Complications possible with TURP

Dear Dr. Roach: I’m an 80-year-old male who learned from a much younger male about the tremendous improvement he’s had in his life since undergoing a TURP (transurethral resection of the prostate) procedure.

I hadn’t know he was having a problem and had been through the drug routine that was providing him with limited improvement.

Against my aversion of being operated upon, he subsequently convinced me to investigate, and ultimately have the operation.

That was a few months ago, and I have subsequently introduced the idea to many other males, or their wives, none of who had heard about the simple, overnight operation.

The benefit of the drug therapy, which left me with persistent symptoms of not being able to urinate for a long time (as long as 10 to 15 minutes), was insignificant relative to the result of the TURP operation, which had greatly improved both of those problems, with the nighttime call to the bathroom now taking closer to a minute.

There must be many more males, and their wives, who would benefit from knowing that the operation is simple and effective.

M.M.

Answer: I am very glad you had such good results after your surgery.

I have had several letters like yours, wondering why I don’t recommend TURP (or other surgical procedures: there are many, including those that use cold, microwave or laser energy to remove prostate tissue) as first-line treatment.

The answer is that I get still other letters about, and have also seen in my own patients, the unusual (but not rare) complications men can get from TURP surgery.

One man, who had bleeding and spasm after surgery, wrote me: “You have never once advised your readers that serious complications can and do occur after this type of surgery. I hope you will print this letter so men who are thinking about getting this surgery will ask their urologists about possible complications that can happen after getting this surgery. Bladder spasms are extremely painful and recur steadily until the bleeding is stopped. I believe that I would rather lead an attack on hell itself with a bucket of ice water than go through this procedure again.”

In my experience with men with symptomatic enlargement of the prostate, most men do get adequate relief from medications, usually without untoward side effects.

There are absolutely men who get inadequate relief or who get side effects from medication that make the cure worse than the disease.

In those situations, TURP or similar surgery is worth considering if a man understands that there are indeed bad outcomes — such as those that afflicted the man I mentioned before — and is still willing to take the risk.

It’s a hard lesson to learn in medicine that what works amazingly well for one person doesn’t work at all well for another, even if they seem to have exactly the same problem and might be similar in many other ways.