Enlarged prostate

SURGERY

Prostate surgery may be recommended if you have:

Incontinence
Recurrent blood in the urine
Urinary retention
Recurrent urinary tract infections

The choice of a specific surgical procedure is usually based on the severity of your symptoms and the size and shape of your prostate gland.

Transurethral resection of the prostate (TURP): This is the most common surgical treatment for BPH. The TURP is performed by inserting a scope through the penis and removing the prostate piece by piece.
Transurethral incision of the prostate (TUIP): This procedure is similar to TURP, but is usually performed in men who have a relatively small prostate. This procedure is usually performed as an outpatient without need for a hospital stay. Like the TURP, a scope is inserted through the penis until the prostate is reached. Then, rather than removal of the prostate, a small incision is made in the prostatic tissue to enlarge the opening of the urethra and bladder outlet.
Open Prostatectomy: An open prostatectomy is usually performed using general or spinal anesthesia. An incision is made through the abdomen or perineal area (i.e., through the pelvic floor, including the region from the scrotum to the anus). Then, the prostate is removed. This is a lengthy procedure, and it usually requires a hospital stay of 5 to 10 days.

The majority of men who have prostate surgery have improvement in urine flow rates and symptoms. Possible complications include impotence, urinary incontinence, retrograde ejaculation (semen flowing back into the bladder rather than out the penis), infertility, and urethral stricture (narrowing). Rates of these complications vary, depending on the surgical procedure that you and your doctor decide is best.

Various other procedures are available, such as those that destroy prostate tissue with heat generated by microwaves or lasers. Photoselective vaporization of the prostate (PVP), one of the newer laser technologies, is typically done as an outpatient procedure. The patient goes home on the same day. However, there is no long-term data for this procedure. Another form of treatment is prostatic stents.

For more information, see prostate surgery.

Support Groups:

Several national groups provide information on BPH. See BPH support groups.

Complications:

Men who have had long-standing BPH with a gradual increase in symptoms may develop: