Benign prostatic hyperplasia (BPH) refers to an enlarged prostate, which is a common condition in older men. Some men with BPH develop lower urinary tract symptoms (LUTS). As the prostate gets larger, it squeezes the urethra, the tube that allows urine and semen to leave the body through the penis. LUTS include difficulty urinating and the need to urinate frequently.
Surgery is one way of treating BPH/LUTS. It is usually considered for men who have moderate to severe cases and haven’t had success with other treatments, such as medications. Men having this surgery are given general anesthesia and are in the hospital for at least one night. The tissue removed comes from inside the prostate gland – the area that is pressing on the urethra.
Common surgical techniques include the following:
• Transurethral resection of the prostate (TURP). TURP is the most common surgical approach and is considered the “gold standard.” Starting at the tip of the penis, the surgeon carefully sends a tool called a resectoscope through the urethra. The resectoscope has an electrical loop that can cut and remove excess prostate tissue with an electric current or laser light. Fluid is used to send the tissue into the bladder, which is later flushed out.
• Transurethral incision of the prostate (TUIP). This procedure also involves accessing the prostate through the urethra. With TUIP, small incisions are made in the prostate, which eases pressure on the urethra.
• Open surgery. With open surgery, the prostate is accessed through an external incision, not through the urethra. Tissue from the inner prostate is removed through this incision. Men are candidates for open surgery if they are unable to have transurethral surgery or if their prostate glands are particularly large.
According to the Urology Care Foundation, improvement rates for TURP, TUIP, and open surgery are 88%, 80%, and 98%, respectively.
After surgery, the patient has a Foley catheter for several days. This type of catheter allows urine to flow from the bladder into a special collection bag. Once the catheter is removed, there might be some discomfort with urination. Some men experience short-term incontinence or bleeding.