What is TURP?
Transurethral resection of the prostate removes the obstructing inner portion of the gland using an electrosurgical loop passed through the urethra — no external incision, but genuine surgery under spinal or general anesthesia. Modern bipolar TURP uses saline irrigation, which has largely eliminated the fluid-absorption complication (“TUR syndrome”) of the older technique.
TURP creates the widest possible channel of any transurethral approach, and its durability is the standard every newer treatment is measured against: symptom relief that routinely lasts decades, with low re-treatment rates.
Who actually needs TURP?
With today's minimally invasive options, TURP is no longer the default — it's the heavyweight reserved for men who need it: severe obstruction, failed minimally invasive treatment, recurrent retention, bladder stones, or anatomy unsuited to other approaches. For very large glands, even TURP gives way to other techniques — which is also where PAE shines without any surgery at all.
Recovery and trade-offs
Expect a hospital stay of about a night, a urinary catheter for one to three days, and several weeks of irritative symptoms, with strenuous activity restricted for two to four weeks. Blood in the urine is normal early on.
The most consequential trade-off: retrograde ejaculation affects the majority of men after TURP — orgasm remains, but semen flows backward into the bladder. Erectile function is usually preserved. There are also small risks of stricture, incontinence, and bleeding requiring transfusion. For men who prioritize ejaculatory function, that single line on the consent form is often the reason to look hard at PAE, Rezūm, or UroLift first.
TURP vs. PAE — the head-to-head
You asked the right question — here is the same comparison we draw on the whiteboard in our consultation room, line by line.
| TURP | PAE | |
|---|---|---|
| Setting | Operating room, spinal/general anesthesia | Outpatient, local/light sedation |
| Hospital stay | Usually overnight | Home the same day |
| Catheter afterward | 1–3 days | None |
| Cutting / tissue removal | Yes — resection through the urethra | None |
| Retrograde ejaculation | Most men, usually permanent | Function preserved |
| Very large prostates | Often needs bigger surgery instead | Yes — a PAE strength |
| Bleeding / transfusion risk | Real, especially large glands | Minimal |
Our verdict: TURP earns its durability reputation — at the price of an operating room, a hospital stay, a catheter, and a coin-flip-or-worse on permanent dry ejaculation. PAE delivers meaningful, lasting shrinkage with none of those costs. In our experience across 1,000+ PAEs — more than any center in New York City — most men who qualify for both never look back after choosing PAE.