This stands for trans urethral resection of the prostate, and is probably the commonest operation performed in urology. It should never be referred to as a turps operation, since turps is a toxic chemical used as a paint stripper! It is not the only treatment for prostate trouble - indeed most men with prostate trouble will require either no treatment, or tablets, but when removal of the prostate is required it is an extremely effective and safe operation, with side effects only occasionally occurring. It should not be confused with radical prostatectomy, the operation done for cancer of the prostate. During the operation, a camera is passed up the penis, and the lower urinary tract is inspected. This is done under either general or spinal anaesthetic, depending on the anaesthetist's assessment of what is best. Once it is confirmed that the prostate is the cause of the trouble, the prostate is removed using a loop on the end of the camera that cuts it away in small strips, thus opening up the channel through which you pass water. A catheter is then placed to allow healing to take place. The catheter is removed after a day or two, after which you can usually go home, though it may be a few days or even weeks before urinary symptoms settle down. The main complications of the operation are bleeding and infection, neither of which are usually severe, and can be treated effectively without long term consequences. Some men notice a loss of ejaculation after the operation, but in the age group usually having the operation, the need to continue to be able to father children is not usually a major consideration. Loss of ejaculation does not usually affect a man's enjoyment of intercourse, as orgasm is usually maintained. A word of warning though - the loss of ejaculation does not cause complete sterility, and it is still possible to father a child, albeit not so easily. The ability to maintain an erection is not usually lost after this operation, although it may sometimes be affected.

In the long term, most men who have TURP will be delighted with the result, but it is possible for scarring and regrowth of the prostate to cause further problems in the future. Because the operation is not perfect, there are alternative procedures available, and the urological community are very optimistic that the new hybrid laser may at last be a potential improvement, but the next 5 years should confirm or refute this optimism. The holmium laser is already available locally, but surgically the technique is hard to learn, and not all the local surgeons have received training in the techniques.