At a glance
Transurethral Resection of the Prostate (TURP) is a surgical procedure in which a surgeon removes excess prostate tissue through the urethra (the tube that carries urine out of the body), without making any cut in the skin. A thin telescopic instrument called a resectoscope is passed through the tip of the penis and up into the urethra, where it uses an electrical loop to shave away the overgrown tissue.
The prostate gland sits just below the bladder and surrounds the urethra. When it grows too large, it squeezes the urethra and makes urination difficult or impossible. TURP widens the channel by removing the inner portion of the gland, so urine can flow freely again. The outer shell of the prostate stays in place.
Medical Condition
TURP is used when an enlarged prostate causes urinary problems that do not improve with medication. The most common underlying diagnosis is benign prostatic hyperplasia (BPH), a non-cancerous growth of the prostate that tends to develop as men age.
- Benign prostatic hyperplasia (BPH) causing moderate to severe urinary symptoms.
- Urinary retention: the inability to empty the bladder fully or at all.
- Recurrent urinary tract infections linked to incomplete bladder emptying.
- Bladder stones that have formed because of poor urine flow.
- Kidney damage caused by long-term backpressure from a blocked bladder.
- Bleeding from the prostate that has not stopped with other treatments.
- BPH that has not responded adequately to medication or other minimally invasive procedures.
TURP is not suitable for every patient. Doctors usually consider other options in certain situations.
- Very small prostate glands, where less invasive office-based treatments may be preferred.
- Prostate cancer that has spread beyond the gland, because TURP addresses obstruction but is not a cancer cure.
- Patients with severe bleeding disorders or those on blood thinners who cannot safely stop them.
- Men who want to preserve the ability to father children naturally, as TURP commonly causes retrograde ejaculation (semen going into the bladder instead of out).
- Poor general health that makes any surgery under anaesthesia too risky.
Risks & Complications
Like all surgical procedures, TURP carries risks, though serious complications are uncommon and your surgical team will take steps to reduce them.
- Retrograde ejaculation: semen flows into the bladder during orgasm instead of out through the penis. This is very common after TURP and is permanent in most men. It does not affect sexual pleasure but does affect fertility.
- Urinary tract infection, a common short-term complication while the catheter (a thin drainage tube) is in place.
- Temporary difficulty controlling urination (urinary urgency or mild leakage), which usually settles within a few weeks.
- Bleeding during or after surgery, occasionally requiring a blood transfusion.
- TURP syndrome: a rare but serious condition in which the irrigation fluid used during surgery is absorbed into the bloodstream, causing confusion, low blood pressure, and salt imbalance. It is less common with modern techniques.
- Urethral stricture (scarring that narrows the urethra), which can develop weeks or months later and may need further treatment.
- Bladder neck contracture (scar tissue forming at the bladder outlet), another delayed complication.
- Erectile dysfunction (difficulty getting or keeping an erection), which is less common than retrograde ejaculation.
- Incomplete removal of tissue, meaning symptoms may return and a repeat procedure could be needed.
- Risks related to anaesthesia, including allergic reactions or breathing problems.
Preparation & Procedure
Preparation for TURP usually begins one to two weeks before the scheduled date. A urology team will review all current medications, because blood thinners and certain anti-inflammatory drugs need to be paused before surgery. Smoking reduces blood oxygen levels and slows healing, so doctors typically ask patients to stop well before the operation. Alcohol is also usually avoided in the days leading up to surgery.
Several tests are run in the weeks before surgery to confirm the diagnosis and make sure the patient is safe to operate on. These commonly include a urine flow test (uroflowmetry) to measure how well urine is passing, a bladder scan (post-void residual ultrasound) to check how much urine remains after voiding, blood tests to assess kidney function and blood counts, and sometimes a cystoscopy (a thin camera passed into the bladder) to view the prostate directly. An electrocardiogram (EKG) and chest X-ray may be requested for patients with heart or lung concerns.
On the day of surgery, patients are asked to fast, meaning no food or drink (including water) for a specified number of hours beforehand. Your medical team will give the exact fasting window based on the planned type of anaesthesia.
The procedure itself follows a predictable sequence, though the details can vary between hospitals and surgeons.
- The patient is taken to the operating room and connected to monitoring equipment.
- Anaesthesia is given. TURP is usually done under spinal anaesthesia (a numbing injection into the lower back that removes sensation below the waist) or general anaesthesia (fully asleep). The choice depends on the patient's health and the surgeon's assessment.
- Once anaesthesia is effective, the surgeon passes the resectoscope through the urethra and positions it within the prostate.
- Using the electrical loop at the tip of the instrument, the surgeon shaves away sections of the overgrown inner prostate tissue in a controlled way.
- Continuous irrigation fluid flushes the removed tissue fragments and any bleeding from the area throughout the procedure.
- When the resection is complete, a catheter is inserted through the urethra into the bladder to drain urine and irrigate the area during the initial recovery period.
- The patient is moved to a recovery area where vital signs and urine output are monitored as the anaesthesia wears off.
Aftercare
Most patients stay in the hospital for one to three days after TURP, though the exact length depends on how the recovery is going and which hospital protocols are followed. The urinary catheter usually remains in place for one to two days after surgery to keep the bladder drained while the urethra heals. Some blood-tinged urine is normal during this period.
- Catheter care: the nursing team manages the catheter in hospital; patients sent home with one receive instructions on keeping it clean and watching for signs of blockage or infection.
- Urine colour: expect pink or lightly blood-stained urine for several weeks. Bright red bleeding or large clots should prompt contact with the medical team.
- Physical activity: heavy lifting and strenuous exercise are usually restricted for four to six weeks while internal tissues heal.
- Driving: most surgeons advise against driving until the catheter is removed and pain is well controlled, often around one to two weeks after surgery.
- Return to work: desk-based work can often resume within two to four weeks; physical jobs take longer.
- Sexual activity: doctors usually recommend waiting four to six weeks before resuming sexual activity to allow healing.
- Bladder irritation symptoms: urgency, frequency, and mild burning during urination are common for several weeks and generally improve gradually.
- Fluid intake: drinking plenty of water each day helps flush the bladder and reduces infection risk. Your team will advise the appropriate amount.
- Follow-up: a clinic visit is usually scheduled within four to six weeks to check urine flow, review symptoms, and confirm that healing is on track. Further urology follow-up may be arranged depending on findings.
- Medications: a short course of antibiotics is typically prescribed to prevent infection. Your doctor may also recommend medication to ease bladder spasms in the early recovery phase.
Cost & What Determines It
The price of TURP varies widely depending on where it is performed, the complexity of the individual case, and what the hospital package includes. Two patients undergoing the same operation in different facilities, or even the same facility, can receive very different bills.
- Prostate size and complexity: a larger or more densely vascularised (heavily supplied with blood vessels) prostate takes longer to resect, adding to operating room and anaesthesia time.
- Hospital class and country: a private tertiary hospital in a major city will charge significantly more than a regional public facility, and prices differ substantially between countries in the region.
- Type of anaesthesia: spinal or general anaesthesia have different fee structures, and the involvement of an anaesthesiologist adds to the total.
- Length of hospital stay: an uncomplicated case may require only one night; complications can extend the stay by several days, increasing room and nursing charges.
- Technology used: bipolar TURP (a newer electrical technique that uses saline irrigation) typically costs more than standard monopolar TURP but may reduce certain risks in high-risk patients.
- Catheter and consumable supplies: the catheter, irrigation fluid, and single-use resectoscope components are billed separately in many hospitals.
- Pre-operative tests: uroflowmetry, ultrasound, blood panels, EKG, and cystoscopy each carry their own fees if not already covered.
- Post-operative medications: antibiotics, bladder-relaxing drugs, and pain relief prescribed after discharge are usually billed separately.
- Pathology: removed prostate tissue is routinely sent for laboratory analysis to rule out cancer; this test carries a separate laboratory fee.
Hospital packages for TURP often bundle the surgeon's fee, operating room use, anaesthesia, standard nursing care, and the hospital room for a set number of nights. Items that tend to be billed outside the package include pre-admission tests run in a separate clinic, the pathology report on the removed tissue, medications taken home at discharge, and any additional procedures needed if a complication arises.
Indonesian patients travelling abroad for TURP should be aware that BPJS Kesehatan does not cover treatment outside Indonesia, and most domestic insurance policies also exclude overseas care. The cost is usually paid out of pocket or through a private international health insurance plan that explicitly covers planned surgical treatment abroad. Before confirming any booking, ask the hospital for a written cost estimate that lists each component separately. This makes it easier to compare options and avoids unexpected charges on the day of discharge.
Frequently Asked Questions
How long does TURP surgery take?
TURP usually takes between 60 and 90 minutes, though the exact time depends on how enlarged the prostate is. The surgeon works through a thin tube passed into the urethra (the channel you urinate through), so there are no cuts on the skin. After the procedure, most patients stay in hospital for one to three days while a catheter (a small tube that drains urine) is in place.
Will I be awake during TURP, and how much will it hurt?
Most patients receive either a spinal block, which numbs the lower body while you stay awake, or a general anaesthetic that puts you fully to sleep. Your anaesthetist will choose the approach that suits your health best. During the operation you should feel no pain. Afterwards, a burning sensation around the urethra and some bladder discomfort are common for a few days, and the team will manage this with appropriate pain relief.
When can I go back to work after TURP?
Most men return to a desk job or light activity within four to six weeks. Jobs that involve heavy lifting or strenuous physical effort usually need a longer wait, and your surgeon will give you a personal timeline at your follow-up visit. For the first few weeks, avoiding anything that strains the lower abdomen helps the urethra heal properly.
How much does TURP surgery cost?
The cost of TURP varies depending on factors specific to your case, such as the size of the prostate, the surgical technique used, the class of hospital room you choose, and the length of your stay. Some patients also need additional investigations before the operation, which can affect the total. The most reliable way to get a real number is to request a written estimate directly from the hospital.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
