TURP Surgery in Germany

Overview

Transurethral Resection of the Prostate (TURP) is a minimally invasive surgical procedure in which a portion of the enlarged prostate gland is removed through the urethra. During the procedure, an instrument called a resectoscope is inserted through the penis and into the urethra to access the prostate. The resectoscope contains a wire loop that is used to trim away excess prostate tissue to relieve urinary obstruction.

Types

There are different variations of TURP surgery, including:

1. Standard TURP: The most common and traditional TURP procedure described above.
2. Laser TURP: Instead of using a wire loop, a laser is used to vaporize or enucleate the excess prostate tissue.
3. Bipolar TURP: In this technique, a bipolar current is used, which may reduce the risk of complications compared to traditional TURP.

Symptoms

Benign prostatic hyperplasia can lead to the following urinary symptoms:

1. Frequent urination, especially at night (nocturia).
2. Weak urine stream.
3. Difficulty starting urination.
4. Incomplete emptying of the bladder.
5. Urgency and the feeling of not being able to hold urine.
6. Urinary retention (inability to urinate).

Diagnosis

1. Diagnosis begins with a comprehensive medical history and physical examination.
2. Specific tests include digital rectal examination to assess prostate size and texture.
3. Urine analysis helps identify urinary tract infections and other abnormalities.
4. Prostate-specific antigen (PSA) blood test aids in ruling out prostate cancer.
5. Uroflowmetry measures the urine flow rate and detects urinary obstruction.
6. Additional evaluations may include ultrasound to visualize the prostate and surrounding structures.
7. Cystoscopy allows direct inspection of the urethra and bladder for any abnormalities.
8. A combination of test results helps determine the presence and severity of BPH.
9. Based on the diagnosis, the medical team decides whether TURP surgery is the appropriate treatment to alleviate BPH symptoms and improve urinary flow, leading to an enhanced quality of life.

Causes

Transurethral Resection of the Prostate (TURP) is a common surgical procedure used to treat benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland. While TURP is generally considered safe and effective, there are some potential causes and risk factors associated with the surgery:

1. BPH: TURP is primarily performed when BPH causes urinary symptoms like frequent urination, weak urine stream, or difficulty in starting and stopping urine flow.

2. Age: BPH is more common in older men, so TURP is often recommended for those whose symptoms do not improve with medications.

3. Complications of BPH: Severe cases of BPH can lead to complications such as recurrent urinary tract infections, bladder stones, or kidney damage, necessitating TURP.

4. Prostate Cancer Rule-out: In some cases, TURP is performed to rule out prostate cancer, as the symptoms of BPH and prostate cancer can overlap.

5. Urinary Retention: If BPH causes acute urinary retention (inability to urinate), emergency TURP may be required.

6. Unresponsive to Medications: When BPH symptoms do not respond well to medications or cause significant quality-of-life issues, TURP becomes a viable option.

7. Enlarged Prostate Size: The size of the prostate, as determined by imaging studies, may influence the decision to undergo TURP.

Risks

TURP is generally considered safe, but like any surgery, it carries some risks. Potential risks and complications may include:

1. Bleeding.
2. Infection.
3. Urinary incontinence (temporary or permanent).
4. Retrograde ejaculation (semen flowing backward into the bladder instead of out through the penis).
5. Erectile dysfunction (rare, but possible).
6. Bladder or urethral injury.
7. Transurethral resection syndrome (rare but serious condition involving fluid absorption during surgery).
8. Rarely, is the need for further surgery.

Purpose

• Relief from Enlarged Prostate Symptoms: TURP surgery is primarily performed to alleviate symptoms caused by an enlarged prostate, medically known as benign prostatic hyperplasia (BPH). BPH can lead to urinary problems, including frequent urination, weak urinary stream, and difficulty in starting or stopping urine flow.
• Improved Urinary Flow: By removing excess prostate tissue that obstructs the urethra, TURP surgery helps improve the urinary flow, making it easier for the patient to urinate.
• Resolving Urinary Retention: In cases of severe BPH, urinary retention can occur, making it difficult for patients to empty their bladder. TURP surgery can relieve this condition and restore normal bladder function.
• Treating Prostate Cancer: In some cases, TURP is used as a diagnostic and therapeutic procedure for early-stage prostate cancer. It helps in obtaining prostate tissue samples for biopsy and can also be used to treat localized cancer.
• Minimally Invasive Procedure: TURP is a minimally invasive surgery performed through the urethra, without the need for external incisions. This approach reduces recovery time and complications compared to traditional open surgery.
• Long-term Relief: TURP surgery often provides long-lasting relief from BPH symptoms, allowing patients to enjoy an improved quality of life and better urinary function.

Procedure and Recovery

• Performed under general or spinal anesthesia.
• Surgeon inserts a resectoscope through the urethra to access the prostate.
• The resectoscope's wire loop removes excess prostate tissue, which is flushed out through a urinary catheter.
• Electrocautery or laser is used to control bleeding.
• Hospital stay for a day or two may be required.
• Urinary catheter may be used temporarily.
• Discomfort and blood in urine are expected for a few days.
• Light activities can resume in 1-2 weeks, but avoid strenuous activities for several weeks.
• Full recovery in about 4-6 weeks.

Preparation

• Medical evaluation and history review.
• Adjust or stop blood-thinning medications.
• Fasting before surgery.
• Bowel preparation if required.
• Shower and maintain hygiene.
• Informed consent process.
• Anesthesia consultation.
• Arrange for a post-surgery caregiver.
• Follow preoperative instructions carefully.
• Discuss any concerns with the healthcare team.

TURP Surgery in Germany

Transurethral Resection of the Prostate (TURP) is a common surgical procedure performed in Germany to treat benign prostatic hyperplasia (BPH). During TURP, a urologist removes excess prostate tissue that obstructs the urethra, alleviating urinary symptoms. The surgery is typically conducted under anesthesia, using a thin tube with a cutting instrument to resect the prostate tissue through the urethra. TURP is considered a safe and effective treatment for BPH, with a high success rate in improving urinary flow and reducing bothersome symptoms. However, like any surgery, it carries potential risks and side effects, such as bleeding, infection, retrograde ejaculation, and urinary incontinence. The cost of TURP surgery in Germany can vary depending on several factors, and interested individuals should consult with healthcare providers for precise information.

Cost in Germany

The cost of Transurethral Resection of the Prostate (TURP) surgery in Germany typically ranges from $4,500 to $6,500 USD. This procedure is commonly used to treat benign prostatic hyperplasia (BPH) and alleviate urinary symptoms in men. The variation in cost is influenced by factors such as the hospital's reputation, the surgeon's experience, and the complexity of the case. Despite the costs, patients can expect high-quality medical care, advanced facilities, and experienced healthcare professionals in Germany, making it a sought-after destination for those seeking TURP surgery.

Side Effects

• Bleeding: During and after the surgery, there may be some bleeding, which is usually temporary and resolves on its own.
• Infection: There is a risk of infection, although precautions are taken to minimize this risk.
• Urinary incontinence: Some patients may experience temporary or permanent urinary incontinence after the procedure, but this is relatively uncommon.
• Retrograde ejaculation: In some cases, TURP can lead to semen flowing backward into the bladder instead of out through the penis during ejaculation. This is known as retrograde ejaculation and is generally not harmful but may affect fertility.
• Erectile dysfunction: While TURP is not designed to treat erectile dysfunction, there is a small risk of it occurring after the surgery.
• Stricture: In rare cases, scar tissue may form in the urethra, leading to a stricture, which can cause difficulty in urination.

Success Rate

Transurethral Resection of the Prostate (TURP) is a well-established surgical procedure to alleviate urinary symptoms caused by an enlarged prostate gland. The success rate of TURP surgery is generally high, with over 90% of patients experiencing significant improvement in urinary flow and relief from bothersome symptoms like frequent urination and difficulty voiding. However, individual outcomes can vary based on the patient's overall health, the extent of prostate enlargement, and any associated medical conditions. Complications are infrequent but may include bleeding or infection. Overall, TURP remains a highly effective and safe treatment option for benign prostatic hyperplasia (BPH) and is considered a gold standard for surgical intervention.

Top Hospitals in Germany

1. Charité – Universitätsmedizin Berlin
2. Universitätsklinikum Heidelberg
3. Universitätsklinikum Freiburg
4. Medizinische Hochschule Hannover
5. Klinikum Stuttgart