Surgery for BPH

When you need a permanent solution.

Men with very bothersome urinary symptoms may opt for surgery. Doctors also may recommend surgery for men who have other conditions or complications such as recurring urinary tract infections or repeated inability to urinate. Surgery involves removing only the areas of the prostate that are pressing against the urethra. The remaining areas of the prostate are left intact.2 Surgery can relieve both flow problems and incomplete bladder emptying.2 The most common forms of surgery take place through the urethra without the need to cut through the skin, but more traditional surgery is sometimes required.

Complete recovery after surgery may take a couple of months. 2 Many men may have problems urinating, temporary problems controlling urination, or blood in the urine after surgery.2 Patients experiencing excessive bleeding should consult their physicians immediately. Surgery affects sexual function in many patients and it may take up to 1 year for men to completely regain their sexual function.2 Some surgical procedures require placement of a tube for several days to drain urine during recovery.2 Help yourself by understanding what's going to happen in advance and talking over your concerns with your doctor before surgery.

Surgical options

Transurethral resection of the prostate (TURP): TURP is an operation that requires no incision and takes about 90 minutes to perform. It is usually performed under general or spinal anesthesia and requires a hospital stay.4 The surgeon uses an instrument that combines a viewing scope and light with an electrical surgical loop and valves for controlling irrigation fluid. The instrument is inserted through the urethra and the loop is used to cut away excess prostate tissue and seal the surrounding blood vessels. The irrigation fluid helps carry the bits of removed tissue into the bladder and the bladder is then flushed out at the end of the procedure.2 TURP is generally recommended over other forms of surgery because patients recover more quickly.2 One common after-effect of TURP is orgasm with reduced or no semen.2 In some patients, urine may be retained in the bladder so irritative BPH symptoms may not be relieved.

Transurethral incision of the prostate (TUIP): TUIP is generally reserved for patients with smaller prostates. In this procedure, a few small cuts are made in the prostate gland to help relieve the pressure on the urethra, allowing for easier urine flow. No prostate tissue is removed. TUIP can be performed in an outpatient clinic.4 The long-term benefits and side effects of TUIP are not yet fully known.2

Laser surgery: In this procedure, a laser fiber is passed through the urethra using an instrument called a cystoscope and delivers several pulses of energy that last less than a minute. The high energy from the laser vaporizes the excess prostate tissue around the urethra. Laser surgery requires anesthesia as well as a hospital stay. Some advantages of laser surgery over TURP include a quicker recovery time and less blood loss. However, laser surgery may not be appropriate therapy for men with larger prostates. It is also a relatively new procedure, so the long-term effects are not known.2

Traditional surgery: Traditional or "open" surgery involves cutting through the skin at the base of the penis and removing the inner portion of the prostate.4 It may be the best option when the prostate is greatly enlarged, or when there are complicating factors such as damage to the bladder.2 Traditional surgery requires a stay in the hospital, anesthesia, and recovery time with a tube to drain urine until you feel better.2

For partners who care
How to start the conversation with your doctor
BPH and sex
Learn about treatment options for BPH