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Asian Healthcare Specialist
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+65‎ 6334‎ 1486
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TURP Surgery in Singapore

If you’re experiencing bothersome urinary symptoms due to an enlarged prostate, you’re not alone. This is a common concern that can affect sleep, daily activities, and quality of life.

Transurethral Resection of the Prostate (TURP) surgery has been helping men manage urinary function for decades, offering relief from the symptoms of benign prostatic hyperplasia (BPH).

This established surgical procedure is a treatment option for moderate to severe prostate enlargement that may help improve symptoms for suitable candidates. Individual results and timelines may vary.

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Dr. Nor Azhari Bin Mohd Zam

MBBS (NUS)|MRCS (Edin.)|MMed Surgery (NUS)|FAMS (Urology)

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surgeon cleaning scalpel in surgery room 2024 11 17 12 40 56 utc TURP Surgery in Singapore
Suitability Techniques Process Recovery Benefits Risks Cost FAQ Conclusion
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Suitability
Techniques
Process
Recovery
Benefits
Risks
Cost
FAQ
Conclusion

What is TURP Surgery?

TURP is a minimally invasive surgical procedure that may help treat urinary problems caused by an enlarged prostate. During TURP surgery, excess prostate tissue that blocks urine flow is removed using a surgical instrument inserted through the urethra or urine passage, eliminating the need for external incisions.

The procedure addresses benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland that commonly affects older men. As the prostate enlarges, it compresses the urethra and can obstruct the bladder outlet, potentially leading to various urinary symptoms. TURP works by creating a wider channel through the prostate, allowing urine to flow more freely from the bladder.

This surgical approach has been performed for many decades and is recognised as an established treatment option for moderate to severe BPH symptoms. The procedure may improve urinary flow rates and symptom scores. While newer technologies have emerged, TURP remains a practical option for specific prostate sizes. This treatment is administered as part of a comprehensive plan supervised by a urologist.

Who is a Suitable Candidate?

Ideal Candidates

Ideal Candidates

  • Men with moderate to severe BPH symptoms that may impact quality of life
  • Patients who have not responded adequately to medical therapy
  • Those experiencing recurrent urinary tract infections due to incomplete bladder emptying
  • Men with bladder stones caused by chronic urinary retention
  • Patients with persistent blood in urine (haematuria) related to an enlarged prostate
  • Those with kidney function deterioration due to bladder outlet obstruction
  • Men unable to tolerate or unwilling to continue long-term medication
  • Patients with acute or chronic urinary retention requiring catheterisation
Contraindications

Contraindications

  • Active urinary tract infection (must be treated first)
  • Uncorrected bleeding disorders or coagulopathy
  • Severe cardiovascular disease makes anaesthesia high-risk
  • Neurogenic bladder dysfunction unrelated to BPH
  • Suspected or confirmed prostate cancer requiring different treatment
  • Previous pelvic radiation therapy affecting tissue healing
  • Urethral strictures preventing instrument passage

A thorough evaluation by Dr Azhari is necessary to determine candidacy for TURP surgery. This assessment includes reviewing your medical history, performing a physical examination, and ordering diagnostic tests to determine whether the procedure is appropriate for your condition.

Treatment Techniques & Approaches

  • Monopolar TURP

    Monopolar TURP represents a traditional approach to prostate resection, using electrical current that passes through the body to remove prostate tissue. This technique employs a wire loop heated by electrical energy to cut and cauterise tissue simultaneously. The procedure requires irrigation with a non-conductive glycine solution, which allows visualisation while the electrical current is applied. Monopolar TURP has been used in medical practice and remains available in many medical centres.

  • Bipolar TURP

    Bipolar TURP utilises technology where electrical current flows between two electrodes on the resectoscope itself, rather than through the patient’s body. This technique allows the use of regular saline irrigation instead of glycine, which may reduce the risk of TUR syndrome (a rare but serious complication). Bipolar technology may enable haemostasis (bleeding control) and can allow treatment of larger prostates. This technique may be considered for patients with certain medical conditions.

  • Technology & Equipment Used

    Modern TURP procedures employ resectoscopes equipped with camera systems for visualisation. The instruments feature cutting loops and continuous irrigation systems to maintain surgical fields. Electrosurgical generators provide controlled energy delivery for tissue removal and coagulation. Some centres utilise video monitoring systems that allow the surgical team to observe the procedure.

Wondering which approach might be suitable for you?

Dr Azhari can evaluate your specific needs and discuss the available techniques.

Schedule Consultation

The Treatment Process

Pre-Treatment Preparation

Before TURP surgery, you may undergo comprehensive testing, including blood tests, urine analysis, and possibly imaging studies. Your urologist may review all medications, particularly blood thinners, which may need to be temporarily discontinued. Antibiotics may be prescribed to start before surgery to help prevent infection. You’ll receive instructions to fast from midnight before the procedure. Arrange for someone to drive you home and assist you for the first period post-surgery. Pre-admission testing may include an ECG and chest X-ray for older patients or those with cardiac conditions.

During the Procedure

TURP surgery typically takes a specific duration, depending on prostate size. After spinal or general anaesthesia administration, you’ll be positioned for optimal surgical access. The urologist inserts the resectoscope through the urethra to reach the prostate. Using the heated wire loop, the urologist systematically removes obstructing tissue in small chips. These tissue fragments are irrigated out and collected for pathological examination. Throughout the procedure, bleeding points are carefully cauterised. Once adequate tissue removal is achieved, the resectoscope is removed, and a urinary catheter is inserted for post-operative drainage.

Immediate Post-Treatment

Following surgery, you’ll recover in a monitored area while anaesthesia wears off. The urinary catheter remains in place with continuous bladder irrigation to help prevent blood clots. Mild discomfort and bladder spasms may occur and can be managed with appropriate medications. Patients typically stay in the hospital for a period of time. Your medical team monitors urine output and clarity, gradually reducing irrigation as bleeding decreases. Before discharge, you’ll receive detailed instructions about catheter care, medications, and warning signs to monitor.

Recovery & Aftercare

First 24-48 Hours

During the initial recovery period, expect blood-tinged urine, which is normal. The catheter may remain for a period while healing begins. Pain is usually minimal and may be managed with oral medications. Drink plenty of water to maintain good urine flow and prevent clot formation. Avoid straining during bowel movements; stool softeners may be prescribed. Walking is encouraged to prevent blood clots, but avoid strenuous activity. Your medical team can monitor for signs of infection or excessive bleeding.

First Week

After catheter removal, you may experience temporary urinary frequency, urgency, and mild burning during urination. These symptoms may gradually improve as healing progresses. Continue drinking adequate fluids daily unless medically restricted. Light activities and short walks are beneficial, but avoid heavy lifting, vigorous exercise, and sexual activity. Some blood in the urine may appear intermittently, especially with activity. Take prescribed medications as directed, including any antibiotics. Attend your scheduled follow-up assessment appointment.

Long-term Recovery

Complete healing may occur over time. Return-to-work timing depends on individual circumstances and job requirements. Avoid vigorous activities, heavy lifting, and strenuous exercise as advised by your urologist. Sexual activity timing could be discussed with your urologist, though retrograde ejaculation (semen entering the bladder) can occur. Continue regular follow-up appointments to monitor your progress.

Dr Azhari provides comprehensive post-procedure support to help with recovery.

Schedule your consultation to learn more about what to expect.

Schedule Consultation

Benefits of TURP Surgery

TURP surgery may help improve urinary function for men with enlarged prostates. Patients may experience improved urine flow following the procedure. Frequent nighttime urination that disrupts sleep may decrease. The urgent need to urinate and difficulty starting urination may improve for some men.

Quality-of-life improvements may extend beyond urinary symptoms. Improved sleep can lead to increased daytime energy and concentration. Men may experience renewed confidence in social situations. Reducing urinary retention may help reduce infection risk and support kidney function. Some patients may be able to discontinue BPH medications following consultation with their urologist.

TURP aims to provide symptom relief for suitable candidates. Unlike medications that require daily compliance, TURP is a one-time procedure. The procedure is the gold standard for BPH surgery.

Risks & Potential Complications

Common Side Effects

Temporary bleeding in urine may occur, typically resolving over time. Mild burning during urination and increased frequency may appear initially. Retrograde ejaculation may affect men, where semen enters the bladder during orgasm rather than exiting through the penis. This doesn’t affect hormone production or sensation but may impact fertility. Temporary urgency and mild incontinence may occur but usually resolve over time. Some men may experience temporary difficulty achieving erections, though this typically improves with healing.

Rare Complications

Severe bleeding requiring transfusion may occur in some cases. Urinary tract infections may persist despite antibiotic prophylaxis in some patients. TUR syndrome, a severe electrolyte imbalance, is rare with modern techniques. Urethral stricture or bladder neck contracture may develop months later in some cases. Complete urinary incontinence is rare. Perforation of the bladder or prostate capsule may occur.

These risks are minimised through careful patient selection, modern surgical techniques, and experienced medical care. Your urologist may discuss your individual risk profile during consultation.

Cost Considerations

TURP surgery costs in Singapore vary depending on the hospital, room type, and the urologist’s fees. The total expense includes pre-operative assessments, surgical fees, anaesthesia charges, hospital stay, and post-operative care. Private hospitals typically cost more than restructured hospitals.

The cost covers comprehensive care from consultation through recovery, including diagnostic tests, the surgical procedure, medications, nursing care, and follow-up appointments. TURP may help reduce ongoing medication expenses over time.

Your healthcare facility can provide detailed cost estimates during consultation. Payment options and instalment plans may be available. Consider the value of experienced surgical care and established facilities when making your decision.

Frequently Asked Questions

How long does TURP surgery take to perform?

TURP surgery may take approximately 60-90 minutes, though this can vary based on prostate size and complexity. Larger prostates or those with unusual anatomy might require additional time. The entire hospital experience, including preparation and recovery, usually lasts 1-2 days. Your urologist can provide a more accurate estimate after examining your specific condition during consultation.

When can I return to normal activities after TURP?

Many men may resume light activities and desk work within 2 weeks after TURP surgery. Driving is usually possible once you’re comfortable and off strong pain medications, often after 1-2 weeks. Strenuous exercise, heavy lifting, and vigorous activities may need to be avoided for 4-6 weeks to allow proper healing. Sexual activity can generally resume after 4-6 weeks, following your urologist’s specific guidance.

Will TURP surgery affect my sexual function?

TURP may cause retrograde ejaculation, where semen enters the bladder instead of exiting normally. This doesn’t affect orgasm sensation or hormone levels but can impact fertility. Many men maintain their ability to achieve erections, though temporary difficulties may occur during healing. Long-term erectile dysfunction directly caused by TURP is possible but rare.

How long do the results of TURP surgery last?

TURP aims to provide long-lasting results, with many men experiencing sustained symptom relief for years. Some prostate regrowth may occur over time, and repeat surgery may be needed in some cases. Factors affecting durability include initial prostate size, age at surgery, and individual healing patterns. Regular follow-up helps monitor long-term outcomes.

Is TURP surgery painful?

TURP surgery is performed under spinal or general anaesthesia, making sure there is no pain during the procedure. Post-operative discomfort is often mild to moderate and can be managed with oral pain medications. Many patients describe bladder spasms and mild burning during urination rather than significant pain. Discomfort usually decreases substantially within the first week.

What’s the difference between TURP and laser prostate surgery?

TURP removes prostate tissue using electrical energy through a wire loop, while laser procedures vaporise or enucleate tissue using laser energy. TURP has longer follow-up data and can be effective for moderate-sized prostates. Laser procedures may offer reduced bleeding and shorter catheter time, but can be more expensive. Both can achieve similar long-term outcomes for suitable candidates. Your urologist can recommend the most appropriate option based on your specific situation.

Can TURP surgery be repeated if needed?

Yes, TURP can be repeated if symptoms recur years later due to prostate regrowth. Repeat procedures are technically feasible, though they may be more challenging due to scar tissue. Repeat TURP can remain effective, though alternative treatments might be considered depending on individual circumstances. Some men may require repeat surgery over time.

Conclusion

TURP surgery is an established procedure for men with moderate to severe enlarged prostate symptoms. This procedure aims to provide relief from urinary difficulties that may impact daily life. The minimally invasive approach, combined with modern surgical techniques, can offer an effective treatment option for suitable candidates. If BPH symptoms are affecting your quality of life despite medical therapy, TURP surgery may be a treatment option to consider.

Ready to Take the Next Step?

If you’re considering TURP surgery, Dr Azhari can help you understand if it’s a suitable option for your needs. With experience in TURP procedures, we provide personalised care throughout your journey.

Book Your Consultation Today
Dr. Nor Azhari Bin Mohd Zam

Dr. Nor Azhari Bin Mohd Zam

MBBS (NUS)|MRCS (Edin.)|MMed Surgery (NUS)|FAMS (Urology)

With more than 15 years experience as a certified Urologist, Dr Nor Azhari specializes in treating a wide range of kidney, bladder and prostate conditions as well as disorders of the male reproductive organs.

He offers minimally invasive treatment options and provides same-day appointments for convenience.

  • Skilled urologist and kidney stone surgeon.
  • Director of Endourology (Urinary stone service) at Singapore General Hospital – 2016 to 2023.
  • Recognized with the College of Surgeons Gold Medal and Singapore Urological Association Book prize.
  • Minimally invasive treatment options available (non-invasive and endoscopic/key-hole techniques).
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