Thyer Urology

The prostate is a walnut sized organ located just below the bladder that forms the junction between the male reproductive and urinary tracts and secretes fluid that makes up part of the semen. As men age the prostate often increases in size making the passage of urine difficult.

Mr Thyer may recommend TURP for one of the following reasons:

1. Deterioration in voiding symptoms where medication has failed
2. Urinary retention (inability to pass urine without a catheter)
3. Occasionally in men with prostate cancer prior to undergoing non-surgical treatments

Pre operation

Ten days prior to the procedure you should have your blood and urine test. Notify Mr Thyer’s rooms if you are taking any blood thinning medication

The procedure

On arrival at hospital you will be prepared for theatre by nursing staff. Mr Thyer will see you just prior to being taken into the operating theatre. You will require a general anaesthetic of approximately 1 hour. Mr Thyer will introduce a thin resectoscope into your bladder via the urethra. No skin incision is required. The middle of the prostate will be removed slowly in chips which will be washed out at the end of the procedure. A catheter will be placed and a washout via the catheter commenced which will stay for 2 nights. After the catheter is removed the nurse will check you have passed urine then you will be sent home.

Note:

1. Occasionally this procedure is performed using a laser instead of the resectoscope and for these patients the stay in hospital is only one night however the procedure generally takes longer.

Risks

• Bleeding. Blood in the urine usually lasts for 2 weeks but can last longer for large prostates.
• Infection. This occurs in less than 5%.
• Urinary retention. Occasionally you may not be able to pass urine after the procedure and you may be discharged with a catheter to be removed after one week.
• Retrograde ejaculation. Following the procedure, semen will no longer be ejaculated via the penis at the time of sexual activity. The semen will instead pass at the time of urination following sexual activity. You will therefore have reduced fertility.
• Erectile dysfunction. Some men notice a reduced erectile capacity but this is rare for men with normal pre-operative erectile function.
• Incontinence. Some men do have incontinence following the procedure but for most this resolves within a couple of weeks. Rarely, we see stress urinary incontinence which happens in less than 1%.
• Urethral stricture or bladder neck stenosis. This is a narrowing in the urethra that can happen after the operation in about 3%. It often requires another operation correct it.
• There are risks with any general anaesthetic which are very rare including blood clots, heart or lung problems and adverse drug reactions. The anaesthetist will discuss these with you at the time of the procedure.

Follow up

You should take laxatives, avoid heavy lifting and sexual intercourse for 3 weeks following the procedure. You will have an appointment made with Mr Thyer in his rooms to check on your progress at 8 weeks. Please come with a full bladder to the clinic. You will be asked to empty the bladder just before you are called in to see Mr Thyer so that he can check how well you are emptying. The pathology will also be checked to make sure there is was cancer detected.

When to contact Mr Thyer

1 week prior to the procedure you should notify Mr Thyer’s rooms if you are taking blood thinning medication that has not been ceased.

Following the procedure, you should contact Mr Thyer if you:

• Have a fever over 38 Degrees
• Are unable to pass urine
• Have large clots in the urine
• Have not received a follow up appointment
• You can contact Mr Thyer via his rooms during working hours or after hours via the after hours nurse at Hollywood Hospital on (08) 9346 6000
• You can attend the emergency department at the hospital at which you had your procedure. (Hollywood Private Emergency Department charge a fee for attendance).