Surgical Procedures

Surgical intervention may be an appropriate treatment option for patients with moderate to severe symptoms of BPH or patients that have developed acute urinary retention or other BPH-related complications.  There are two primary surgical options currently available:

  • Transurethral Resection of the Prostate (TURP)
  • Laser Therapies

Transurethral resection of the prostate is the surgical removal of part of an enlarged prostate gland utilizing an endoscopic approach through the urethra.  This procedure is currently the most common surgical treatment for symptomatic BPH.  This procedure requires a hospital stay and is performed under general or spinal anesthesia.  As with any surgical procedure, there are possible complications including TURP syndrome (a dilutional hyponatremia that occurs when irrigant solution is absorbed into the bloodstream), sexual dysfunction, irritative voiding symptoms, bladder neck contracture, the need for blood transfusion, UTI, and hematuria.

Benefits

  • Effective for treatment of BPH symptoms
  • Most common surgery used to remove part of an enlarged prostate
  • Long track record of success

Perioperative and Short-Term Risks1,2

  • General anesthesia
  • Intracapsular perforation
  • TUR syndrome
  • Transfusions
  • Post operative pain and discomfort
  • Infection

Longer Term Complications1,2

  • Urethral stricture
  • Bladder neck stenosis
  • Retrograde ejaculation
  • Erection problems
  • Painful Urination

Laser therapies are another treatment option and are considered an alternative to the TURP surgical option.  There are two primary laser therapies: holmium laser enucleation (HoLEP) and photoselective vaporization (PVP) of the prostate.1 HoLEP involves a resectoscope  inserted through the penis into the urethra. The prostate tissue is removed by cutting away the tissue with the holmium laser.  PVP, also referred to as the GreenLight™ Laser Procedure, consists of a high-powered laser inserted through an endoscope placed in the urethra, which vaporizes and removes prostate tissue.

“TURP may be considered the “Gold standard” for treatment of BPH, but with the aging male population, the risks and expense of a hospital procedure, an office CTT or Prostiva can be served on a “Silver Platter” with far less risk and comorbidity for the patient.” – J. Randall Beahrs, MD

1AUA Treatment Guidelines: Benign Prostatic Hyperplasia (2010) 2Carter HB. Prostate Disorders: The Johns Hopkins White Papers. Baltimore, MD: Johns Hopkins Medicine; 2010:1-24.