Transurethral resection of the prostate (TURP)
TURP is an operation done through the tip of the penis, with no cuts on the skin. A surgeon uses a thin scope with an electric wire loop to shave away the inner part of an enlarged prostate so urine can flow freely again.
Also called TURP, TUR-P, transurethral resection of the prostate, bipolar TURP, monopolar TURP, B-TURP, prostate resection, roto-rooter prostate surgery
- Where
- Hospital operating room or outpatient surgery center
- Anesthesia
- General anesthesia (asleep) or a spinal (numb from the waist down)
- Time in the room
- About 1 to 2 hours in the operating room
- Hospital stay
- Usually one night; some men go home the same day
- Going home with
- Urinary catheter for about 1 to 3 days
- Back to normal
- 2 to 3 weeks for light activity, about 4 to 6 weeks for everything
- Back to work
- Desk work in about 1 to 2 weeks; heavy physical work in 4 to 6 weeks
Overview
The prostate is a gland about the size of a walnut that sits just below the bladder and wraps around the urethra, the tube that carries urine out. With age, the inner part of the prostate often grows. This is called benign prostatic hyperplasia, or BPH. Benign means it is not cancer. As it grows, it can squeeze the urethra like a hand around a garden hose.
TURP has been the standard operation for this problem for decades, and many other treatments are still compared against it. The surgeon passes a scope through the urethra, so there are no cuts on the skin. A thin electric wire loop on the end of the scope shaves away the overgrown inner prostate in small pieces, a bit like coring an apple. The outer layer of the prostate stays in place.
Most surgeons now use bipolar TURP, which works in salt water. This lowers the chance of a rare problem caused by absorbing rinse fluid. TURP works best for prostates of small to medium size, roughly 30 to 80 grams, which is the range the American Urological Association (AUA) guideline uses for it. A normal adult prostate is about 20 to 25 grams. Very large prostates are usually better treated with laser enucleation (HoLEP) or simple prostatectomy.
TURP gives one of the strongest and longest-lasting improvements in urine flow of any BPH treatment. The main trade-off is that most men afterward have dry orgasms, because semen flows back into the bladder instead of out the penis. It is safe and does not change your health, but it matters to many men, so talk it over before you decide.
The parts of your body involved
Urine is stored in the bladder, a muscular balloon in the lower belly. When you urinate, it leaves through the bladder neck and runs down the urethra. The first part of the urethra passes straight through the middle of the prostate. When the inner prostate grows, it narrows this passage. Sometimes a middle lobe also grows up into the bladder like a plug. Over years of pushing against a blockage, the bladder wall can thicken and become irritable or weak.
- Prostate
A gland below the bladder that adds fluid to semen. Its inner part, the transition zone, is what grows with BPH and what TURP removes.
- Urethra
The tube that carries urine (and semen) from the bladder out through the penis. The scope travels along it.
- Bladder and bladder neck
The bladder holds urine. The bladder neck is its outlet, where the urethra begins. It also closes during orgasm to send semen forward.
- Verumontanum
A small bump in the urethra where the semen ducts open. Surgeons use it as a landmark and stop cutting just above it to protect the continence muscle.
- External sphincter
A ring of muscle just below the prostate that you squeeze to hold urine. TURP is designed to leave it untouched.
Why it’s done
TURP is offered when urinary symptoms from an enlarged prostate bother you enough, or cause enough harm, that you want a lasting fix. Many men try medicines first. Surgery moves up the list when medicines stop working, cause side effects, or when the blockage starts to damage the bladder or kidneys.
- Symptoms that disrupt life
A weak stream, straining, getting up many times a night, rushing to the bathroom, or feeling you never fully empty. Your team may score these with a short questionnaire called the IPSS.
- Medicines are not enough
Pills such as tamsulosin or finasteride have stopped helping, or they cause dizziness, tiredness, or sexual side effects you do not want to live with.
- Urinary retention
You cannot urinate, or you have needed a catheter because your bladder will not empty.
- Complications of blockage
Bladder stones, repeated urine infections, bleeding from the prostate, or kidneys that are swelling or losing function because urine is backing up.
- A lasting result
TURP has decades of long-term results. Most men keep their improvement for many years.
Other options
- Watching and waiting
If symptoms are mild and not causing harm, you can make simple changes (less fluid at night, less caffeine and alcohol, timed bathroom trips) and check in with your urologist yearly.
- Medicines
Alpha blockers (such as tamsulosin) relax the prostate within days. 5-alpha reductase inhibitors (finasteride, dutasteride) shrink it slowly over 6 to 12 months. Tadalafil can also help. They are often combined.
- Laser enucleation (HoLEP)
Removes the whole inner prostate with a laser through the same route. It works for any size prostate, usually needs a shorter catheter time, and is very durable.
- GreenLight laser vaporization
Vaporizes prostate tissue with a laser. Often chosen for men who cannot stop blood thinners. Little or no tissue is left to examine.
- Minimally invasive office options
UroLift, Rezum, and iTind are shorter, gentler treatments that usually protect ejaculation, but they give smaller improvements and are more likely to need repeat treatment later.
- Aquablation
A robot-guided waterjet removes tissue under ultrasound. It aims to protect ejaculation and can treat prostates up to about 150 grams.
Getting ready
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Weeks before
The week before
The day before
The morning of
In the operating room, step by step
Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.
1. Anesthesia
In the operating room, the anesthesia team either puts you fully to sleep or gives a spinal injection in your lower back so you are numb from the waist down, often with medicine to make you drowsy. Monitors track your heart, blood pressure, and oxygen the whole time.
After the operation
Right afterward
- Waking up
You wake in the recovery room with the catheter in place. If you had a spinal, your legs may stay numb for a few hours.
- Watching the urine color
Nurses adjust the rinse to keep the urine light pink. Darker red or clots mean the flow is turned up or the catheter is flushed by hand.
- Bladder spasms
The catheter balloon can make the bladder cramp, with a sudden urge to urinate or a sharp pain behind the pubic bone. Medicine such as oxybutynin or a belladonna and opium suppository can calm these.
- Eating and walking
You can usually drink and eat the same day. Walking soon after surgery helps prevent blood clots and gets your bowels moving.
- Catheter removal and voiding trial
Most catheters come out in 1 to 3 days, sometimes in the hospital and sometimes at a clinic visit. Your bladder is filled with water or allowed to fill, then you urinate and a scan checks how well you empty. If you cannot empty well, the catheter goes back in for about a week. This is common when the bladder muscle was weak before surgery.
- Going home
Most men go home the next day, some with the catheter and a leg bag. You will get a prescription for pain medicine and a stool softener, and sometimes a short antibiotic course.
At home
- Pain
Pain is usually mild. Acetaminophen often is enough. Burning with urination is common for a few weeks and is not usually a sign of infection.
- Blood in the urine
Pink urine on and off is normal for up to 4 to 6 weeks. Around 10 to 14 days after surgery, the scabs inside the prostate fall off and bleeding can pick up for a day or two. Drink more water and rest. If it turns thick or you pass clots that block flow, call.
- Catheter care
If you go home with a catheter, keep the bag below your bladder, wash where the tube enters the penis with mild soap and water daily, and switch to the larger bag at night.
- Drinking
Aim for about 6 to 8 glasses of water a day unless you have been told to limit fluids. Cut back on caffeine, alcohol, and spicy food, which can irritate the healing area.
- Bowels
Avoid straining. Use a stool softener and eat fiber. Hard pushing on the toilet can start bleeding.
- Activity and lifting
Walk every day. Avoid lifting more than about 10 to 15 pounds (5 to 7 kg), hard exercise, and straddle activities such as cycling or horseback riding for about 4 to 6 weeks.
- Driving
Do not drive while you have a catheter or while taking opioid pain medicine. Most men drive again within about a week.
- Showering
You can shower right away. Skip baths, hot tubs, and swimming for about 2 to 3 weeks.
- Sex
Most surgeons suggest waiting about 3 to 4 weeks. Expect your first orgasms to be dry or nearly dry, and the first ejaculations may contain a little blood.
- Work
Desk work is often possible in 1 to 2 weeks. Jobs with heavy lifting usually need 4 to 6 weeks.
Recovery timeline
- Day 0Surgery
You wake with a catheter and bladder rinse running. Mild burning and an urge to urinate are normal.
- Days 1 to 3Catheter out
The rinse stops once urine clears. The catheter usually comes out and you try urinating on your own. The first few times sting.
- Week 1Settling in at home
Frequent urges and burning are common. The stream is often already stronger than before surgery.
- Weeks 2 to 3Scab bleeding
A short bout of more blood in the urine is common when the inner scabs fall off. Drink more and take it easy.
- Weeks 4 to 6Back to full activity
Most burning and urgency fade. You can usually return to lifting, exercise, and cycling.
- 6 to 12 weeksFollow-up visit
Your urologist checks your symptom score, urine flow, and how well you empty, and goes over the lab report on the removed tissue.
- 3 monthsFully healed
The inside of the prostate has healed over with new lining. Urgency, if it lingered, often keeps improving up to about 6 months.
- Long termLasting results
Most men keep their improvement for many years. Keep up with PSA checks as your doctor advises; your PSA level usually drops after TURP, so a new baseline is set.
What it feels like
TURP is not usually very painful. What men tend to remember is the catheter, the burning and urgency for a few weeks, and the surprise of a dry orgasm. Most also remember the first strong stream they have had in years.
The night before
Many men feel nervous, especially about having a scope and a catheter in a very private place. Some worry about leaking or losing their sex life.
What helpsWrite your questions down and ask them at check-in. Knowing exactly what will happen, and that TURP leaves the continence muscle and erection nerves alone, helps many men relax.
Waking up
A feeling that you badly need to urinate, even though the catheter is draining. Some men feel a little cold or shaky from anesthesia.
What helpsThis urge comes from the catheter balloon and the healing prostate. Tell your nurse; medicine for bladder spasms often helps quickly.
Bladder spasms
Sudden cramps low in the belly or at the tip of the penis, sometimes with urine leaking around the catheter.
What helpsSpasm medicine, slow breathing, and making sure the catheter tube is not kinked. Spasms usually ease within a day or two.
The catheter coming out
Quick and strange more than painful. The first few times you urinate it burns and the urge comes on fast.
What helpsHave a urinal or bathroom close by. Drink steadily. The burning eases a bit more each day.
The first week home
Going often, sometimes every hour, with some urgency and a few drips. It can be frustrating when you expected instant relief.
What helpsThis is the healing surface inside the prostate, not a failed operation. Cutting back on caffeine and alcohol and timing bathroom trips helps.
Around day 10 to 14
A sudden return of red urine or a few small clots can be alarming.
What helpsThis is usually the scab coming away. Drink extra water and rest. Call if the urine turns thick red or you cannot pass urine.
The first orgasm
Little or no fluid comes out. The feeling of orgasm is usually the same, but some men find the change upsetting, and partners may have questions.
What helpsKnowing this ahead of time helps. The semen goes into the bladder and passes out with your next urination. It is harmless.
A few weeks on
Standing at the toilet and emptying with a strong stream, sleeping through more of the night.
What helpsMany men say they did not realize how much their symptoms had shrunk their life until they were gone.
How well it works
Success means you urinate more easily, empty better, and get up less at night. Most men see a big drop in their symptom score and a large rise in flow rate. Results build over the first 3 months as the inside heals.
- Symptom score
The IPSS questionnaire is usually repeated at follow-up. Many men see their score fall by about half or more.
- Flow rate and emptying
A uroflow test measures how fast you urinate, and a bladder scan shows how much is left behind. Both usually improve a lot.
- Durability
TURP results last for many years. Roughly 1 to 2 in 100 men a year need another procedure, often for regrowth or scar narrowing.
- Bladder recovery
If your bladder muscle was weakened by years of blockage, it may recover slowly or only partly. Urgency and night-time urination can linger even when the blockage is gone.
- Pathology and PSA
Your team reviews the lab report on the removed tissue and usually sets a new PSA baseline, since PSA drops once tissue is removed.
Risks
Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.
Common
Semen flows back into the bladder instead of out the penis. Orgasm still feels the same for most men. It can make fathering a child naturally difficult.
Stinging, frequent urination, and urgency for several weeks while the inside heals.
On and off for up to 4 to 6 weeks, often with a short flare around 10 to 14 days.
Usually treated with a short course of antibiotics.
Some leaking with urgency in the first weeks. It usually settles as healing goes on; pelvic floor exercises help.
Less common
Less common with bipolar TURP and more likely with larger prostates.
May need the catheter flushed or a short return to hospital for bladder washouts.
More likely if the bladder muscle was weak before surgery. Usually managed with a catheter for another week or so.
Scar tissue in the urethra (stricture) or at the bladder neck (contracture) can slow the stream months later and may need a small procedure to open it.
The prostate can slowly regrow, or some tissue may remain. Another treatment is sometimes needed years later.
Rare
Ongoing stress leakage (with coughing or lifting) from injury to the continence muscle.
Absorbing too much rinse fluid can lower blood sodium, causing confusion, nausea, or high blood pressure. Very rare with bipolar TURP.
Usually heals with a catheter left in longer; rarely needs another operation.
Studies have not shown a clear effect on erections for most men, but a small number notice a change.
As with any operation under anesthesia. Walking early and leg compression help prevent clots.
Call your care team or go to the emergency room if
- Fever of 101°F (38.3°C) or higher, or shaking chills
- No urine coming out of your catheter for 1 hour, especially with a full or painful belly
- Not able to urinate for 6 hours or more after the catheter is out, or a painful, swollen lower belly
- Urine that is thick and dark red like ketchup, or clots that keep blocking the flow
- New confusion, severe headache, or repeated vomiting in the first day or two
- Swelling, pain, or warmth in one calf or thigh
- Chest pain or sudden shortness of breath (call 911)
Questions to ask your surgeon
- Is my prostate the right size for TURP, or would HoLEP or another option suit me better?
- Do you use bipolar or monopolar TURP?
- How many TURPs do you do each year?
- What are my chances of a dry orgasm, and is there any way to lower them?
- How long will I have a catheter, and will I go home with it?
- Do I need to stop my blood thinner, and who will tell me when to restart it?
- Is my bladder muscle strong enough to empty once the blockage is gone? Do I need urodynamics first?
- Will I be able to stop my prostate medicines after surgery?
- What symptoms should I expect in the first month, and which ones mean I should call?
- How will my PSA testing change afterward?
- How likely is it that I will need another procedure later?
Words you may hear
- BPH (benign prostatic hyperplasia)
- Non-cancer growth of the inner prostate that can squeeze the urethra.
- Urethra
- The tube that carries urine and semen from the bladder out through the penis.
- Resectoscope
- A straight scope with a camera, rinse channels, and an electric wire loop used to shave tissue.
- Bipolar
- A type of electric current that flows between two points on the instrument, used in salt-water rinse.
- Bladder neck
- The outlet of the bladder where the urethra begins.
- Verumontanum
- A small bump in the urethra where semen enters; a key landmark that protects the continence muscle.
- Capsule
- The firm outer shell of the prostate that stays in place after TURP.
- Retrograde ejaculation
- Semen goes backward into the bladder during orgasm, so little or none comes out.
- Catheter
- A soft tube through the urethra that drains urine from the bladder into a bag.
- Continuous bladder irrigation
- Salt water running in and out of the bladder through a catheter to wash away blood.
- Urinary retention
- Not being able to empty the bladder.
- IPSS
- International Prostate Symptom Score, a short questionnaire that scores urinary symptoms from 0 to 35.
- PSA
- Prostate-specific antigen, a blood test used to watch for prostate cancer.
- TUR syndrome
- A rare reaction to absorbing too much rinse fluid that lowers blood sodium.
Common questions
Will TURP affect my erections?
For most men, no. The nerves for erections run outside the prostate and are not in the area that is shaved. Large studies have not shown a clear drop in erections after TURP, though a small number of men notice a change.
Is a dry orgasm harmful?
No. The semen simply goes into the bladder and passes out the next time you urinate. Orgasm usually feels the same. It does make it harder to father a child naturally, so tell your surgeon if that matters to you.
Will I leak urine afterward?
Some urgency and leaking are common for a few weeks while things heal. Permanent leakage is rare, about 1 in 100 men or fewer, because the continence muscle below the prostate is left alone.
Does TURP remove my whole prostate or protect me from prostate cancer?
No. Only the inner part that blocks urine is removed. The outer part, where most cancers start, stays. You still need PSA checks as your doctor advises.
Can I go back to my prostate medicines if needed?
Most men can stop tamsulosin and similar pills after recovery. A few still need medicine for an overactive bladder. Your urologist will guide you.
My prostate is very large. Can I still have TURP?
TURP is usually used for prostates up to about 80 grams. For larger ones, HoLEP or simple prostatectomy is usually a better fit because the operation would otherwise be long and bloody.
Why do I still get up at night?
Night-time urination has many causes, including bladder changes from years of blockage, drinking late, sleep apnea, and swelling in the legs. TURP fixes the blockage but not all of these.
Sources this page draws on
- American Urological Association, Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline
- European Association of Urology, EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms
- Urology Care Foundation, Benign Prostatic Hyperplasia (BPH)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Prostate Enlargement (Benign Prostatic Hyperplasia)
- MedlinePlus (U.S. National Library of Medicine), Transurethral resection of the prostate
Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.