What is Transurethral Resection of the Prostate (TURP)?

For many men, particularly as they age, the prostate gland, a small gland located just below the bladder, begins to enlarge. This common condition is known as Benign Prostatic Hyperplasia (BPH). While benign, meaning non-cancerous, an enlarged prostate can significantly impact a man's quality of life by pressing on the urethra, the tube that carries urine from the bladder out of the body. This compression can lead to a range of uncomfortable and disruptive urinary symptoms.

In the landscape of urological treatments in India and globally, Transurethral Resection of the Prostate (TURP) stands as a foundational and highly effective surgical procedure for managing BPH. Often referred to as the "gold standard" for surgical treatment of moderate to severe BPH, TURP has decades of proven success in alleviating urinary obstruction and restoring normal urinary function. Despite the emergence of newer, often laser-based techniques, TURP continues to be a widely practiced and preferred option for many urologists and patients across India due to its established efficacy, predictable outcomes, and cost-effectiveness.

Essentially, TURP is a minimally invasive procedure designed to remove excess prostate tissue that is blocking the urethra. It is performed without external incisions, accessing the prostate through the natural urinary opening. This intricate procedure addresses the root cause of BPH symptoms by carving out the obstructive tissue, thereby widening the urinary channel and allowing urine to flow freely. For countless men struggling with the daily challenges of BPH, TURP offers a pathway to significant symptom relief and an improved quality of life. Understanding TURP – its purpose, procedure, potential benefits, risks, and the practicalities of undergoing it in India – is crucial for anyone considering this important medical intervention.

Why is Transurethral Resection of the Prostate (TURP) Performed?

The primary objective of Transurethral Resection of the Prostate (TURP) is to alleviate the disruptive and often debilitating lower urinary tract symptoms (LUTS) that arise from benign prostatic hyperplasia (BPH). When the enlarged prostate gland obstructs the urethra, it creates a bottleneck, making it difficult for the bladder to empty efficiently. While medications can help manage these symptoms for some, TURP becomes a necessary and highly effective solution when conservative treatments fail to provide adequate relief or when complications arise.

The decision to proceed with TURP is typically made after a thorough evaluation of the patient's symptoms, overall health, and the impact BPH has on their daily life. It is indicated for moderate to severe LUTS that have not responded sufficiently to pharmacological interventions.

Key indications for considering TURP include:

• Frequent and Urgent Need to Urinate, Including Increased Nighttime Urination (Nocturia): This is one of the most common and bothersome symptoms. Patients may find themselves needing to urinate every hour or two, both day and night, severely disrupting sleep patterns and daily routines. The urgency can be so intense that it causes anxiety and limits social activities. TURP helps by removing the obstruction that irritates the bladder and prevents complete emptying, thereby reducing the frequency and urgency.
• Difficulty Initiating Urination or a Slow, Intermittent, or Weak Urine Stream: Men with BPH often report a hesitant stream, meaning they have to strain to start urinating. The stream itself may be weak, stop and start (intermittency), or dribble, taking a long time to empty the bladder. This indicates significant obstruction, and TURP aims to clear this pathway, restoring a strong, steady urine flow.
• The Sensation of Incomplete Bladder Emptying: Even after urinating, many men with BPH feel as though their bladder hasn't fully emptied. This sensation is often accurate, as residual urine can remain in the bladder due to the obstruction. This not only contributes to frequent urination but also increases the risk of complications. TURP addresses this by allowing complete bladder drainage.
• Recurrent Urinary Tract Infections (UTIs): Residual urine in the bladder creates a fertile breeding ground for bacteria, leading to repeated UTIs. These infections can be painful and, if left untreated, can potentially spread to the kidneys. By enabling complete bladder emptying, TURP significantly reduces the risk of recurrent UTIs.
• Acute Urinary Retention: This is a medical emergency where a man suddenly becomes unable to urinate at all, despite having a full bladder. It is extremely painful and requires immediate catheterization to drain the urine. For individuals who experience acute urinary retention, TURP is often recommended to prevent future episodes by removing the underlying obstruction.
• Kidney or Bladder Damage Due to Obstruction: Chronic, severe obstruction from BPH can lead to long-term damage to the bladder and kidneys. The bladder wall can thicken and become overactive or, conversely, lose its tone and ability to contract effectively. Backpressure from urine retention can also affect kidney function, potentially leading to hydronephrosis (swelling of the kidneys) and, in severe cases, kidney failure. TURP is critical in preventing or reversing such damage.
• Bladder Stones: When urine stagnates in the bladder due to incomplete emptying, minerals can crystallize and form bladder stones. These stones can cause pain, bleeding, and further obstruction. TURP not only removes the prostate obstruction but also allows for the removal of existing bladder stones, preventing their recurrence.
• Blood in the Urine (Hematuria): While hematuria can be a symptom of various conditions, in the context of BPH, it can occur when enlarged prostate blood vessels rupture, or due to irritation from bladder stones or severe inflammation. If other serious causes are ruled out, TURP can resolve hematuria related to BPH by removing the problematic tissue.

In essence, TURP is a therapeutic intervention designed to restore anatomical and functional normality to the lower urinary tract when BPH has become a significant health concern, profoundly improving a man's quality of life and preventing more serious complications.

Preparation for Transurethral Resection of the Prostate (TURP)

Thorough preparation is a cornerstone of any successful surgical procedure, and Transurethral Resection of the Prostate (TURP) is no exception. A comprehensive pre-operative assessment ensures patient safety, minimizes risks, and optimizes the chances of a positive outcome. This preparatory phase involves a series of consultations, diagnostic tests, and specific instructions tailored to the individual patient's health profile.

Key steps in preparing for TURP include:

• Consultation and Medical History:

  • Detailed Discussion: Your urologist will sit down with you to explain the TURP procedure in detail, including its benefits, potential risks, and expected recovery process. This is your opportunity to ask any questions and express concerns.
  • Medical History Review: The doctor will meticulously review your complete medical history, including any pre-existing conditions such as heart disease, diabetes, hypertension, lung disorders, or neurological conditions. Information about previous surgeries, hospitalizations, and family medical history will also be collected.
  • Medication Reconciliation: A comprehensive list of all medications you are currently taking, including prescription drugs, over-the-counter medications, herbal supplements, vitamins, and natural remedies, will be documented. This is crucial for identifying potential interactions or medications that need to be adjusted or stopped before surgery.

• Physical Examination and Diagnostic Tests:

  • General Physical Exam: To assess your overall health status.
  • Digital Rectal Examination (DRE): The urologist will perform a DRE to manually feel the prostate gland through the rectum, assessing its size, shape, and consistency, and ruling out suspicious areas that might indicate prostate cancer.
  • Blood Tests:
    • Complete Blood Count (CBC): To check for anemia or infection.
    • Kidney Function Tests (KFT) and Liver Function Tests (LFT): To assess organ health and ensure they can handle anesthesia and recovery.
    • Electrolyte Levels: To check for imbalances.
    • Coagulation Profile (PT/INR, aPTT): To assess blood clotting ability, especially important before surgery.
    • Prostate-Specific Antigen (PSA): A blood test to screen for prostate cancer. While BPH is non-cancerous, a high PSA level may warrant further investigation (e.g., biopsy) before TURP.
    • Blood Grouping and Cross-matching: In case a blood transfusion is needed, though rare.
  • Urine Tests:
    • Urinalysis: To check for signs of infection, blood, or other abnormalities.
    • Urine Culture and Sensitivity: If an infection is suspected, this identifies the specific bacteria and the most effective antibiotics. Prophylactic antibiotics may be prescribed even without infection.
  • Imaging Studies:
    • Ultrasound of the Kidneys, Ureters, and Bladder (KUB): To visualize the size of the prostate, the volume of urine remaining in the bladder after urination (post-void residual), and to check for kidney swelling (hydronephrosis) or bladder stones.
    • MRI or CT Scan: May be ordered in complex cases for more detailed anatomical information.
    • Voiding Cystourethrography (VCUG): Can be used to evaluate bladder and urethral function during urination.
  • Uroflowmetry and Post-Void Residual (PVR):
    • Uroflowmetry: A non-invasive test where you urinate into a special device that measures the speed and volume of your urine flow. This helps quantify the degree of obstruction.
    • PVR: Measures how much urine remains in your bladder immediately after you urinate, indicating bladder emptying efficiency.
  • Cystoscopy: A procedure where a thin, flexible tube with a camera (cystoscope) is inserted into the urethra to directly visualize the urethra, prostate, and bladder. This allows the surgeon to assess the size and configuration of the prostate lobes, the degree of obstruction, and rule out other bladder pathologies.
  • Electrocardiogram (ECG) and Chest X-ray: To assess heart and lung health, particularly for older patients or those with pre-existing cardiac or respiratory conditions.

• Medication Review and Adjustment:

  • Blood-Thinning Medications: This is perhaps the most critical instruction. You will be advised to stop taking blood-thinning medications several days to weeks before surgery to minimize the risk of bleeding. This includes:
    • Aspirin and NSAIDs (ibuprofen, naproxen sodium)
    • Anticoagulants (warfarin, dabigatran, rivaroxaban, apixaban)
    • Antiplatelet drugs (clopidogrel, ticagrelor)
    • Certain supplements like Vitamin E, fish oil, and ginkgo biloba, which also have blood-thinning properties.
    • Your doctor will provide a specific timeline for discontinuing these, often in consultation with the prescribing physician if you are on them for a cardiac condition.
  • Diabetes Medications: If you have diabetes, your doctor will provide instructions on adjusting your insulin or oral diabetic medications, especially regarding fasting.
  • Other Medications: Discuss all other medications with your doctor to determine if any need to be paused or adjusted.

• Fasting: You will typically be required to avoid eating or drinking (NPO - nil per os) for at least 6-8 hours before the procedure. This is crucial to prevent aspiration (inhaling stomach contents into the lungs) during anesthesia.

• Allergies: It is imperative to inform your doctor about any known allergies to medications (including antibiotics, pain relievers), latex, contrast dyes, or anesthesia agents.

• Prophylactic Antibiotics: To minimize the risk of post-operative urinary tract infection, you may be prescribed a course of antibiotics to start before or on the day of the surgery.

• Personal Hygiene: You may be asked to shower with an antiseptic soap the night before or the morning of surgery to reduce skin bacteria.

• Logistics: Arrange for transportation to and from the hospital, and ensure you have someone to assist you during the initial recovery period at home.

Adhering strictly to these pre-operative instructions is vital for a safe and effective TURP procedure, setting the stage for a smoother recovery and optimal long-term results.

The Transurethral Resection of the Prostate (TURP) Procedure

Transurethral Resection of the Prostate (TURP) is a sophisticated surgical procedure performed with remarkable precision, designed to alleviate urinary symptoms caused by an enlarged prostate without the need for external incisions. It is a testament to minimally invasive surgical techniques, focusing on internal access and targeted tissue removal. The procedure typically takes about 60 to 90 minutes, depending on the size of the prostate and the complexity of the case.

Here's a detailed breakdown of the TURP procedure:

1. Anesthesia: The first step involves administering anesthesia to ensure your comfort and prevent pain during the surgery. There are typically two main options:

   • Spinal Anesthesia: This is a common choice for TURP. An anesthetic agent is injected into the space around your spinal cord, numbing you from the waist down. You remain conscious during the procedure but will not feel any pain. Many patients prefer this as it avoids the deeper effects of general anesthesia and allows for quicker recovery of alertness post-surgery.
   • General Anesthesia: In this option, you are completely asleep and unconscious throughout the procedure. It's often chosen based on patient preference, the surgeon's recommendation, or if spinal anesthesia is not suitable due to other medical conditions. The choice of anesthesia will be discussed with you by the anesthesiologist, taking into account your medical history and preferences.

2. Insertion of Resectoscope: Once anesthesia has taken effect, the surgeon begins the procedure. A specialized instrument called a resectoscope is carefully inserted into the tip of the penis. This is a thin, rigid, tube-like instrument, approximately the diameter of a pencil, equipped with several crucial components:

   • Camera (Endoscope): Provides a magnified, high-definition view of the urethra, prostate, and bladder on a monitor, allowing the surgeon to navigate and perform the procedure with precision.
   • Light Source: Illuminates the surgical field inside the body.
   • Irrigating Fluid Channels: Allows a continuous flow of sterile fluid (often glycine solution) to distend the bladder and flush away blood and tissue fragments, maintaining a clear view.
   • Working Channel: Through this channel, an electrical loop (for monopolar or bipolar TURP) or a laser fiber (for laser TURP) is advanced.

   The resectoscope is gently guided through the urethra until it reaches the area of the prostate gland that is causing obstruction, just below the bladder.

3. Tissue Resection: This is the core of the TURP procedure. The surgeon uses the working element of the resectoscope to precisely remove the excess prostate tissue.

   • Electrical Loop (for Monopolar/Bipolar TURP): The most common method involves a small, heated electrical wire loop. As the surgeon passes this loop across the obstructive prostate tissue, the electrical current heats the loop, allowing it to:
     • Cut: Shave off small pieces (chips) of the enlarged prostate tissue, effectively widening the urethral channel.
     • Cauterize: Simultaneously seal blood vessels, minimizing bleeding during the procedure.
   • Laser (for HoLEP/GreenLight/Thulium Laser Prostatectomy): While the prompt focuses on traditional TURP, it's worth noting that some newer techniques use laser energy to vaporize or enucleate (scoop out) prostate tissue. The principle is similar: remove obstructive tissue.

   The surgeon meticulously works to remove only the obstructive inner portion of the prostate gland (the adenoma) while leaving the outer capsule intact. This careful approach ensures the relief of symptoms while preserving the structural integrity of the prostate and surrounding tissues.

4. Tissue Removal: Throughout the resection process, the irrigating fluid continuously flows through the resectoscope. This fluid serves a dual purpose: it distends the bladder to provide a clear view and, crucially, it washes the resected prostate tissue fragments (the "chips") into the bladder. At the end of the resection phase, the surgeon removes these tissue fragments from the bladder using a special suction device integrated into the resectoscope or via a separate evacuator. These removed tissues are then sent to a pathology lab for microscopic examination to confirm they are benign and rule out any unexpected cancerous cells.

5. Catheter Placement: Once the resection is complete and all tissue fragments are removed, the resectoscope is carefully withdrawn. A urinary catheter is then inserted into the bladder through the urethra. This catheter typically has a balloon at its tip that is inflated inside the bladder to keep it in place. The catheter serves several important functions:

   • Drain Urine: It continuously drains urine from the bladder, preventing it from accumulating and allowing the urethra to heal.
   • Bladder Irrigation: Often, the catheter is a "three-way" catheter, allowing for continuous or intermittent irrigation of the bladder with saline solution. This helps to flush out any blood clots that may form after surgery, preventing blockages.
   • Pressure Application: The balloon can sometimes be gently pulled down slightly to apply pressure to the prostate bed, which helps to minimize bleeding.

   The catheter usually remains in place for 24 to 48 hours, or sometimes longer (up to a few days), depending on the amount of bleeding and swelling, and until you are able to urinate effectively on your own. Before discharge, the catheter is removed, and your ability to urinate naturally is assessed.

The TURP procedure is a highly skilled operation that requires significant expertise from the urologist. Its effectiveness in restoring urinary function has made it a cornerstone of BPH treatment for decades.

Understanding Results

Transurethral Resection of the Prostate (TURP) is widely regarded as a highly effective treatment for lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH). For the vast majority of patients, the procedure leads to significant improvement in quality of life by directly addressing the anatomical obstruction. However, like any surgical intervention, it comes with a recovery period and potential risks that patients should be thoroughly aware of.

Immediate and Long-term Benefits

• Significant Symptom Improvement: The primary goal of TURP is to alleviate bothersome LUTS. Patients typically experience substantial relief from symptoms such as:
  • Reduced urinary frequency and urgency: Fewer trips to the bathroom, day and night.
  • Stronger and more consistent urine stream: The obstruction is removed, allowing urine to flow freely.
  • Complete bladder emptying: The sensation of residual urine is largely eliminated, reducing the risk of complications.
  • Cessation of straining: Urination becomes easier and more natural.
• Restoration of Normal Urinary Flow: By removing the obstructive prostate tissue, TURP effectively widens the urethral channel, restoring the normal physiological pathway for urine. This improved flow rate is measurable and directly correlates with symptom relief.
• Long-term Efficacy: TURP offers durable results. Studies indicate that the relief from BPH symptoms can last for almost 15 years for most patients. While some prostate tissue may regrow over time, requiring potential re-treatment, this is relatively uncommon.
• Prevention of Complications: For patients who experienced recurrent UTIs, acute urinary retention, bladder stones, or kidney damage due to obstruction, TURP effectively addresses the root cause, preventing these serious complications.
• Enhanced Quality of Life: Beyond specific urinary parameters, the overall impact on a patient's daily life is profound. Improved sleep, reduced anxiety about needing a bathroom, and the ability to participate in social activities without constant worry contribute significantly to a better quality of life.

A prospective study conducted in South India involving 50 male patients with BPH who underwent TURP showcased these positive outcomes. The study reported significant improvement in both the International Prostate Symptom Score (IPSS) and the Index of Quality of Life (IQL) scores at both 4 and 12 weeks post-surgery, underscoring the procedure's effectiveness in the Indian context.

Recovery Journey

The recovery process after TURP is generally straightforward, though it requires patience and adherence to post-operative instructions.

• Hospital Stay: Most patients are hospitalized for 2-3 days following TURP. In some cases, with modern techniques and good patient health, discharge on the same day might be possible, but typically an overnight stay is required for observation and catheter management.
• Catheter Removal: The urinary catheter, which is placed during surgery, is usually removed within 24 to 48 hours, or once the urine clears and swelling has subsided. After catheter removal, it's common to experience a burning sensation during urination, urinary frequency, and urgency for a few days to weeks.
• Resuming Activities:
  • Most individuals can resume light, normal activities within 3 days to a week.
  • Strenuous activities, heavy lifting, and vigorous exercise should be avoided for two to six weeks to prevent bleeding and allow the prostate bed to heal.
  • Sexual activity can usually be resumed after about 3-4 weeks, as advised by your surgeon.
• Hydration: Drinking plenty of fluids (water, clear juices) after surgery is highly recommended. This helps to flush the bladder, prevent clots, and maintain urinary flow.
• Common Post-operative Experiences:
  • Pain or Discomfort: Mild pain or discomfort in the lower abdomen or perineum is common and can be managed with prescribed pain relievers.
  • Blood in the Urine (Hematuria): It is very common to see blood in the urine for several days or even a few weeks after TURP. This is usually light pink or reddish. Intermittent passage of small clots may also occur. However, if you notice thick, ketchup-like blood, large clots, or difficulty urinating due to clots, you must report it to your doctor immediately. Straining during bowel movements or physical exertion can sometimes temporarily increase bleeding.
  • Urinary Symptoms: Initial urinary frequency, urgency, and some temporary incontinence (dribbling) are normal as the bladder adjusts.
• Pelvic Floor (Kegel) Exercises: Your doctor or a physiotherapist may recommend starting pelvic floor (Kegel) exercises a few weeks post-surgery. These exercises can help strengthen the muscles that control urination, improving urinary control and potentially aiding in erectile function recovery post-TURP.

Potential Risks and Complications

While TURP is generally considered safe and effective, like any surgical procedure, it carries potential risks and complications. Understanding these is vital for informed consent.

• Temporary Inability to Urinate (Post-Catheter Removal): After the catheter is removed, some patients may temporarily struggle to urinate, especially if there's residual swelling. This may necessitate re-catheterization for a short period.
• Blood in Urine (Hematuria): As mentioned, some blood is expected. However, heavy, persistent bleeding requiring extended irrigation or, rarely, a blood transfusion is a potential complication.
• Urinary Tract Infection (UTI): Due to catheter placement and the nature of the surgery, UTIs can occur. Symptoms include fever, chills, burning urination, and cloudy urine. Prophylactic antibiotics help reduce this risk.
• TURP Syndrome: This is a rare but potentially life-threatening complication, occurring in about 0.5-1% of cases. It happens when the body absorbs excessive amounts of the irrigating fluid (typically glycine) used during the procedure, leading to an electrolyte imbalance, particularly low sodium levels (hyponatremia). Symptoms can include confusion, nausea, vomiting, visual disturbances, headache, slow heart rate, and, in severe cases, seizures or coma. The use of bipolar TURP techniques has significantly reduced the risk of TURP syndrome because it allows for the use of saline solution as an irrigant, which is isotonic with blood.
• Retrograde Ejaculation: This is the most common long-term side effect of TURP, occurring in over 70% of patients in some studies. During orgasm, semen flows backward into the bladder instead of being expelled through the penis. This is due to the removal of the prostate tissue around the bladder neck, which normally constricts during ejaculation. It is not harmful and does not affect the sensation of orgasm, but it does impact fertility. Patients planning future children should discuss this extensively with their surgeon.
• Erectile Dysfunction (ED): While TURP typically does not cause ED, some patients (5-8% in some studies) may experience new or worsened erectile difficulties. This can be due to nerve damage during surgery, psychological factors, or underlying vascular issues. It's important to distinguish this from pre-existing ED.
• Loss of Bladder Control (Urinary Incontinence): This is a rare but possible long-term complication (less than 1-2%). It can range from mild stress incontinence (leaking with coughs or sneezes) to more severe urge or total incontinence, though this is highly uncommon.
• Urethral Stricture: Narrowing of the urethra can occur due to scarring from the surgical instrumentation or inflammation. This can lead to a weakened urine stream and may require further procedures to correct.
• Bladder Neck Contracture: Similar to urethral stricture, scarring at the bladder neck (where the bladder meets the urethra) can narrow the opening, causing obstruction.
• Re-treatment: In a small percentage of cases, symptoms may not improve as much as expected, or they may recur over time due to incomplete tissue removal or prostate regrowth. This might necessitate further medical or surgical treatment.
• Other General Surgical Risks: These include risks associated with any surgery, such as blood clots (e.g., deep vein thrombosis, pulmonary embolism), adverse reactions to anesthesia, and wound infection (though external wounds are absent in TURP, internal infection is possible).

It is crucial for patients to have an open discussion with their urologist about these potential risks and benefits, weighing them against the severity of their symptoms and their overall health. Timely reporting of any unusual symptoms post-surgery to your medical team is paramount for prompt management.

Costs in India

India has emerged as a prominent destination for medical tourism, offering high-quality healthcare at significantly more affordable rates compared to Western countries. This affordability extends to specialized procedures like Transurethral Resection of the Prostate (TURP), making it an attractive option for both domestic and international patients. However, the cost of TURP surgery in India can vary considerably based on several influencing factors.

Factors Influencing TURP Cost in India

1. Hospital Choice:
   • Government Hospitals: Generally offer the most economical options, often heavily subsidized. However, they may have longer waiting lists and fewer private amenities.
   • Private Hospitals (Tier 1, 2, 3): Costs increase with the level of facilities, technology, and services offered. A multi-specialty corporate hospital in a metro city will be more expensive than a smaller private hospital in a non-metro area. Different hospitals also offer various room categories (general ward, semi-private, private, deluxe), impacting the daily hospital charges.
2. City/Location:
   • Major metropolitan cities like Delhi, Mumbai, Bangalore, Chennai, Hyderabad, and Kolkata typically have higher costs due to superior medical infrastructure, availability of highly experienced surgeons, and higher operational expenses.
   • Tier 2 and Tier 3 cities might offer more budget-friendly options for the same procedure, though the choice of hospitals and specialists might be narrower.
3. Surgeon's Fees:
   • The experience, reputation, and specialization of the urologist play a significant role. Highly renowned surgeons with extensive experience in TURP may charge higher consultation and surgical fees.
4. Medical Condition and History:
   • The complexity of your BPH (e.g., very large prostate size, presence of bladder stones, severe obstruction) can influence the duration and complexity of the surgery, and thus the cost.
   • Pre-existing medical conditions (comorbidities) like heart disease, diabetes, or kidney issues may require additional pre-operative assessments, consultations with other specialists, and more intensive post-operative care, adding to the overall expense.
5. Diagnostic Tests:
   • The extent and number of pre-surgical investigations (blood tests, urine tests, ultrasounds, uroflowmetry, cystoscopy, PSA screening, ECG, etc.) contribute to the overall bill. These are crucial for accurate diagnosis and surgical planning.
6. Hospital Stay Duration:
   • The typical hospital stay for TURP is 1-3 days. However, if there are complications, or if more extensive post-operative monitoring or rehabilitation is required, a longer stay will increase costs.
7. Type of TURP:
   • While the core TURP technique involves an electrical loop, there can be variations (e.g., monopolar vs. bipolar TURP). Bipolar TURP, which uses saline irrigation, reduces the risk of TURP syndrome and might have slightly different equipment costs, though often the overall procedure cost remains similar. Newer laser techniques (like HoLEP or GreenLight Laser) are generally more expensive than traditional TURP.

General Cost Estimates in India

The cost of TURP surgery in India is quite competitive.

• Overall Range: Generally, the cost can range from approximately ₹75,000 to ₹2,50,000.
• For international patients, this translates to roughly USD 900 to USD 3,000 or more, which is considerably lower than the USD 10,000 - USD 20,000 often seen in Western countries.

Approximate Cost Breakdown (in INR)

It's helpful to understand what contributes to the total cost:

• Initial Consultation & Evaluation: ₹1,000 – ₹3,000 (may include DRE)
• Lab Tests & PSA Screening: ₹5,000 – ₹8,000 (includes CBC, KFT, LFT, coagulation profile, PSA, urinalysis, etc.)
• Imaging & Diagnostic Procedures:
  • Ultrasound (KUB, PVR): ₹2,000 – ₹4,000
  • Uroflowmetry: ₹1,000 – ₹2,000
  • Cystoscopy (if performed pre-operatively): ₹5,000 – ₹10,000
  • ECG/Chest X-ray: ₹500 – ₹1,500
• Anesthesia Fees: ₹10,000 – ₹20,000 (varies by type and duration)
• Surgeon's Fees: ₹30,000 – ₹70,000 (highly variable based on experience)
• Operation Theatre (OT) Charges: ₹15,000 – ₹30,000
• Hospital Stay (2-3 days, per day):
  • General Ward: ₹3,000 – ₹5,000 per day
  • Semi-Private Room: ₹5,000 – ₹8,000 per day
  • Private Room: ₹8,000 – ₹15,000 per day
  • ICU Charges (if required): ₹15,000 – ₹30,000 per day
• Medications & Consumables (during hospital stay): ₹5,000 – ₹15,000
• Pathology for Tissue Biopsy: ₹2,000 – ₹4,000
• Post-operative Follow-up Consultations: ₹1,000 – ₹2,000 per visit

Example Total (Approximate for a Private Room in a Metro City):

• Pre-op tests: ₹10,000
• Surgery (Surgeon, OT, Anesthesia): ₹80,000
• Hospital Stay (2 days private): ₹20,000
• Medications/Consumables: ₹10,000
• Estimated Total: ₹1,20,000

This is an approximation, and actual costs can be higher or lower. It's always advisable to get a detailed cost estimate from the hospital's billing department before proceeding with the surgery.

Additional Expenses to Consider

Beyond the direct surgical costs, patients, especially those traveling from other cities or countries, should budget for:

• Accommodation: For accompanying family members or for post-discharge recovery outside the hospital.
• Travel: Air tickets, local transportation (taxis, ambulances).
• Visa: For international patients.
• Post-surgical Medications: Prescriptions for pain relief, antibiotics, etc., after discharge.
• Follow-up Consultations: Subsequent visits to the urologist.
• Physiotherapy/Rehabilitation (if needed): For pelvic floor exercises.

Insurance Coverage

Most health insurance providers in India offer coverage for TURP surgery, as it is considered a medically necessary procedure for BPH. However, it is crucial to:

• Check your specific policy details: Understand the terms and conditions, waiting periods, co-pays, deductibles, and network hospitals.
• Pre-authorization: Inform your insurance provider well in advance and complete the necessary pre-authorization process to ensure a smooth claim experience.
• Cashless vs. Reimbursement: Understand if your policy offers cashless facilities at your chosen hospital or if you will need to pay upfront and claim reimbursement later.

Careful financial planning and understanding all potential costs are essential steps in preparing for TURP surgery in India.

How Ayu Helps

Ayu streamlines your healthcare journey, securely managing all your medical records, appointments, and prescriptions in one accessible platform, making your TURP preparation and recovery smoother.

FAQ

1. What is BPH and how does it relate to TURP? BPH stands for Benign Prostatic Hyperplasia, a common condition where the prostate gland enlarges as men age. This enlargement can obstruct the urethra, leading to bothersome urinary symptoms. TURP is a surgical procedure specifically designed to remove the excess prostate tissue causing this obstruction, thereby alleviating BPH symptoms.

2. Is TURP a major surgery? While TURP is a surgical procedure requiring anesthesia and a hospital stay, it is considered minimally invasive because it's performed through the urethra without external incisions. However, it is still a significant surgical intervention with potential risks and requires a recovery period.

3. How long is the recovery period after TURP? Hospitalization typically lasts 1-3 days. You can usually resume light activities within 3-7 days, but strenuous activities, heavy lifting, and vigorous exercise should be avoided for 2-6 weeks to allow for proper healing and to prevent bleeding. Full recovery varies for each individual.

4. Will TURP affect my sexual function? The most common sexual side effect is retrograde ejaculation (semen flowing into the bladder during orgasm), which occurs in over 70% of patients. This does not affect the sensation of orgasm but can impact fertility. While erectile dysfunction is not a direct consequence for most, a small percentage (5-8%) may experience new or worsened ED.

5. What are the signs of a complication after TURP that I should watch for? Immediately contact your doctor if you experience thick, ketchup-like blood or large clots in your urine, fever (over 101°F or 38.3°C), chills, severe abdominal or bladder pain, inability to urinate (even with the urge), or symptoms of TURP syndrome (confusion, nausea, vomiting, sudden headache).

6. Are there alternatives to TURP? Yes, depending on the severity of BPH and patient preference, alternatives include:

• Medications: Alpha-blockers (e.g., tamsulosin) and 5-alpha reductase inhibitors (e.g., finasteride).
• Newer minimally invasive procedures: Various laser therapies (e.g., HoLEP, GreenLight Laser), prostatic urethral lift (UroLift), or water vapor thermal therapy (Rezum).
• Open Prostatectomy: For very large prostates, though rarely performed today.

7. How often do I need follow-up appointments after TURP? Typically, you'll have an initial follow-up appointment a few weeks after surgery to assess healing and symptom improvement. After that, your urologist will likely recommend annual check-ups to monitor your prostate health and ensure long-term success of the procedure.

8. Can BPH come back after TURP? While TURP provides long-lasting relief for most patients, prostate tissue can slowly regrow over time. This happens in a small percentage of cases, potentially leading to a recurrence of symptoms and, rarely, the need for re-treatment after many years (e.g., 10-15 years or more).