Known as simple prostatectomy, surgery for benign prostatic hyperplasia (BPH) typically involves removing only the prostate tissue that is surrounding and pressing on the urethra. The procedure is performed either transurethrally (through the urethra) or by making an incision in the lower abdomen. Here are the most commonly-performed surgeries, in brief.
The most common surgical procedure for BPH, transurethral prostatectomy (TURP), is considered the "gold standard" treatment for the condition. Some newer treatments that use heat to relieve symptoms are less invasive, do not require a hospital stay, and are associated with fewer complications. However, many men who receive these minimally invasive treatments need to undergo TURP years afterwards because their symptoms eventually recur.
- TURP (transurethral prostatectomy). In this procedure, a long, thin instrument called a resectoscope is inserted through the urethra. A wire loop at the end of the instrument cuts away excess prostate tissue that obstructs the urethra. The loose bits of tissue collect in the bladder and are flushed out of the body through the resectoscope at the end of the procedure.
In minimally invasive procedures, other types of devices are inserted through the urethra to obliterate tissue by means other than cutting it away.
- TUMT (transurethral microwave therapy) uses a small antenna to emit microwave energy that heats the prostate to a temperature above 110° F. A cooling system in the catheter protects the urethra from heat damage.
- TUEVP (transurethral electrovaporization of the prostate) uses a resectoscope fitted with a small grooved roller at the end to deliver electric current that vaporizes prostate tissue.
- TUNA (transurethral needle ablation), TUIP (transurethral incision of the prostate), and PVP (photoselective laser vaporization of the prostate) all involve inserting an instrument through the resectoscope that delivers either low-level radiofrequency energy (TUNA) or laser energy (PVP or TUIP) to vaporize excess tissue. Some versions of TUIP use a miniature electric knife rather than a laser to cut the tissue. Shields in the instrument protect the urethra from heat damage.
