Trans-urethral resection of the prostate (TURP)

Sometimes a tumour presses on the urethra (the tube between the bladder and the outside) and prevents the passage of urine. Surgery can be carried out to relieve symptoms (TURP). An instrument is placed down the penis, which cuts away the prostate tissue from inside the urethra. This may be done under general anaesthetic or by injecting anaesthetic directly into the spinal column, an epidural anaesthetic. This form of surgery is not intended to remove cancerous tissue, but is a procedure to relieve the symptoms of slow urine flow and urine retention.

Men who do not have cancer also have TURP operations to relieve urinary problems. Confusion sometimes arises, for example one man who had this operation thought that he had undergone surgery to cure his cancer, and he was clearly upset when he discovered that this was not the case. Usually men said that their symptoms were much better after their TURP operations and they spoke positively about their experiences.

Speaks positively about his experiences with TURP.

Age at interview 49

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Well they arranged the appointment pretty quickly because it was a private medical health so it was all done in a few weeks. Then I went into the hospital and it was a fairly straight forward operation, no complications, a bit messy because you’ve got these tubes, it’s an irrigation system of water flowing round you and they keep that going until it takes on a special colour you know a very light red colour and then they disconnect it and you heal up.

So that’s what they call a Trans Urethral Resection is it, they just take a little bit of prostate away to make it easier for you to pass urine?

Well chip away, they do it, they do it sort of, it’s keyhole surgery. And I, it took me quite a few months to recover full health actually, I was a bit feeble you know. When I came out of hospital after about 10 days.

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Explains his disappointment with TURP after confusion over what the operation was for.

Age at interview 68

Gender Male

Age at diagnosis 67

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When the biopsy came back and the consultant told me that it was an aggressive tumour and that practically all of the prostate was affected by it. I then began to think in my mind, well if it’s a 10 year growth and it’s all affected I have now had it for this length of time so what’s going to happen now? And I raised this question with the consultant, he said Well we shall now do tests to see whether or not it’s got outside of the prostate.

And so then we went through another sort of series of scans and one thing and another. We had a isotopic bone scan and it said there was nothing in the bones. And at that stage we had not had the conclusive scan which said that it had gone into the tissues so at that stage we were still talking operation.

My perception of the whole thing was that I going to have an operation to remove the prostate. So I signed the form and had the, oh it was about a months wait and then I got in on 13th December. The anaesthetist came round, had his chat, the surgeon or whoever was going to do the job, he came round and had his chat, and off we went, had the operation. When I came round the surgeon came round to see me or one of the team, whether it was the actual man or not I don’t know and I said Oh I’m surprised, I said You know I thought it was sort of a bigger operation than this, you know because we were talking, going home by the weekend, this was the Tuesday or something. So he said Oh no, he said We think it’s done the job anyway and everything looks alright and were quite happy. I don’t know how it came about but I said ‘so that will be the end of it then? sort of thing you know I said and at least weve got rid of the, we shant have this sort of problem again? And he said Well it wont affect the prostate, and I said What do you mean? and he replied, Well all weve done is take the pressure off your kidneys. I said But I came in to have the prostate removed, Well no, he said No, we were not commissioned to do that, he said We havent removed the prostate, he said We have done this enlargement and we did the operation to take the pressure off your kidneys because that’s what your doctor was originally bothered about.

And he said Er this would never have cured your prostate cancer. I said Well that’s what I came in for, I said That was the only reason I agreed to have an operation, my family had said you know youve got cancer in your body and it shouldnt stay there and what have you. And he said Well youve either been misinformed or misled or whatever, he said But this was never the intention. So I said Oh well, that’s a bit disappointing.

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Describes how the TURP operation cured his symptoms for a number of years.

Age at interview 49

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He suggested I go into the local infirmary to have TURP operation, that’s a trans urethral resection of the prostate. That really means putting a catheter up the penis as far as the prostate gland and then cutting away some of the gland to reduce the restriction on the urethra from the enlarged prostate. This was a fairly straight forward operation, it’s under general anaesthetic, but the surgeon then scrapes away part of the prostate. You’re completely unaware of what’s happening, when you come to in the recover room there’s no real pain, and, but you’re kept in hospital for about a week drinking loads of water and passing the water through a catheter into a container until all the debris from the operation is washed away and any blood is washed away.

Unfortunately in my case, and probably about in 3 of the 9 in the ward there was a bit of infection and so I was kept in for a further 3 days. But after that the operation proved to be completely successful, passing urine was perfectly normal and that, the power was back there and it seemed to have completely cured the symptoms. I did have a little bit of bother with the urine spraying somewhat for the first year or so really but I did learn afterwards I could have had that corrected at the time if I’d mentioned it. So after that I’d no problems at all until oh, 12, 13 years later.

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However, one man, who had had two trans-urethral resections some years apart in the same hospital, complained that conditions on the ward had deteriorated as far as food, hygiene, cleanliness and nursing care were concerned.

Complains how conditions in hospital have deteriorated.

Age at interview 66

Gender Male

Age at diagnosis 57

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Hygiene is unbelievable now from 8 years ago it was good the last time I was in hospital, well the last few times I’ve been it’s unbelievable. You get like you get blood on the floor round your bed, not yours. The worst I’ve, the worst, well I was just, you just lay in bed like you touch the metal frame of the bed and I thought oh what’s that chewing gum and it wasn’t it was just dried blood. Another time [laughs] I remember recently was in your night bag they come and empty it at night and obviously they spilt some and I got out of bed and I’d just worn, my bare feet was in my urine on the floor.

Oh dear

But this is, that is hygiene and you just sit, you just lay in your bed and watch them clean, it’s just if theres a chair they don’t clean and move the chair, they just go round the chair. This is my experience.

So you think things have got worse in hospital, in the hospitals?

Yes 8 years ago, yes theres no comparison the last, you know that gap of that 6 years what’s happened I don’t know.

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