MR. RAYMOND TONG Urological Surgeon
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Urology consultations at the following locations
 
Suite 8.6, Level 8, Bridge Rd Tower,
Epworth Hospital, 89 Bridge Rd. Richmond VIC 3121
(Main rooms)

Suite 20, Level 3, Epworth Eastern Medical Centre,
1 Arnold St. Box Hill VIC 3128

7/307 Ballarat Rd. Footscray VIC 3101

Knox Private Hospital Consulting Suites, 262 Mountain Hwy, Wantirna VIC 3152




Archive

 

TRANSURETHRAL RESECTION OF PROSTATE (TURP)

(Also known as a REBORE of the prostate)





 

MAIN PURPOSE :  to hollow out the prostate in order to improve urine flow and bladder emptying

 

In turn this should decrease the urgency and frequency to go to the toilet during the day and night.   There is a period of time for the bladder to adjust.

 

OPERATIVE TIME : It takes about one hour

 

TYPE OF ANAESTHETIC : General or Spinal Anaesthetic

 

LENGTH OF STAY: usually 2 nights

 

-        First night will be with a catheter in the penis to drain blood and wash out the bladder.

-        The catheter is usually removed the second night in hospital and you will be kept in hospital until the urine flow and bladder emptying is satisfactory (usually around noon).

 

PAIN POST SURGERY : is usually minimal but patient may feel like they need to pass urine or use bowels because of the catheter tube (best to try relax and ignore the false signals).

 


WHAT CAN HAPPEN AFTER SURGERY?

 

COMMON

-        Bleeding (usually intermittent for at least 2 weeks)

-        Post operative urgency (the bladder still thinks it has to push vigorously against the obstructing prostate to pass urine – approx. 6 weeks)

-        Dry ejaculation

-        Mild Burning on voiding

 

UNCOMMON

-       Infection

-        May still have problems emptying bladder because of poor bladder contraction.

-        Scar tissue in the penis tube (urethra)

-        Regrowth of prostate (if occurs usually after 10 years)

 

RARE

-        Leakage of urine (from strenuous activity)

-        Decrease erections

-        Bleeding requiring transfusion or return to theatre

 

DRUGS GIVEN IN HOSPITAL and DISCHARGE

 

1.      Laxatives (Lactulose, Coloxyl & Senna): to prevent constipation and straining which can lead to acute and prolonged bleeding post surgery.

 

2.      Antibiotic s: to prevent or treat infection.   They may sometimes cause a stomach upset or diarrhoea.   Take probiotic yogurt or Yakult at the same time.

 

3.      Lignocaine gel : Local anaesthetic gel to decrease irritation from the catheter at the tip of the penis.

 

4.      Ditropan (oxybutynin) or Oxytrol patch : These medications work on the bladder to decrease its sensitivity and hyperactivity.   Required because initially post surgery, the bladder may still think it has to push vigorous against the prostate obstruction which has been removed by the surgery.

 

These drugs can cause dry mouth, eye, skin; constipation, skin rash (patch).   It can sometimes decrease the contraction of the bladder and make it difficult to void.

 

       5.   Ural: decreases urine acidity to decrease burning on voiding.

 

 

WHAT TO DO AFTER DISCHARGE

 

-        No lifting, strenuous activity, exercise or straining for bowels for at least two weeks post op.

 

-        Avoid drinking caffeine drinks (coffee, tea,) and alcohol as they can stimulate the bladder and produce urgency.

 

-        Drink slowly and with food.   Drink about 1.5L of water a day – Don’t over drink.

 

-        No sexual activity for about 4 to 6 weeks.

 

-        Try to hold on for 2 to 3 hours between voids so the bladder is full first.   This will allow the bladder to fill so a proper flow can be achieved.   Initially post op urinary urgency and frequency can lead to a poor flow simply because there is not much to pass.

 

Be aware of sub-conscious urges to go to the toilet even though bladder is not full.  

 

Eg. Hearing running water, washing hands, watering garden, washing dishes,   Strong urges to void as you physically get closer to home or to the bathroom.

 

-        Withhold blood thinners and fish oil tablets until instructed by Dr. Tong (usually between 1 to 2 weeks post op)

 

 

PLEASE NOTE OCCASSIONALLY ABOUT 4 TO 6 WEEKS POST OP WHEN THE BLEEDING HAS ALL SETTLED, THERE CAN BE SUDDEN SHORT TERM RECURRENCE OF BLEEDING WHEN THE SCAB INSIDE THE PROSTATE (WHERE WE OPERATED) SHEDS OFF.  

 

IF THIS HAPPENS PLEASE REST, WITHHOLD ANY BLOOD THINNERS AND DRINK PLENTY OF WATER AS THIS SHOULD SETTLE BY ITSELF WITHIN 24 HOURS.

 

 

 

 

POST OP REVIEW WITH DR TONG IS IN ABOUT 6 TO 8 WEEKS.