Ask the Doctor: ‘My husband is suffering with transurethral resection of the prostate — how do we address it?’

”My husband underwent a TURP procedure 10 years ago, but his symptoms are back and worse than ever. He hated the recovery process after the procedure, and is now putting off going back to his consultant. How can I encourage him to stop avoiding getting seen and address this?”

Answer from Dr. Michel de Wildt, Consultant Urological Surgeon in Beacon Hospital.

I understand your concern about your husband’s symptoms returning and his hesitation to see a consultant again after his previous TURP procedure. However, I fully agree with you that your husband needs to be supported and encouraged to go back to his consultant and to have it investigated.

To briefly discuss the TURP procedure he had in the past: TURP stands for Transurethral Resection of the Prostate, which is a surgical treatment for an enlarged prostate gland. The procedure aims to relieve symptoms such as difficulty urinating, frequent urination, weak urine flow, and incomplete bladder emptying. Unfortunately, in the years following a TURP, a significant number of men may have persistent or recurrent urinary symptoms in up to 35% of men.

Medical advancements have taken place over the past decade. Fortunately, now in Ireland, a new alternative surgical treatment is available that is less invasive or has improved recovery time compared to his previous experience. This Holmium Laser Enucleation of the Prostate (or HoLEP), completely removes the obstructive part of the prostate and is considered the most beneficial surgical solution.

There can be several reasons why your husband has recurrent urinary symptoms now: Over time, the prostate can continue to grow, leading to a recurrence of symptoms. Sometimes the bladder function has decreased and is no longer able to empty the bladder. Rarely complications of the surgery can occur: an obstruction of the tube he urinates through or an obstruction at the level of the bladder neck can cause the recurrent symptoms.

By avoiding a consultation, your husband is potentially delaying the diagnosis and appropriate treatment of his current condition and may lead to further complications and impact his quality of life. It’s important for him to understand that seeking medical attention can help identify the underlying cause of his symptoms and allow for appropriate treatment options to be explored.

By consulting a urologist, your husband can receive up-to-date information about potential treatment options that may suit his needs and preferences better.

For the last three years, Beacon has offered the novel HoLEP surgical procedure with minimal side effects and significantly shorter recovery time and hardly any blood loss during and after surgery. After HoLEP surgery, the majority of patients can have their (post-operative) bladder catheter removed the next day and they can be discharged then as well. The postoperative complaints are less than seen after TURP. Long term results of HoLEP are more permanent than after TURP and re-growth of the prostate does not occur.

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