Treatment Of Complications After TURP (Trans-urethral resection of the prostate) Surgery for Enlarged Prostate

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

Some men experience complications after TURP surgery.  These complications may include persistent bleeding, persistent urinary retention, urethral strictures and urinary incontinence.  They may also include frequent urination and incomplete bladder emptying.

We have extensive experience evaluating and helping men with complications after TURP surgery.

Persistent Hematuria

shutterstock_95332513 (1)There are a few different reasons for persistent hematuria after TURP surgery.  Sometimes minor bleeding can occur for some time after TURP.  Resection or fulguration may be necessary to stop the persistent bleeding.  Careful reevaluation may be necessary as in some rare circumstances bleeding may not be originating from the prostate.  UTI may complicate the situation and may require treatment if present.

Urinary Incontinence After TURP

Urinary incontinence after TURP is not uncommon.  There are 2 causes of urinary incontinence after TURP.  An anatomical cause is usually a result of resection of the sphincter muscle and is very rare.

Functional urinary incontinence is much more common after TURP.  This is caused by high pressure voiding against lower resistance.

The first step is to differentiate what is the cause of urinary incontinence.

For sphincteric urinary incontinence, surgical treatment with an artificial urinary sphincter or urethral sling is usually the best option.  For functional urinary incontinence, medical treatment is usually successful.

What we find is that the significance of functional urinary incontinence after TURP is not widely recognized.  As a result of many men unnecessarily experience urinary incontinence after TURP.

Depending on the duration of time that has passed since TURP surgery, most man would require cystoscopy to evaluate the anatomy inside of the urethra and the prostate.  A PSA test would also be ordered.  Additional studies may include CT scan, transrectal prostate ultrasound, and urodynamic studies.

Urinary Retention After TURP

Some men experience persistent inability to urinate after TURP.  Careful reevaluation as necessary to determine the cause of persistent urinary retention.  For some men, incomplete resection of the prostate may be the cause.  For these men repeat surgery may be necessary.

Some men continue to be in urinary retention or develop new urinary retention after TURP as a result of a urinary stricture.  From diagnosis and treatment is essential to prevent the development of renal insufficiency.

Some men have a nonfunctional urinary bladder that does not generate pressure.  Treatment of these men is usually more challenging.  Experimental treatment with neuromodulation may work for some men.

Split urinary stream after TURP is often caused by a urinary stricture but may also be caused by high-pressure voiding.

Frequent urination after TURP surgery or a sensation of incomplete bladder emptying may be an indication that the patient is not urinating normally.  This may indicate an underlying urinary retention where the bladder does not empty completely.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

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