When medical therapy fails and in severe cases, surgery can remove obstructing prostate tissue. Surgery is often recommended if you:
- Are unable to urinate
- Have kidney damage
- Have frequent urinary tract infections
- Have a lot of bleeding
- Have stones in the bladder
Transurethral Resection of the Prostate (TURP) is the most common surgery for BPH. In the United States, about 150,000 men have TURPs each year. TURP uses electric current or laser light. After anesthesia, the surgeon inserts a resectoscope through the tip of the penis into the urethra. The resectoscope has a light, valves for irrigating fluid, and an electrical loop. The loop cuts tissue and seals blood vessels. The removed tissue flushes into the bladder and out of the body. A catheter is placed in the bladder through the penis.
Transurethral incision of the prostate (TUIP) is used if you have a smaller prostate gland but major blockage. Instead of cutting and removing tissue, this procedure widens the urethra. The surgeon makes small cuts in the bladder neck, where the urethra joins the bladder, and in the prostate. This reduces the pressure of the prostate on the urethra. It makes urination easier.
The UroLift® System treatment is a minimally invasive approach to treating an enlarged prostate that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. The urologist places tiny implants to hold the prostate lobes apart, like open curtains on a window, to relieve compression on the urethra. This allows urine to flow normally again.
Suprapubic prostatectomy is a procedure to remove the inside part of the prostate gland to treat an enlarged prostate. It is done through a surgical cut in your lower belly, and may be required if you have a gland that is too large to remove with endoscopic treatment options or if you have significant stones within the bladder. The surgeon removes only the inner part of the prostate gland. The outer part is left behind. The process is similar to scooping out the inside of an orange and leaving the peel intact. After removing part of your prostate, the surgeon will close the outer shell of the prostate with stitches. A drain may be left in your belly to help remove extra fluids after surgery, and a catheter is required during healing. This does require a hospital stay of a few days.