Surgery

• The common operation for prostate enlargement is transurethral resection of the prostate (TURP). In this procedure, the doctor scrapes away the innermost core of the prostate through a small instrument inserted through the urethra. The surgery reduces pressure on the urethra and generally gives relief from symptoms.



• A more limited operation called transurethral incision of the prostate (TUIP) may be an option for some men. In this operation, instead of removing prostate tissue, the doctor passes an instrument through the urethra to make one or two small cuts in the prostate. These cuts reduce the prostate's pressure on the urethra, making urination easier.



• Several newer treatments which may be performed in the office with local anesthetic alone or supplemented by sedation have been introduced and may be effective for men with an enlarged prostate. These include transurethral microwave thermotherapy (TUMT), transurethral needle ablation of the prostate (TUNA), and interstitial laser coagulation (ILC). The general principle of these three treatments is similar. In each case, the prostate tissue is heated to a level that will lead to death of portions of the prostate tissue, thus shrinking away and removing some of the obstruction.



• Another popular new treatment is photovaporization of the prostate (PVP), in which a laser is used to directly remove prostate tissue in a similar fashion to what is accomplished with a TURP (see above). The advantage of this technique compared with TUMT, TUNA, or ILC is that it offers immediate removal of tissue with rapid improvement in symptoms. Conversely, these other three treatments lead to delayed tissue loss and are not associated with immediate improvement of urinary symptoms in most cases.



• Other new surgical alternatives are being developed. Ask your doctor about the potential risks and benefits of medication and surgery. An operation for an enlarged prostate does not eliminate the risk of developing prostate cancer.