Transurethral Incision of the Prostate (TUIP): Procedure, Risks and Recovery
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is transurethral incision of the prostate (TUIP)?
Transurethral incision of the prostate (TUIP) is a minimally invasive treatment for benign prostatic hyperplasia (BPH) in which one or two incisions are made in the prostate near the bladder neck to improve urine flow, without removing tissue. The procedure takes about 30 to 45 minutes, and full recovery can take three to five weeks.
What the research says
TUIP and TURP appear to relieve symptoms to a similar degree, with different trade-offs. A systematic review of 10 randomized trials (795 participants) found no difference in symptom improvement between the two procedures. Peak urine flow improved less with TUIP, while blood transfusion and TUR syndrome were more frequent after TURP. TUIP was associated with a shorter operation and hospital stay but a higher re-operation rate; the trials were of moderate to poor quality (Lourenco et al., World J Urol, 2010).
Prostate size may predict how long the benefit lasts. In a single-surgeon series of 82 men who had holmium laser TUIP and were followed for a median of 5.3 years, the re-operation rate was 3.9% with prostates of 30 cc or less versus 22.6% with larger prostates (p = 0.02). Symptom scores and peak flow improved in both groups, and retrograde ejaculation was detected in 25.6% of sexually active men in this series (Elkoushy et al., Can Urol Assoc J, 2015).
What is transurethral incision of the prostate?
Transurethral incision of the prostate is commonly abbreviated as TUIP. It treats benign prostatic hyperplasia, a noncancerous enlargement of the prostate. During TUIP, a healthcare provider uses a laser or electric current to make one or two cuts in the prostate where it meets the bladder, an area called the bladder neck.
The incisions free the opening of the bladder and allow urine to drain better. The provider reaches the prostate through the urethra, the tube that carries urine out of the body, using a thin instrument called a resectoscope.
TUIP does not remove part of the prostate. Instead, it uses incisions to relieve pressure around the bladder opening.
Who may be considered for TUIP?
Providers use TUIP when a small or only mildly enlarged prostate (usually 30 mL or less) blocks the flow of urine. Symptoms may include difficulty urinating and leaking urine, also called urinary incontinence.
TUIP may be considered instead of another BPH treatment when fertility-related side effects are a concern, another treatment is risky or less preferable because of other health conditions or concerns, or the person and provider decide that a minimally invasive option is the best fit.
This information does not determine whether TUIP is appropriate for an individual. A urology team considers symptoms, prostate enlargement, other health concerns and treatment goals before recommending an option.
Reason TUIP may be considered | What it means for the discussion |
Small or mildly enlarged prostate (usually 30 mL or less) blocking urine flow | The obstruction may cause difficulty urinating or leakage. |
Concern about fertility-related side effects | The relative likelihood of certain side effects may influence the comparison of treatments. |
Other health conditions or concerns | Another treatment may be risky or less preferable for that person. |
Preference for a minimally invasive option | TUIP may be discussed as one minimally invasive treatment approach. |
TUIP vs. TURP: what is the difference?
TUIP and transurethral resection of the prostate, or TURP, both treat BPH, but they use different approaches. TUIP makes one or two incisions in the prostate without removing tissue. TURP cuts away and removes parts of the prostate.
Feature | TUIP | TURP |
Purpose | Treats BPH and improves urine drainage by making prostate incisions. | Treats BPH by cutting away and removing parts of the prostate. |
Tissue removal | No prostate tissue is removed. | Parts of the prostate are removed. |
Invasiveness | Less invasive than TURP. | A surgery that removes prostate tissue. |
Fertility-related side effects | Less likely than TURP to cause side effects such as retrograde ejaculation. | More likely than TUIP to cause retrograde ejaculation. |
Additional treatment | More likely than TURP to require additional surgery within a few years. | Used as the comparison procedure for that outcome. |
The choice between procedures depends on the person's health, symptoms, treatment goals and the clinical assessment. Ask the treating team to explain why one option is being considered.
How should you prepare for TUIP?
The treating provider will give specific preparation instructions. Following those directions closely can reduce the risk of complications. Before TUIP, the care team may ask you to fast, stop or adjust medications only as directed, and arrange for someone to drive you home after the procedure.
Possible preparation step | What it involves |
Fasting | Do not eat for eight hours before the procedure if instructed. |
Medication instructions | Stop or take medicines only as directed; do not stop medicines unless the provider tells you to. |
Transportation | Arrange for someone to drive you home after the procedure. |
Questions | Contact the provider with questions before the procedure. |
Do not stop, restart or change a prescribed medicine based on this article. Follow the individualized instructions from the treating team.
What happens during TUIP?
Just before the procedure, the provider may give general or regional anesthesia. With general anesthesia, the person is asleep. With regional anesthesia, the person is awake while the lower half of the body is numb.
The provider then uses a resectoscope to reach the prostate through the urethra. One or two small incisions are made in the prostate. Afterward, the resectoscope is removed and a urinary catheter is inserted to drain urine and other fluid from the bladder and help prevent blood clots. The catheter is removed in a few days.
Main procedural steps
The provider gives general or regional anesthesia.
The resectoscope is inserted through the urethra to reach the prostate.
One or two small incisions are made in the prostate near the bladder neck.
The resectoscope is removed.
A urinary catheter is inserted to drain the bladder and help prevent blood clots.
The catheter is removed in a few days.
How long does TUIP take?
The TUIP procedure itself takes about 30 to 45 minutes. If you are not staying in the hospital, you may be monitored at the provider's office for an hour or more before going home. Some people may need to stay overnight for a day or two.
The planned length of observation depends on the procedure and the treating team's instructions. Ask in advance whether you should expect same-day discharge or an overnight stay.
What are the advantages of TUIP?
TUIP is an alternative to other BPH treatments for people who cannot or do not want to undergo those treatments because of additional health concerns. It is less invasive than TURP and is less likely than TURP to cause fertility-related side effects such as retrograde ejaculation.
These are potential advantages, not a guarantee of a particular result. The treating team should explain how the benefits and trade-offs apply to the individual situation.
Potential advantage | Description |
Alternative treatment | May be considered when another BPH treatment is not suitable or preferred. |
Less invasive than TURP | TUIP uses incisions without removing prostate tissue. |
Fertility-related side effects | Retrograde ejaculation is less likely with TUIP than with TURP. |
What are the risks and disadvantages of TUIP?
Like other procedures, TUIP has potential risks and disadvantages. About 18% of people who have TUIP experience retrograde ejaculation. Although this side effect is less likely with TUIP than with TURP, it can still occur.
Risk or disadvantage | Explanation |
A listed potential risk. | |
Retrograde ejaculation | About 18% of people who have TUIP experience it; it means orgasm without ejaculating. |
A UTI is a listed potential risk. | |
Bladder neck contracture | Scar tissue in the bladder can make urination difficult. |
Urinary incontinence | Leakage of urine is a listed potential risk. |
Narrowing of the urethra is a listed potential risk. | |
Additional treatment | Additional surgery may be more likely within a few years than after TURP. |
Discuss fertility, sexual function, urinary control and the possibility of further treatment before consenting to the procedure.
What is recovery like after TUIP?
Full recovery can take three to five weeks. Symptoms may not improve immediately; some people may not notice improvement for a few weeks or months after the procedure.
For a few days to a week, you may notice blood in the urine, an urgent or frequent need to urinate, or burning or pain while urinating.
About 83% of people who have TUIP for mild to moderate prostate enlargement see symptom improvement. This figure describes a group result and does not predict an individual outcome.
Recovery phase | What to expect |
First few days to one week | Blood in urine, urinary urgency or frequency, and burning or pain while urinating may occur. |
About three to five weeks | Full recovery may take this long. |
Weeks to months | Symptom improvement may not be noticeable immediately. |
Overall outcome | About 83% of people treated for mild to moderate enlargement see symptom improvement. |
How can you care for yourself after TUIP?
Take medications as prescribed. An antibiotic may be prescribed to help prevent a UTI. Follow instructions for urinary-catheter care, drink plenty of water each day, avoid heavy lifting and exercise until the provider says the activity level is appropriate, avoid bike riding, and avoid hot baths and saunas.
Recovery-care instruction | Why it matters |
Take prescribed medicines | The provider may prescribe an antibiotic to help prevent a UTI. |
Follow catheter instructions | The urinary catheter requires provider-directed care until removal. |
Drink plenty of water | Hydration is part of the aftercare guidance. |
Avoid heavy lifting and exercise | Ask the provider when and how activity can resume. |
Avoid bike riding | This is listed as a recovery restriction. |
Avoid hot baths and saunas | These are listed as activities to avoid while recovering. |
Do not use this article to decide when to resume exercise, sexual activity or other demanding activities. Follow the treating team's instructions.
When should you call a healthcare professional?
Contact the treating provider if you have questions before or after TUIP. Let the provider know right away if you develop a fever, cloudy or foul-smelling urine, unexpected or severe pain, or excessive blood in the urine.
Symptom after TUIP | Action |
Fever | Contact the provider. |
Cloudy or foul-smelling urine | Contact the provider. |
Unexpected or severe pain | Contact the provider. |
Excessive blood in the urine | Contact the provider right away. |
If symptoms feel severe or rapidly worsen, use the treating team's instructions for urgent assessment. This article cannot determine the cause or severity of an individual symptom.
What questions should you ask before a TUIP procedure?
A short question list can help clarify the procedure and recovery plan.
Topic | Example question |
Reason for treatment | What symptoms or prostate changes make TUIP an option for me? |
Alternatives | How does TUIP compare with TURP for my treatment goals? |
Fertility and sexual function | Which side effects could affect fertility, ejaculation or erections? |
Preparation | When should I stop eating, and which medicines should I take? |
Anesthesia | Will general or regional anesthesia be used? |
Catheter | How should I care for the catheter, and when will it be removed? |
Recovery | When can I return to normal activity, exercise or cycling? |
Warning signs | Who should I contact for fever, urine changes, pain or blood in urine? |
Conclusion: Weigh the benefits, trade-offs and recovery plan
TUIP is a minimally invasive BPH procedure that uses one or two incisions near the bladder neck to improve urine drainage without removing prostate tissue. It is performed through the urethra with a resectoscope and is followed by temporary urinary-catheter drainage.
The procedure takes about 30 to 45 minutes, but observation may continue for an hour or more or may include an overnight stay. Full recovery can take three to five weeks, and urinary symptoms may take longer to improve.
If TUIP has been proposed, bring a current medication list and ask the treating team to explain the alternatives, fertility and sexual-function considerations, catheter plan, activity restrictions, recovery timeline and warning signs. Contact the team for fever, cloudy or foul-smelling urine, unexpected or severe pain, or excessive blood in the urine.
Frequently Asked Questions
Is TUIP a treatment for an enlarged prostate?
Yes. TUIP treats benign prostatic hyperplasia, or BPH, which is an enlarged prostate. It can relieve pressure around the bladder opening and improve urine drainage.
Does TUIP remove prostate tissue?
No. TUIP makes one or two incisions in the prostate without removing prostate tissue. TURP, by contrast, cuts away and removes parts of the prostate.
How does the provider reach the prostate?
The provider inserts a thin resectoscope through the urethra to reach the prostate.
What type of anesthesia is used for TUIP?
General or regional anesthesia may be used. With general anesthesia the person is asleep; with regional anesthesia the person is awake while the lower half of the body is numb.
How long does the urinary catheter stay in after TUIP?
A provider removes the catheter in a few days. Follow the treating team's instructions for catheter care.
How long does the procedure take?
TUIP itself takes about 30 to 45 minutes. Some people are monitored for an hour or more afterward, and some stay overnight for a day or two.
How long does TUIP recovery take?
Full recovery can take three to five weeks. Symptom improvement may not be noticeable for a few weeks or months.
Is retrograde ejaculation possible after TUIP?
Yes. About 18% of people who have TUIP experience retrograde ejaculation, which means orgasm without ejaculating. The risk is lower than with TURP but is not zero.
What other risks are associated with TUIP?
Listed risks include erectile dysfunction, UTIs, bladder neck contracture, urinary incontinence, urethral stricture and the possibility of additional treatment.
Can there be blood in the urine after TUIP?
Blood in the urine may occur for a few days to a week. Excessive blood in the urine should be reported to the healthcare provider right away.
Who may be considered for TUIP?
TUIP may be used when a small or mildly enlarged prostate (usually 30 mL or less) blocks urine flow, especially when fertility-related side effects or other health concerns shape the treatment choice.
How do I prepare for TUIP?
Don't eat for eight hours before the procedure. [1] Stop medicines only as your provider instructs, or take them with a small sip of water, and arrange for someone to drive you home. [1]
When should I contact a healthcare professional after TUIP?
Contact the provider for fever, cloudy or foul-smelling urine, unexpected or severe pain, or excessive blood in the urine.
Related guides
Benign Prostatic Hyperplasia (BPH): Symptoms, Causes, and Treatment
Urinary Incontinence: Symptoms, Causes, and Treatment Options Explained
Urinary Tract Infection (UTI): Symptoms, Causes, Treatment, and Prevention
Urethral Stricture: Symptoms, Causes, Diagnosis, and Treatment Explained
Anesthesia Essentials: A Guide to Types, Safety, and Recovery
References
Cleveland Clinic. Transurethral Incision of the Prostate (TUIP): Procedure. Cleveland Clinic. Last updated June 19, 2024. https://my.clevelandclinic.org/health/procedures/transurethral-incision-of-the-prostate-tuip
Lourenco T, Shaw M, Fraser C, et al. The clinical effectiveness of transurethral incision of the prostate: a systematic review of randomised controlled trials. World J Urol. 2010;28(1):23-32. PMID 20033744. https://doi.org/10.1007/s00345-009-0496-8
Elkoushy MA, Elshal AM, Elhilali MM. Holmium laser transurethral incision of the prostate: can prostate size predict the long-term outcome? Can Urol Assoc J. 2015;9(7-8):248-254. PMID 26316907. https://doi.org/10.5489/cuaj.2735
Disclaimer
This article is for general educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional with any questions about a medical condition or treatment.
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