What Is TURP?

Transurethral resection of the prostate (TURP) is a surgical procedure for benign prostatic hyperplasia (BPH) — a non-cancerous enlargement of the prostate that can block the flow of urine. During TURP, your surgeon passes a thin instrument called a resectoscope through the urethra (the tube that carries urine out of the bladder) — there is no cut or incision on the skin. Using a wire loop, the surgeon trims away the inner prostate tissue that is narrowing the channel, widening the passage so urine can flow normally again.

TURP has been used for decades and remains one of the most effective, durable treatments for moderate-to-large prostates causing bothersome symptoms — weak stream, frequent urination, getting up at night, straining to start, or a feeling of incomplete emptying.

TURP treats BPH, not prostate cancer

TURP removes the tissue blocking urine flow. It is not a treatment for prostate cancer, and it does not remove the outer capsule of the prostate gland.

Bipolar TURP: Our Technique

We perform Bipolar TURP in our Surgery Center and Hospitals. Bipolar technology uses saline (salt water) instead of the older water-based irrigation fluid used in traditional monopolar TURP. This has real, practical benefits:

Why Bipolar

  • Saline irrigation is much safer to absorb than older fluids
  • Very low risk of TUR syndrome (a rare fluid/electrolyte complication seen with older monopolar TURP)
  • Allows for longer, more thorough resections when the prostate is larger
  • Comparable bleeding control to monopolar technique

At-a-Glance

  • Setting: Surgery Center or Hospital
  • Anesthesia: Spinal or general
  • Irrigation: Saline (bipolar)
  • Typical duration: 45–90 minutes

Median Lobe TURP

The prostate normally has two side (lateral) lobes. In some men, a third lobe — the median lobe — grows on the inside of the gland, closest to the bladder. As it enlarges, the median lobe can act like a ball valve, sitting right at the bladder neck and blocking urine even more than the side lobes alone. Men with a significant median lobe often have more severe symptoms — a sudden urge to go, a stream that starts and stops, or a higher risk of not being able to urinate at all (urinary retention).

Median lobe TURP is not a separate operation — it is a focused part of the same procedure where extra attention and tissue removal is directed at this middle lobe specifically. Because the median lobe projects into the bladder, resecting it well is important for a good outcome, and your surgeon will address it directly during your TURP if imaging or cystoscopy shows one is present.

Why this matters to you

If you've been told you have a median lobe, it's a normal — and treatable — variation of BPH. It doesn't change the type of procedure, but it does mean your surgeon plans the resection to fully open the bladder neck, not just the side channels.

Who Is a Candidate?

Ideal Candidates

  • Moderate-to-severe BPH symptoms not controlled by medication
  • Prostates too large for smaller in-office procedures
  • A median lobe contributing to blockage or retention
  • Recurrent urinary retention or catheter dependence from BPH
  • Recurrent urinary tract infections or bleeding from an enlarged prostate

May Not Be Ideal For

  • Very large prostates better suited to laser enucleation or simple prostatectomy
  • Men who want to preserve ejaculatory function above all else (see Risks)
  • Active untreated urinary tract infection
  • Certain bleeding disorders or blood thinners that can't be safely paused

How It Works

TURP is performed with a resectoscope passed through the urethra — no incision is needed anywhere on the body.

The Steps

  • Anesthesia: spinal or general anesthesia is given so you feel nothing
  • Access: the resectoscope is passed through the urethra to the prostate — no cutting of the skin
  • Resection: a bipolar wire loop trims away the obstructing tissue, including the median lobe if present, widening the channel
  • Catheter placement: a Foley catheter is placed at the end of the procedure to drain the bladder and control bleeding while the area heals

At-a-Glance

  • Duration: 45–90 minutes, depending on prostate size
  • Anesthesia: Spinal or general
  • Hospital stay: Same day or one night, depending on your case
  • Catheter: Foley catheter, typically removed in-office 3–5 days later

Recovery

Right After Surgery

  • You go home with a Foley catheter in place — this is expected and normal
  • Blood-tinged or pink urine and some bladder spasms are common in the first few days
  • Drink plenty of water to help flush the bladder
  • Avoid straining, heavy lifting, and constipation while the catheter is in

Catheter Removal — Day 3–5

  • Most patients have the Foley catheter removed in our office 3–5 days after surgery
  • Some burning, urgency, or leakage for a few days after removal is normal as your bladder relearns to empty on its own
  • Blood in the urine can come and go for 2–4 weeks — this is expected, especially with increased activity

Weeks 2–6

  • Most men see steady improvement in stream and urgency over 2–6 weeks as swelling resolves
  • Avoid heavy lifting, straining, and strenuous exercise until your surgeon clears you
  • Avoid long car/plane travel and blood thinners as directed by your surgeon
  • Full benefit is often felt by 4–6 weeks, once healing is complete

Risks & Side Effects

  • Retrograde ejaculation — semen goes into the bladder instead of out during ejaculation; this is the most common lasting side effect of TURP and does not affect the ability to have an orgasm
  • Bleeding — some bleeding in the urine is expected for days to weeks; significant bleeding requiring treatment is uncommon
  • Infection — urinary tract infection risk, reduced with antibiotics around the time of surgery
  • Temporary urgency, frequency, or leakage — usually improves over several weeks as the bladder and prostate area heal
  • Urethral or bladder neck stricture — scar tissue narrowing that can develop later and, if it happens, is treatable
  • Erectile dysfunction — uncommon, but a small risk exists with any prostate surgery
  • Need for repeat treatment — prostate tissue can regrow over many years, occasionally requiring a repeat procedure
  • TUR syndrome — a rare fluid-absorption complication historically seen with older monopolar TURP; very low risk with our bipolar/saline technique

Frequently Asked Questions

Will I have a catheter after surgery?

Yes. A Foley catheter is placed at the end of the procedure and stays in place while the prostate heals. We typically remove it in the office 3–5 days after surgery.

What's different about Bipolar TURP?

Bipolar TURP uses saline irrigation instead of older non-conductive fluids. It carries a much lower risk of TUR syndrome and is the technique we use in our Surgery Center and Hospitals.

What is a median lobe, and does it change my surgery?

The median lobe is a third lobe of prostate tissue that grows toward the bladder neck and can worsen blockage. It doesn't change the type of procedure — it's addressed as part of the same TURP — but your surgeon will direct extra attention there if one is present.

Will TURP affect my ability to have sex?

Erections are usually not affected. The most common lasting change is retrograde ejaculation (semen goes into the bladder instead of out), which does not affect orgasm but can affect fertility.

How long until I feel back to normal?

Most men notice steady improvement over 2–6 weeks. Some blood in the urine and mild urgency can continue for a few weeks — this is expected and improves with time.

Is TURP a cure for BPH?

TURP provides excellent, long-lasting symptom relief for most men. Because the prostate can continue to grow with age, a small number of men eventually need a repeat treatment years later.

Ready to Talk About TURP?

If medication hasn't controlled your BPH symptoms, our surgeons can help you decide whether Bipolar TURP — including median lobe resection, if needed — is the right fit for you.

  • ✅ Performed with bipolar technology in our Surgery Center and Hospitals
  • ✅ Addresses median lobe obstruction when present
  • ✅ Foley catheter removed in-office, typically 3–5 days after surgery
  • ✅ Decades of proven, durable symptom relief
Schedule Your Consultation

Call 678-344-8900 to speak with our team