TURP recovery in Nigeria: the catheter, bleeding, and sex after prostate surgery

Step by step

1. 1

   Day of surgery

   Spinal or general anaesthetic. You wake with a catheter and the bag may look red. Someone from the family should be reachable.

2. 2

   Days one to three

   The washout runs until the urine clears, then the catheter comes out and you show you can pass urine on your own.

3. 3

   Going home

   Arrange an escort home. Take your pain relief and any stool softener as prescribed, and drink plenty of water.

4. 4

   Weeks one to two

   Rest, walk gently, no lifting. Some burning and urgency is expected.

5. 5

   Around days ten to fourteen

   A short bleed is common as the scab separates. Drink more and rest; call if it does not settle.

6. 6

   Weeks four to six

   Most men return to normal activity and sex in this window, if the surgeon agrees at follow-up.

In hospital: the catheter and the washout

You wake with a catheter, a soft tube in the urine tube, often with fluid running through it to wash out blood and stop clots forming. The urine in the bag will look pink or red at first. This is expected.

When the urine clears, usually after one to three days, the catheter comes out. Passing urine for the first time afterwards can sting and feel urgent. Once you can empty your bladder properly you can go home. A few men cannot pass urine at first and go home with the catheter for a short while before trying again.

The first six weeks at home

The inside of the prostate is healing like a graze. Most of the advice is about not putting pressure on it:

• Drink plenty of water through the day so your urine stays pale; Nigerian heat makes this more important
• Avoid constipation: eat fruit, vegetables and fibre, and ask for a stool softener if needed, because straining on the toilet can restart bleeding
• No heavy lifting, bending to carry loads, or hard exercise for about four to six weeks
• Avoid long, bumpy journeys in the first weeks where you can; if you must travel, plan for toilet stops in traffic
• Most men with office jobs return to work in two to three weeks; physical jobs need longer, and your surgeon will advise
• Do not drive until you can make an emergency stop without discomfort, and check with your surgeon first

Bleeding and burning: what is normal

Pink urine on and off for a few weeks is normal. Many men notice fresh blood or small clots around ten to fourteen days after surgery, when the healing scab separates. Drink more water and rest; it usually settles within a day or two.

Burning, urgency and needing to rush to the toilet are common for several weeks while the area heals. Some men leak a little urine at first. For most this improves over the following weeks, and pelvic floor exercises help.

Sex, erections and ejaculation after TURP

Most surgeons advise waiting about four to six weeks before sex or masturbation, but your surgeon's own advice wins. Blood in the semen at first is not unusual.

The biggest change is ejaculation. After TURP most men have retrograde ejaculation: you still feel the orgasm, but little or no semen comes out because it goes back into the bladder and leaves in the urine later. It is harmless, but it does reduce fertility. If you still want children, tell your surgeon before the operation.

TURP does not usually affect erections, but some men notice a change. No surgeon can guarantee your sexual function after prostate surgery. If you have problems after recovery, see a doctor: erection problems are treatable and often have other causes such as diabetes or blood pressure.

Go back to a doctor quickly if

Call your surgical team, or go to an emergency department, if:

• You cannot pass urine, or only drops come out and your belly is swelling
• You are passing thick clots or the urine looks like dark red juice and does not clear with water
• You have a fever, shivering, or feel very unwell
• Pain is getting worse rather than better

Common questions