Should You Continue Tamsulosin After TURP Surgery?

First: Tamdura May Not Be Tamsulosin Alone

An important correction to the original answer is that Tamdura is commonly marketed as a combination of tamsulosin 0.4 mg and dutasteride 0.5 mg.

The two medicines have different actions:

• Tamsulosin is an alpha blocker. It relaxes smooth muscle around the prostate and bladder outlet and can make urination easier.
• Dutasteride is a 5-alpha-reductase inhibitor. It gradually reduces prostate volume by decreasing conversion of testosterone to dihydrotestosterone (DHT).

Does TURP Remove the Whole Prostate?

No.

This is one of the most important corrections to the older version of this page.

During a transurethral resection of the prostate (TURP), the urologist removes obstructing prostate tissue from inside the gland through the urethra.

The operation creates a wider channel for urine to pass through, but the entire prostate is not removed.

The same general principle applies to GreenLight laser photovaporization: obstructing prostate tissue is vaporized to improve urine flow, but the whole prostate is not destroyed.

Learn more in our BPH Surgery and Procedures guide .

Why Would Tamsulosin Be Continued After TURP?

Ideally, successful surgery relieves the obstruction enough that the alpha blocker is no longer required.

In real clinical practice, however, a substantial number of men continue urinary medicines after surgery.

Possible reasons include:

1. Persistent weak urine flow
   Urination may remain slow despite removal of obstructing prostate tissue.
2. Incomplete bladder emptying
   A post-void residual urine measurement may show that significant urine remains in the bladder.
3. Detrusor underactivity
   The bladder muscle may not contract strongly enough to empty efficiently, particularly after years of obstruction.
4. Residual or recurrent outlet obstruction
   Some prostate tissue remains after TURP, and other anatomical causes of obstruction can exist.
5. Early postoperative symptoms
   Swelling and inflammation can temporarily affect urination during the healing period.
6. Another lower urinary tract condition
   Not every urinary symptom comes from BPH.

What Does Research Show About Tamsulosin After TURP?

Studies show that medication use after BPH surgery is more common than many patients expect.

In one study of 406 men who underwent transurethral prostate surgery, about one-third were still taking an alpha blocker 12 months later. Continued use was associated with factors such as older age, poorer urine flow, higher residual urine and detrusor underactivity.

Larger database studies have also found substantial continued use of urinary medicines after TURP and other BPH procedures.

However, this does not mean everyone should routinely continue tamsulosin.

A randomized study testing tamsulosin during the first four weeks after TURP did not find a significant additional overall improvement in urinary symptoms compared with TURP alone.

When Can Tamsulosin Be Stopped After TURP?

There is no universal number of days or weeks after which every patient should stop tamsulosin.

Your urologist may consider stopping it when:

• urine flow has improved substantially;
• you are emptying your bladder adequately;
• post-void residual urine is acceptable;
• there is no significant remaining obstruction;
• the postoperative healing period is progressing normally;
• and there is no other reason for the medication.

Conversely, persistent urinary symptoms may prompt continued treatment or further evaluation rather than automatic discontinuation.

What About Dutasteride or Finasteride After TURP?

Dutasteride and finasteride work differently from tamsulosin.

They gradually reduce the hormonal stimulation that contributes to prostate enlargement and are usually used long term in men with an enlarged prostate who are at increased risk of progression.

After an effective TURP or other tissue-removing procedure, the reason for continuing a 5-alpha-reductase inhibitor may be less obvious because much of the obstructing tissue has already been removed.

Nevertheless, some prostate tissue remains.

Whether dutasteride or finasteride should continue depends on factors such as:

• remaining prostate size;
• the type and extent of surgery;
• persistent or recurrent BPH;
• the reason the medicine was originally prescribed;
• PSA interpretation;
• and the urologist’s postoperative plan.

Read our BPH Medications guide for an explanation of the main drug classes.

Why Might One Doctor Say Stop and Another Say Continue?

This was also raised by a reader whose urologist advised stopping BPH medicines after prostate surgery while another specialist advised continuing them.

When two clinicians give different instructions, the safest approach is not to choose between them yourself.

Ask:

1. Which exact medicine are we discussing?
2. What condition is it intended to treat now?
3. What did my postoperative urine-flow and bladder scan show?
4. Is there residual obstruction or significant residual urine?
5. Is the plan temporary or long term?

A kidney specialist may be particularly concerned about poor bladder emptying or urinary obstruction affecting the upper urinary tract, while the urologist has the most direct information about what was found and removed during the prostate operation.

Ideally, the clinicians should reconcile their recommendations.

What If Urinary Symptoms Continue After TURP?

TURP is highly effective for relieving obstruction, but it does not guarantee that every urinary symptom will disappear.

Persistent symptoms can include:

• frequency;
• urgency;
• nocturia;
• weak stream;
• hesitancy;
• incomplete emptying;
• or urinary leakage.

Some storage symptoms such as urgency and frequency may take weeks or months to settle after surgery.

Persistent symptoms should be evaluated rather than automatically attributed to regrowth of the prostate.

What Should Be Checked Before Long-Term Medication Is Continued?

Current European guidance recommends follow-up after prostate surgery, typically around four to six weeks after catheter removal.

Depending on symptoms, assessment may include:

1. International Prostate Symptom Score (IPSS)
2. uroflowmetry to measure urine flow
3. post-void residual (PVR) measurement
4. review of urinary continence
5. review of erectile and ejaculatory function
6. and further testing when recovery is not proceeding as expected.

These findings are more useful than deciding about tamsulosin simply on the basis that surgery has or has not occurred.

How Should You Look After Yourself After TURP?

Follow your own surgeon’s discharge instructions because recovery varies according to the procedure and your general health.

Typical advice includes:

• drink adequate fluids during the early recovery period unless you have been given a fluid restriction;
• avoid heavy lifting and strenuous exercise while the prostate cavity heals;
• walk gently rather than remaining in bed continuously;
• avoid constipation and excessive straining;
• use pain medicines as instructed;
• and follow catheter instructions if you leave hospital with a catheter.

What About Aspirin, Warfarin or Other Blood Thinners?

The old advice to routinely stop blood-thinning medicine for a fixed number of days after TURP is unsafe.

Anticoagulant and antiplatelet medicines include:

• warfarin;
• apixaban;
• rivaroxaban;
• dabigatran;
• edoxaban;
• clopidogrel;
• and aspirin in selected patients.

The timing of stopping and restarting these drugs depends on:

• the medicine;
• why you take it;
• your bleeding risk;
• your blood-clot or stroke risk;
• kidney function;
• and how postoperative bleeding is progressing.

Does Having a Catheter Mean You Will Not Have Urinary Problems?

No.

A catheter temporarily drains the bladder while the surgical area heals. After catheter removal, some men experience:

• burning;
• urgency;
• frequency;
• temporary leakage;
• or difficulty urinating.

If you cannot urinate after the catheter is removed, another catheter may occasionally need to be inserted temporarily.

Should You Put Antiseptic Cream Around a Urinary Catheter?

Not routinely.

Keep the catheter and genital area clean according to the instructions given by the nursing or urology team.

Do not apply antiseptic creams, antibiotic creams or other products around the catheter unless a healthcare professional has specifically advised you to do so.

Related BPH Guides