Benign prostate hyperplasia (BPH) surgery may be done to address severe symptoms reducing the quality of life.
What is the Prostate?
The prostate is a walnut-sized gland that wraps around the urethra, which is a tube that carries urine from the bladder to outside the body. Its main job is to make fluid for semen. The prostate is located below the bladder and in front of the rectum.
Diagnosing BPH
An enlarged, non-cancerous prostate is called benign prostatic hyperplasia. The condition is common in men over age 50. Though there isn’t a sure way to prevent BPH, patients can eat a healthy diet, lose weight, and stay active to reduce their risk.
To diagnose BPH, a physician or urologist will:
- Ask questions about the patient’s symptoms
- Review the patient’s medical history
- Perform a digital rectal exam to look for enlargement, tenderness, lumps, or hard spots
- Order urine tests, such as urinalysis, post-void residual volume (PVR), uroflowmetry, or urodynamic pressure flow study
Treating BPH With Surgery
BPH surgery may be necessary if the patient is experiencing the following severe symptoms:
- Bladder stones
- Kidney damage
- Frequent urinary tract infections (UTIs)
- Excessive blood in the urine
- Inability to urinate
Types of BPH Surgery
Minimally invasive BPH surgery may include:
- GreenLight ™ laser. Also called photoselective vaporization of the prostate (PVP), this surgery vaporizes excess prostate tissue to create a channel in the urethra that allows urination. The patient is under general anesthesia during the operation.
- Plasma button electrovaporization. During this type of BPH surgery, prostate tissue is removed using low temperature plasma energy.
- Water vapor therapy. Treatment is performed under a local nerve block. The physician delivers water vapor directly to the prostate tissue and over the next three months, the tissue is destroyed and reabsorbed by the body.
- UroLift. This procedure places implants to pin away the lateral prostate lobes and reduce obstruction.
- Prostatic artery embolization. The physician uses catheters to deliver agents that inhibit blood flow to the prostatic artery to shrink tissue and address symptoms of BPH.
Patients with severe symptoms or who don’t experience relief from minimally invasive surgical treatment may need the following procedures:
- Transurethral resection of the prostate (TURP). During treatment, the urologist will insert a resectoscope into the urethra to remove excess tissue blocking urine flow from the bladder. The patient may be placed under general or local anesthesia and will need to stay in the hospital for one to two days.
- Transurethral incision of the prostate (TUIP). The physician cut the bladder neck and prostate to relax the bladder opening and allow urine to flow freely. TUIP is most effective on patients with smaller prostates.
- Simple prostatectomy. The surgeon will make an incision through the abdomen or laparoscopically to remove the inner portion of the gland and leave the outer segment intact.
Potential Risks of BPH Surgery
BPH surgery is common and generally very safe. However, potential risks or complications include urinary tract infections, blood in the urine, frequent urination, incontinence, painful urination, difficulty urinating, large blood clots, sexual dysfunction, infections, erectile dysfunction, and scar tissue.
