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About Prostate Surgery Procedures

Benign prostatic hyperplasia, otherwise known as BPH, is a nonmalignant overgrowth of the prostate. Also called prostate enlargement, the condition can lead to a blockage of the urinary stream, urinary frequency, urinary hesitancy, an intermittent stream, and dribbling. As the symptoms become more severe, surgery may be indicated.

  1. Transurethral Resection of the Prostate (TURP)

    • According to Peter T. Scardino, M.D., Chairman of the Department of Urology at Memorial Sloan-Kettering Cancer Center, TURP accounts for 95 percent of surgeries performed to relieve prostate enlargement. That makes the procedure, nicknamed the "Roto-Rooter" surgery, one of the most practiced surgeries nationwide.

      While the patient is under anesthesia, the surgeon removes all excess prostate tissue that is bulging into the urethra and inhibiting urinary flow by inserting a small electric loop through the penis into the urethra. Electrical current then cauterizes the wound. TURP requires a hospital stay of up to three days, but it is a highly effective therapy for BPH, and only rare cases of side effects or complications have been reported.

    Transurethral Electrovaporization of the Prostate (TUVP)

    • The TUVP procedure vaporizes and cauterizes all prostate overgrowth by the insertion of an electrode that rapidly heats excess prostate tissue, turning it into steam. Although sufficient data is unavailable, it appears that side effects are as minimal as that of the TURP procedure, but with the advantage of a much shorter hospital stay.

    Laser Prostatectomy

    • Laser therapy involves the relatively new KTP high-energy lasers, which vaporize and cauterize prostate overgrowth. Hospital stay is shorter than TURP, and although long-term data is unavailable, so far the severity of side effects seems minimal.

    Transurethral Incision of the Prostate (TUIP)

    • Although TUIP does not remove all of the BPH , the procedure can improve symptoms of an enlarged prostate. While under anesthesia, a scope is passed through the patient's urethra. Lasers are then allowed to make small incisions in the prostate, enabling an improved urine flow. While TUIP can be done on an outpatient basis, the operation has a greater risk of additional procedures.

    Transurethral Microwave Thermotherapy (TUMT)

    • TUMT involves the cooking of excess prostate tissue by microwave heat. After a period of three to six months, the dead prostate tissue sloughs off and improvement of urinary flow is experienced. Favorable data has been collected for short-term results.

    Other BPH Surgeries

    • Transurethral Needle Ablation (TUNA) is a new surgery that attempts to bake the BPH by microwave needles. It takes one to two months for symptoms to improve and, as with TUMT, no long-term studies are available.

      High-Intensity Focused Ultrasound (HIFU) is another tissue-cooker operation. An ultrasound probe is placed in the rectum, heating the excess prostate tissue to 90 degrees Celsius. Heavy sedation is necessary and the success rate is fair at best.

      Open prostatectomy is a traditional surgery beneficial for men with very enlarged prostates. Excess prostate tissue is removed through an incision in the abdomen. Three-day hospital stays are required. Side effects such as ejaculation issues, bleeding, heart attack and stroke, have been reported.

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