TURP and HoLEP surgery in Atlanta
Transurethral resection of the prostate (TURP) removes prostate tissue through the urethra. It is a long-established surgery for BPH. Holmium laser enucleation (HoLEP) removes tissue with a laser and less bleeding risk.
Medically reviewed by Dr. Chirag Dave
Key facts
- TURP is done under general anesthesia.
- A catheter is needed for several days after TURP, and typically after laser surgery.
- Laser option: holmium laser enucleation (HoLEP). See also ThuLEP.
- Possible long-term effects: retrograde ejaculation, ED, incontinence.
What is TURP?
Under general anesthesia, prostate tissue is removed through the urethra. The remaining tissue may swell before it shrinks, so relief may not be immediate. Short-term problems can include bleeding, infection, erectile dysfunction and urinary incontinence.
What is HoLEP (holmium laser enucleation)?
A holmium laser is passed through the urethra to separate the enlarged inner part of the prostate from its outer shell. The freed tissue is pushed into the bladder, broken up and removed. This lessens the bleeding risk of traditional TURP and can be used for large prostates. A similar procedure uses a thulium laser: see ThuLEP.
Who may be a candidate
- Men with moderate to severe urinary symptoms from BPH that medication has not controlled.
- Men with complications of BPH, such as repeated urinary retention, bladder stones or repeated urinary infections.
- Men whose prostate size or shape makes other options, such as UroLift or prostate artery embolization, less suitable.
Before surgery
Your evaluation can include a urine test, a urine flow test, an ultrasound to measure the prostate and leftover urine, and a look inside the urethra and bladder (cystoscopy). You will be told which medications to stop beforehand, especially blood thinners, and when to stop eating and drinking.
Recovery
- A catheter drains the bladder for a period after surgery while the area heals.
- Some blood in the urine and burning or urgency are common for a few weeks.
- Avoid heavy lifting, straining and vigorous activity until your urologist says it is fine.
- Drink fluids as instructed and call the office for heavy bleeding, clots that block urine, fever or inability to urinate.
A patient's experience
“After months of self-treatment using a catheter for my only means to void, I turned to my Urologist, Dr. Jitesh Patel for help. In previous visits I had found him and his staff caring and thorough in meeting my needs. Having suffered septic shock from severe urinary infection, I knew that it was time for prostate surgery. My options were explained. I chose the TURP procedure. Dr. Patel did my surgery with excellent results. A month post-surgery, I can void normally without any problems.”
Frequently asked questions
How long will I have a catheter after TURP?
Patients have a catheter attached to a urine bag for several days after TURP. A catheter is also typically needed after laser procedures.
What are the long-term side effects of TURP?
Possible long-term effects include dry orgasm (retrograde ejaculation), erectile dysfunction and incontinence (leaking urine).
How is laser surgery different from TURP?
HoLEP uses a holmium laser to separate the enlarged inner part of the prostate from its outer shell, which lessens the bleeding risk of traditional TURP. Because tissue is still removed, there can be swelling and an uncomfortable healing period.
When will my symptoms improve after TURP?
Relief may not be immediate, because remaining tissue can swell before it settles, but once it occurs it lasts a long time for many patients.
Physicians who treat BPH
Talk with a urologist
Appointments at 14 Advanced Urology offices across metro Atlanta and north Georgia. Find an office.