What is Transurethral Incision of the Prostate (TUIP)?
Transurethral incision of the prostate (TUIP) is a method of relieving urinary symptoms caused by an enlargement of the prostate gland. TUIP is generally used in cases with small to moderately sized prostate glands.
Benefits of TUIP Surgery
This surgery has certain advantages over the TURP (trans-urethral resection of the prostate) which is currently the gold standard for treating cases of mild to moderate benign prostatic hyperplasia. The benefits include:
- A lower risk of bleeding, making it more suitable for patients with a bleeding disorder or those on blood thinning medications.
- TUIP can be completed as a day procedure in certain cases, minimizing hospital stay and allows faster relief from symptoms.
- TUIP is also considered to have a lower associated risk of resulting in dry orgasms, which may cause difficulties in starting a family.
Preparation Before TUIP Surgery
In order to prepare for the surgery, the patient should be adequately counselled to ensure that the informed consent obtained is fully understood.
These will include:
- Pathology tests
- Urine analysis
- PSA test
- Ultrasounds scans and
- a thorough physical examination
This is a surgery and the patient is advised not to eat anything for eight hours before the procedure. Some hospitals may keep the patient overnight before surgery the next day.
Steps in TUIP Surgery
In preparation for the surgery, the patient is:
- instructed to empty his bladder and
- an IV line is inserted in his arm
The anesthesia administered will either be general or spinal in nature, which is decided by the surgeon on a case by case basis.
The surgical device required for this operation is called a resectoscope. It is a narrow metal tube carrying a loop of wire, the camera lens and a bright light at the end.
The surgery includes the following steps:
- The patient is positioned on his back and administrated anesthesia.
- The legs of the patient are placed in stirrups and elevated and spread apart.
- The surgeon inserts the resectoscope in the urethra.
- Using the resectoscope, the physician makes single or multiple incisions on the inner surface of the prostate.
- The resectoscope is removed and a soft catheter is placed into the bladder of the patient. This helps in urination.
- The patient wakes from the anesthesia and placed in post-operative care.
Immediate Post TUIP Surgery
The patient is kept in the recovery room for observation and their vitals are monitored. Pain medication is administered as needed via IV lines. In a few hours, the patient is shifted to a room when he is stable, and he can begin to take liquids.
As the patient gains his strength, he can consume solid foods.
The catheter is kept in place for up to 3 days after surgery, to ensure that urine can pass without problems. As the recovery progresses, the catheter is usually removed around day 3. The patient may be discharged on the same day or kept for overnight observation, at the discretion of the physician.
Recovery After TUIP Surgery
Recovery after surgery requires drinking a lot of fluids, as a purpose to help flush the bladder of any remnant clots or blood from the surgery.
The doctor might also prescribe a course of oral antibiotics. Driving, heavy lifting and other strenuous activities are prohibited until the doctor signs off on it, as they may result in bleeding. Pain medication can also be taken on an as per need basis. Normal work activities can be resumed within a few days of the procedure.
Care Plan After TUIP Surgery
The doctor will devise a care plan for the patient for the next few months, to aid in recovery and to help improve bladder control.
He will also advise a follow-up visit chart to check the patient’s progress in the clinic as well and to check for any post-surgical complications. Improvements in urinary symptoms are often noticeable within a few weeks of the procedure.