LONDON UROLOGY PARTNERS
For a comprehensive elective and emergency urological service in London
 
 
CONTACT DETAILS
To contact Mr Barry Maraj Consultant Urologist
 
 
EDUCATIONAL BACKGROUND
summary of educational background and urological training
 
 
ACADEMIC BACKGROUND AND PUBLICATIONS
 
 
MEMBERSHIPS
Memberships to important medical associations
 
 
'KEY HOLE' SURGERY
Laparoscopic Urological Operations
 
 
BOTOX and BALDDER PROBLEMS
Botox injections for urinary frequency and urgency
 
 
HAVING A CYSTOSCOPY ?
What is cystoscopy
 
 
HAEMATURIA
Blood in your urine
 
 
HAVING A TURP
A guide for patients having a TURP
 
 
Photosensitive Vaporisation of the Prostate (Green Light)
A revolutionary new day surgery treatment for benign prostate enlargement
 
 
PSA
Prostate Specific Antigen and Prostate Cancer
 
 
Trans-rectal ultrasound (TRUS) guided biopsy of the prostate
Having a TRUS biopsy of your prostate?
 
 
MULTIDICIPLINARY TEAM MEMBERS
GYNAECOLOGISTS, GENERAL SURGEONS, GASTROENTEROLOGISTS, RELAXATION SPECIALISTS AND NUTRITIONISTS
 
 
NEED TO SEE A GP ?
Same day and Emergency call out GP service
 
 
ROBOTIC UROLOGICAL SURGERY
The Da Vinci si system is now widely used for a number of urologic disorders including prostate kidney nad bladder cancer and obstructed kidneys (UPJO)
 
 

HAVING A TURP

TURP is an operation to remove the inner part of the prostate gland. The operation can be performed under general or spinal anaesthesia. A telescopic instrument is passed along the urethra (your water pipe). Hence, there is no wound or stitches.

Why have a TURP
This is because you are having difficulty urinating that is bothersome and is due to your enlarged prostate gland.
The prostate gland lies against the exit from the bladder base and surrounds the urethra (see diagram). An enlarged prostate can compress the urethra at this level thus making it difficult to empty your bladder.

Symptoms due to an enlarged prostate
These are termed lower urinary tract symptoms (LUTS).
Symptoms of LUTS can include difficulty starting urination, intermittent flow, reduced pressure of flow, a sense of incomplete bladder emptying, urinary frequency, urge to urinate or frequent night time urination.

Alternative treatments
Surveillance
Medical therapy to reduce the size of or relax the prostatic muscles
High energy procedures such as Green Light Vaporization (refer to other section)
Prostatic urethral stents


Risks of TURP
All operative procedures have associated risks. Those specific to TURP are:

(1) Infection. The incidence may be reduced by prophylactic antibiotics.

(2) Bleeding. Up to 4% of patients undergoing this procedure may require transfusion of blood.

(3) Retrograde ejaculation. This may occur in up to 8 in 10 men. When it occurs, semen is propelled into the bladder as opposed to down the penis. This is not harmful but you should not rely on it as a method of contraception.

(4) Impotence. This can occur in 5-10%.



Aspirin and Warfarin
You must inform us if you take either of these medications.
Aspirin must be discontinued 10 days prior to surgery.



Preparation for surgery
Most patients are admitted on the day of surgery.
You must NOT HAVE ANYTHING TO EAT OR DRINK FROM MIDNIGHT THE NIGHT BEFORE YOUR OPERATION
What is involved
The procedure is performed utilising a telescope that is passed down the penis. Thus, there are no cuts or stitches. The operation can last between 45 minutes to one hour.
Rarely, the prostate is very large requiring an open procedure. In the majority of these cases, we will know before the operation. You would therefore have the opportunity to discuss this.

Immediately after the operation
You will be transferred to the recovery area next to theatre where you are monitored closely. Once the staff are happy that your condition is stable, you will be transferred back onto the ward area.
On the ward, a cathether (which is inserted at the end of the procedure) will be utilised to irrigate your bladder with saline solution.
Usually on the second day after the operation, the fluid returning from your bladder is ‘clear’, the cathether will be removed (usually a straightforward and painless procedure). You are now ready for discharge from hospital.

Going home
You will then be encouraged to drink enough fluid (2-3 litres per day).
Avoid becoming constipated by eating a high fibre diet.
You can take analgesics as prescribed.
Some patients notice blood stained urine 10 days after the operation. Do not be alarmed. Simply have more fluids to drink.
Gentle physical activity is important.
The first two weeks after the operation you can feel somewhat lethargic.

Resuming normal activity

Work: When you feel well enough. This dependent on factors such as the type of job, general health and an uncomplicated procedure.

Sex: When you are comfortable

Driving: Approximately six weeks after your operation.

Lifting: Nothing heavy for one month

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