TURP (Trans Urethral Resection of the Prostate)

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TURP (Trans Urethral Resection of the Prostate) UHN Information for patients You are having your operation at: (please check one) Toronto General Hospital Princess Margaret Cancer Centre Toronto Western Hospital Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca 2014 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Author: Leah Jamnicky, RN and Division of Urology 1995 Reviewed by: Susan Stehle, Jennifer Harris, Liz Allan, Rebecca McKinney, Monica Zarello and Audrey Bunce Created: 01/2006 Form: D-3366 (02/2014)

What is a TURP? The prostate is a gland that surrounds your urethra where your urethra meets your bladder. This gland can get bigger and make it hard to urinate. It's natural for this gland to get bigger as you get older. The condition is called BPH or Benign Prostate Hyperplasia. "Benign" means that it is not cancer. TURP stands for Trans Urethral Resection of the Prostate. In this operation, we cut away the extra prostate tissue. We use an instrument called a resectoscope to go inside your prostate through your urethra. The tissue that we cut away gets flushed out of your body. What happens before my operation? You have an appointment in the pre-admission department. We do a blood test and an ECG (electrocardiogram) and/or a chest x-ray to prepare you for the operation. You will have an in-depth assessment by the nurse in pre-admission. This helps us to manage your stay effectively. You might also see an anesthetist or a medical doctor during this appointment. What happens the evening before my operation? You need to buy a fleet enema at a pharmacy and give it to yourself the evening before your surgery. Don't eat or drink for 5 to 6 hours before your operation. We call this being "NPO." 2

What happens the morning of my operation? Arrive at the hospital 2 hours before your operation is scheduled. We will give you an intravenous (IV). This is a small needle that goes in your arm to give you fluids or antibiotics. What can I expect after the operation? You will wake up in the Patient Anesthetic Care Unit (PACU). You will be attached to some tubes: an IV a catheter, which goes in your penis to drain urine from your bladder. The catheter is also connected to a bag of saline (salt water) solution. This solution flushes the blood and clots from your bladder. We call this Continuous Bladder Irrigation (CBI). It's normal for your urine to have a pinkish colour for a few days. It is important to keep the catheter clean. Your nurse will show you how to do this. What does a catheter feel like? You may feel like you have to urinate. You may also feel muscle spasms in your bladder. These spasms may come and go. We may give you a medication that can help to calm them. We usually take the catheter out the day after your operation, depending on the colour of your urine. When we've taken the catheter out, you should drink lots of fluid. This means about 8 glasses of water a day (each glass should be 8 ounces). 3

How to take care of yourself when you go home You will probably go home on the day of surgery or you may stay 1 night in the hospital. Your healing will take about 4 to 6 weeks. Keep drinking lots of fluid to flush out your bladder. This will also water down your urine so that you feel less burning when you urinate. Sometimes your urine may have a pinkish to reddish colour. This means you need to drink more fluids. For the next 6 weeks, don't lift anything over 5 kilograms (10 pounds) such as groceries, grandchildren or pets. Don't do heavy exercise such as shoveling snow, gardening, jogging, golfing or skiing. You can go for walks. In 6 weeks, you can go back to your normal activities. Don't take long car trips. Keep them short. Make stops to urinate when you need to. Don't strain when you're having a bowel movement. Eat food that is high in fibre (bran, fruits, vegetables) so that you don't get constipated. You can take mild laxatives like Metamucil, Prodiem, or Milk of Magnesia. But don't use enemas or suppositories. Don't take any anti-inflammatory medicines for 2 weeks after your operation unless your doctor has asked you to continue taking them. Don't have sex for 2 or 3 weeks after your operation because you may have some bleeding. 4

What are the side effects from this operation? For awhile, you might have to urinate often. You might also feel burning when you urinate. Increase the amount of water you drink to about 2 litres a day. This helps dilute your urine and decreases the burning feeling. Some people have problems with ejaculation. Your semen might flow into the bladder instead of the penis. This side effect is called retrograde ejaculation. When to call the nursing unit: If you bleed heavily when you urinate and this lasts for more than 24 hours. If you have a fever (temperature higher than 38 Celsius or 101 Fahrenheit) or you feel chills. If you cannot urinate. If you feel pain in your abdomen (bladder area) or on your side (near your kidneys). 5

Your follow up appointment Before you leave the hospital, we will make a follow up appointment for you about 6 weeks after your operation. How to contact us Urologists Toronto General Hospital Dr. T. Finelli 416 964 2851 Dr. N. Fleshner 416 946 2899 Dr. R. Hamilton 416 946 2909 Dr. M. Jewett 416 946 2909 Dr. G. Kulkarni 416 946 2246 Dr. M. Robinette 416 340 3855 Dr. J. Trachtenberg 416 946 2100 Dr. A. Zlotta 416 586 3910 Urologists Toronto Western Hospital Dr. Dean Elterman 416 603 5033 Dr. M. Hassouna 416 603 5018 Dr. S. Radomski 416 603 5713 Toronto General Hospital Nursing Unit 6 A West 416 340 3521 Toronto Western Hospital Nursing Unit 9B FP 416 603 5830 Princess Margaret Cancer Centre Nursing Unit 18 B 416 946 5510 6