Transurethral Prostatectomy (TURP)

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If you have elected to have a Transurethral Prostatectomy, the following instructions are general pre-operative and post-operative guidelines.

Four Weeks Before Surgery:
Stop any herbal medicines and excessive dosages of Vitamin E. You may take a multivitamin with Vitamin E.

Two Weeks Before Surgery:
Stop any Aspirin use and also do not take any over the counter pain relievers. This includes Ibuprofen ("AdviI"), Aleve, Motrin, etc. The only over the counter pain reliever that is alright to take is Tylenol (Acetaminophen) and this can be taken up until the day before surgery. You should also stop any other non-steroidal anti-inflammatory drugs. If you are on any other blood thinners such as Coumadin (Warfarin) or Plavix, you will need to stop these as well. Your doctor will discuss the timing of this with you. You should also slay off these drugs after surgery and the doctor will advise when to restart.

One Day Prior to Surgery:
On the day before surgery, take only clear liquids (no solid foods) and take nothing after midnight. Sometime in the early afternoon take one bottle of Magnesium of Citrate which you can purchase at a pharmacy without a prescription. This is a rapid acting laxative and will usually work within 4-6 hours. Continue to drink clear fluids until bedtime or midnight to avoid dehydration.

The Day of Surgery:
Remember not to eat or drink anything with one exception. If you take blood pressure or heart medications, you may take these with a very small sip of water prior to 5:00 a.m. If you have questions regarding certain medications, please inquire ahead of time. Check in at the hospital is 2 hours prior to surgery. The hospital will send you separate information regarding check-in procedures. Your surgery will be done under spinal anesthesia (in most cases) or general anesthesia. Spinal anesthesia is preferred as it is generally safer for this type of surgery but if not possible, or desired, you may have a general anesthetic. This will be determined the day of surgery by the anesthesiologist. After surgery there is generally a 1-2 hour stay in the recovery room, then you will be transferred to a room.

Following surgery you will be at bed rest and there will be a catheter in the bladder and this is generally removed the day after surgery, in the morning. Following catheter removal, you may get out of bed and ambulate, and if able to pass urine satisfactorily, you will likely be discharged from the hospital.

After Surgery:
The following are common after this type of surgery:

Urinary urgency and frequency
(could last days to weeks).
Blood in the urine (hematuria). This will vary greatly from day to day and may last up to six weeks.
Passage of blood clots or tissue.
Burning with urination.

After surgery you should drink plenty of fluids and take extra fluids when the urine is bloody. Take a variety of fluids (not just water) as there are no restrictions.

Bleeding may be exacerbated with activity, straining, bowel movements, etc. Accordingly, you should limit your activity for 6 weeks following surgery. You may walk as much as you like but
do not lift heavy objects (greater than 10 lbs.), work out, ride a bike or horse, golf, do yard work, etc. At 6 weeks you may resume all activities. Constipation can also increase bleeding so take a
laxative (anyone is fine) or stool softener if necessary. Do not do an enema or use suppositories for 6 weeks following surgery.

Post-operative follow up is generally 3 weeks after surgery. Please call the office to set up this appointment. Your pathology is generally discussed at this appointment but may be done
sooner if necessary.

The symptoms of Benign Prostatic Hyperplasia (BPH) that lead to your surgery may improve rapidly but often can take weeks or months to gradually improve. Please notify your doctor if the following occur:

Heavy bleeding or the inability to pass urine.
High fever (generally above 1020 F).

This information is a general guideline for most patients. As with anything in medicine your case may vary or need to be individualized.