Prostate resection - minimally invasive
Minimally invasive prostate resection is surgery to remove part of the prostate gland, to treat an enlarged prostate. The surgery will improve the flow of urine through the urethra, the tube that carries urine from the bladder outside of your body. It can be done in different ways. There is no incision (cut) in your skin.
These procedures are often done in your doctor's office or at an outpatient surgery clinic.
The surgery can be done in many ways. The type of surgery will depend on the size of your prostate and what caused it to grow. Your doctor will consider the size of your prostate, how healthy you are, and what type of surgery you may want.
All of these procedures are done by passing an instrument through the opening in your penis (meatus). You will be given general anesthesia (asleep and pain-free), spinal or epidural anesthesia (awake but pain-free), or local anesthesia and sedation. Choices are:
General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...Read Article Now Book Mark Article
Spinal or epidural anesthesia
Spinal and epidural anesthesia are procedures that deliver medicines that numb parts of your body to block pain. They are given through shots in or ...Read Article Now Book Mark Article
- Laser prostatectomy (laser TURP): This procedure takes about 1 to 2 hours. The laser destroys prostate tissue that blocks the opening of the urethra. You will probably go home the same day. You may need a Foley catheter placed in your bladder to help drain urine for a few days after surgery.
- Transurethral incision (TUIP): Your surgeon makes small surgical cuts where the prostate meets your bladder. This makes the urethra wider. This procedure takes 20 to 30 minutes. Many men can go home the same day. Full recovery can take 2 to 3 weeks. You may go home with a catheter in your bladder.
- Transurethral electrovaporization (TUVP): A tool or instrument delivers a strong electric current to destroy prostate tissue. You will have a catheter placed in your bladder. It may be removed within hours after the procedure or you may go home with it.
- Photoselective vaporization (PVP): A high-powered green-light laser is used to vaporize and remove excess prostate tissue with very little loss of blood.
- Prostatic urethral lift (PUL): Small implants are placed in the prostate lobes to compress the prostate tissue.
- Transurethral microwave thermotherapy (TUMT): TUMT delivers heat using microwave pulses to destroy prostate tissue. Your doctor will insert the microwave antenna through your urethra. You may need a Foley catheter placed in your bladder to help drain urine after surgery for 3 to 5 days.
- Water vapor thermal therapy (WVTT): This procedure releases sterile water vapor (steam) into the prostate to remove extra tissue. It can be done in the provider’s office or an outpatient surgery center.
- Transurethral needle ablation (TUNA): The surgeon passes needles into the prostate. High-frequency sound waves (ultrasound) heat the needles and prostate tissue. You may need a Foley catheter placed in your bladder to help drain urine after surgery for 3 to 5 days.
Why the Procedure Is Performed
An enlarged prostate can make it hard for you to urinate. You may also get urinary tract infections. Removing all, or part, of the prostate gland can make these symptoms better. Before you have surgery, your doctor may tell you changes you can make in how you eat or drink. You may also try some medicines.
Urinary tract infections
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...Read Article Now Book Mark Article
Your doctor may recommend prostate removal if you:
- Cannot completely empty your bladder (urinary retention)
- Have repeat urinary tract infections
- Have bleeding from your prostate
- Have bladder stones with your enlarged prostate
- Urinate very slowly
- Took medicines and they did not help your symptoms
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
- Blood loss
- Breathing problems
- Heart attack or stroke during surgery
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...Read Article Now Book Mark Article
- Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
- Reactions to medications
Other risks for this surgery are:
Before the Procedure
You will have many visits with your doctor and tests before surgery:
- Complete physical exam
- Visits with your doctor to make sure medical problems such as diabetes, high blood pressure, and heart or lung problems are being treated well
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.Read Article Now Book Mark Article
If you are a smoker, you should stop several weeks before the surgery. Your doctor or nurse can help.
Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.
During the weeks before your surgery:
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and other drugs like these.
- Ask your doctor which drugs you should still take on the day of your surgery.
On the day of your surgery:
- Do not eat or drink anything after midnight the night before your surgery.
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive at the hospital or clinic.
After the Procedure
Most people are able to go home the day of surgery or the day after. You may still have a catheter in your bladder when you leave the hospital or clinic.
Most of the time, these procedures can relieve your symptoms. But you have a higher chance of needing a second surgery in 5 to 10 years than if you have transurethral resection of the prostate (TURP).
Transurethral resection of the prostate (TURP) is a surgery to remove the inside part of the prostate gland. It is done in order to treat symptoms o...Read Article Now Book Mark Article
Some of these less invasive surgeries may cause fewer problems with controlling your urine or ability to have sex than the standard TURP. Talk to your doctor.
You may have the following problems for a while after surgery:
- Blood in your urine
- Burning with urination
- Need to urinate more often
- Sudden urge to urinate
Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Djavan B, Teimoori M. Surgical management of LUTS/BPH: TURP vs. open prostatectomy. In: Morgia G, ed. Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia. Cambridge, MA: Elsevier Academic Press; 2018:chap 12.
Foster HE, Barry MJ, Dahm P, et al. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline. J Urol. 2018;200(3):612-619. PMID: 29775639 pubmed.ncbi.nlm.nih.gov/29775639/.
Han M, Partin AW. Simple prostatectomy: open and robotic-assisted laparoscopic approaches. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 147.
Helo S, Welliver C, McVary KT. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 146.
Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part II - surgical evaluation and treatment. J Urol. 2021;206(4):818-826. PMID: 34384236. pubmed.ncbi.nlm.nih.gov/34384236/.