Transurethral Resection of the Prostate History

What is Transurethral Resection of Prostate?

Transurethral resection of the prostate (TURP) is a surgical method through which parts of the prostate gland are dissected through the urethra.

History of Transurethral Resection of the Prostate

For majority of the 20th century, from 1909 until the 1990s, the treatment for symptomatic benign prostatic hypertrophy (BPH) was transurethral removal of the prostate (TURP). TURP was the initial successful and minimally invasive surgical procedure of the modern time. Till this day, it remains the standard therapy for obstructive prostatic hypertrophy and is both the surgical removal of prostate and the ideal care option when other methods fail.

The standards for opting for TURP surgery are now getting more strict compare to earlier times. In general, TURP surgery is only suggested for patients with symptomatic BPH who have

  • Severe, recurrent, or chronic urinary retention.
  • Medical management and less-aggressive prostatic surgical procedures did not work.
  • Prostates of an unusual volume and shape.
  • Azotemia or renal inadequacy because of prostatic obstruction.

The frequency of TURP vis-à-vis open prostatectomy in surgical patients is different from country to country. The relative frequency rate of TURPs in surgical patients with BPH in the US was 97%, which was similar in Denmark and Sweden in 1990. Japan has been recorded as the lowest rates (70%) of TURP.

Transurethral Resection of the Prostate Purpose

The prostate is a part of male reproductive system consisting of three lobes, and covers the neck of the bladder and urethra. A most general form of prostate disorder is called benign prostatic hyperplasia (BPH) or benign prostatic enlargement (BPE). BPH is because of hormonal changes in the prostate, and is witnessed due to the enlargement or overgrowth of the gland as a result of an accentuation in the number of its constituent cells. BPH can increase PSA levels two to three times greater compared to normal.

BPH generally affects the inner part of the prostate basically, and enlargement subsequently results in a squeezing of the urethra at the phase where it runs through the prostate. The squeezing often causes urinary disorders, like difficulty in urinating. Eventually, it may lead to bladder and kidney disorders.  

Transurethral resection of the prostate (TURP) is the ideal treatment for BPH, and the most common surgery conducted for the condition. The purpose of TURP is to clear the section of the prostate that is obstructing the urine flow.

Types of Transurethral Resection of the Prostate

TURP is a kind of transurethral surgery where there is no need to make any external incision. The surgeon approaches the prostate by inserting a device via the urethra. Apart from TURP, two other types of transurethral surgery are generally prevalent, transurethral incision of the prostate (TUIP), and transurethral laser incision of the prostate (TULIP). The TUIP procedure stretches the urethra wide open by making small cuts in the bladder neck (where the urethra and bladder integrate), and in the prostate gland itself. In TULIP process a laser beam is inserted through the urethra and its melts the tissue obstructing the urine.