modified: February 25, 2007
Dear OncoLink "Ask the Experts,"
Please direct me to information on the procedure called T.U.R.P. As I understand it, this procedure removes part of the prostate. I would like to know more about it? How is the procedure done? Is it possible to have it done by laser? What can the patient expect? Is it dangerous? Does it increase the likelihood of cancer?
Thank you very much for your immediate attention and assistance.
Neha Vapiwala, MD Senior Editor of OncoLink and Assistant Professor in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania responds:
The term TURP stands for transurethral resection of prostate. It is a therapeutic procedure typically utilized for a non-cancerous condition known as benign prostatic hypertrophy, or BPH. This condition is a benign swelling of the prostate tissue that often leads to urinary symptoms, such as frequency of urination both during the day and at night, urinary hesitation, decreased force of stream, etc. A TURP removes large portions of the central zone of the prostate, which is the zone that enlarges when a patient has BPH. This enlargement causes compression of the urethra (tube that urine passes through), which is what leads to the urinary symptoms.
A TURP procedure usually requires hospitalization and is done using a general or spinal anesthetic drug. First, the urologist uses a tube-like instrument called a cystoscope to enter the urethra through the penis and into the prostate (prostatic portion of the urethra). The area is then basically carved away with electrocautery ( application of a needle heated by an electric current to destroy tissue) in order to increase the diameter of the lumen and thus allow improvement of urine flow through that region. It can also be performed using a laser, and this can often be done o n an outpatient basis without requiring a hospital stay. Overall, it t is a relatively safe and minimally invasive procedure with very good success rates. O n average, patients who undergo TURP experience an 85% improvement in their urinary symptoms.
Please discuss your case with your urologist to go over the indications, expected outcomes, and possible complications. TURP has not been correlated with an increased risk of prostate cancer. The one way this procedure can affect prostate cancer treatment is that it may compromise the patient's eligibility for radiation seed implantation (brachytherapy) as a future treatment option, should he ever develop prostate cancer. This must be discussed with your radiation oncologist and urologist should prostate cancer ever become an issue in the future.