Benign Prostatic Hyperplasia (Part Three)

Surgical Treatment

The doctor may recommend surgical intervention when medications do not yield results or in cases with severe symptoms. There are several types of surgery for prostate enlargement. The decision to find the type of surgery depends on several factors such as the size of the prostate, the severity of symptoms, bladder stones, the equipment available to the surgeon, etc.

Every type of prostate surgery can cause side effects such as retrograde ejaculation, inability to control urine (incontinence), and impotence.

Standard Surgery

This group includes:

Transurethral Resection of the Prostate (TURP). TURP is a surgical technique commonly used in urology for the treatment of benign prostatic hyperplasia. In recent decades, it has been called the gold standard. Through a cystoscope, the urologist uses a loop-shaped wire connected to electric current to cut the prostate into slices until it is completely removed. It effectively removes the parts of the prostate that have blocked urine flow. TURP is performed under regional or general anesthesia. The patient stays in the hospital for an average of 2 or 3 days. Complications include: bleeding, urine retention, retrograde ejaculation (backward flow of sperm), and rarely problems with erection.

Transurethral Incision of the Prostate (TUIP). It consists only of a cut of the prostate to reduce its pressure on the urine canal. This is a minimally invasive method and is used for small prostates.

Laser therapy. Consists in the use of laser beams to make cuts or to remove the prostate. The advantage over TURP is the lower percentage of complications.

Transurethral Microwave Therapy (TUMT). Consists in the use of microwave energy to destroy part of the prostate through heat.

Open Surgery. This is the oldest method. The urologist makes an incision in the lower abdomen skin reaching the prostate and completely removing it within its capsule. This operation is increasingly rare and reserved for very large prostates or when accompanied by bladder stones.