If you have difficulty urinating because of
benign prostatic hyperplasia (BPH), you probably will
not need surgery unless you:
- Cannot urinate.
- Have a partial blockage in your
urethra that is causing repeated
urinary tract infections,
bladder stones, or bladder damage.
- Have blood in your urine that is not getting better and is causing other problems such as clots that make it hard to urinate.
- Have kidney
If you have no complications but have symptoms that bother
you or if other treatment has not worked, you may choose to have surgery. In
this case, think about:
- How bad your symptoms are.
- How much you expect the surgery to improve your
- How you feel
about the risk of developing a
complication because of the surgery.
For more information on this decision, see:
Enlarged Prostate: Should I Have Surgery?
Surgery that does not require an incision through the
skin is usually used. The surgical instruments are passed up the urinary
opening in the penis to the location of the prostate. This is described as a
transurethral surgery of the prostate.
Transurethral resection of the prostate (TURP) is the
surgery for benign prostatic hyperplasia that has been studied the most. It is
the surgery that is used the most to treat symptoms of BPH. All other surgeries
are compared to TURP. In TURP, part of the prostate is removed.
Some of the other surgeries that have been studied and compared to TURP
In most cases, these treatments have been studied for
only a few years, so their long-term effectiveness is not yet known. There are
also some other surgeries.
The oldest surgical method to treat BPH is an
open prostatectomy, in which an incision is made
through the skin to reach the prostate. Doctors use this method less often now,
but it is still preferred if the prostate is very large.
What to think about
Surgery is the most reliable way
to relieve symptoms. But surgery may not relieve all your symptoms. And it puts
you at risk for certain
surgical complications, including
erection problems (erectile dysfunction). Other
complications include the inability to control the release of urine (urinary
incontinence) and ejaculation of semen into the bladder instead of out through
the penis (retrograde ejaculation). The complication depends on which type of
surgery is used.
Men who have severe symptoms often notice great
improvement in the quality of life following surgery. Men whose symptoms are
mild may find that surgery does not greatly improve quality of life, and they
may want to think carefully before deciding to have surgery to treat
If you have decided to have surgery, or if there are clear
medical reasons to have surgery, the best surgical option depends on the size
and shape of your prostate and the experience of the surgeon.
- Transurethral resection of the prostate
(TURP) is the most common surgery for
- Other types of surgery have fewer risks and a shorter recovery period than TURP. But they may not work as well to stop symptoms. And you may need more treatment or surgery in the future.