Prostate resection - minimally invasive
Laser prostatectomy; Transurethral needle ablation; TUNA; Transurethral incision; TUIP; Holmium laser enucleation of the prostate; HoLep; Interstitial laser coagulation; ILC; Photoselective vaporization of the prostate; PVP; Transurethral electrovaporization; TUVP; Transurethral microwave thermotherapy; TUMT; TURP- transurethral resection of prostateMinimally 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.
Enlarged prostate
The prostate is a gland that produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube th...
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These procedures are often done in your doctor's office or at an outpatient surgery center.
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 surgeon 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
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 ArticleSpinal 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.
Foley catheter
A urinary catheter is a tube placed in the body to drain and collect urine from the bladder.
Read Article Now Book Mark Article - 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 surgeon'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.
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
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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 health care provider 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 ArticleYour provider 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
Bladder stones
Bladder stones are hard buildups of minerals. These form in the urinary bladder.
Read Article Now Book Mark Article - Urinate very slowly
- Took medicines and they did not help your symptoms
Risks
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
Blood clots
Blood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...
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Blood loss
Bleeding is the loss of blood. Bleeding may be:Inside the body (internal)Outside the body (external)Bleeding may occur:Inside the body when blood le...
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Breathing problems
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Heart attack or stroke during surgery
Heart attack
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 ArticleStroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark Article - Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
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Other risks for this surgery are:
- Erection problems (impotence)
Impotence
An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...
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- Passing semen back into your bladder instead of out through the urethra (retrograde ejaculation)
Retrograde ejaculation
Retrograde ejaculation occurs when semen goes backward into the bladder. Normally, it moves forward and out of the penis through the urethra during ...
Read Article Now Book Mark Article - Problems with urine control (incontinence)
Incontinence
Urinary (or bladder) incontinence occurs when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries ...
Read Article Now Book Mark Article - Urethral stricture (tightening of the urinary outlet from scar tissue)
Urethral stricture
Urethral stricture is an abnormal narrowing of the urethra. The urethra is the tube that carries urine out of the body from the bladder.
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Before the Procedure
You will have many visits with your providers and tests before surgery:
- Complete physical exam
- Visits with your provider to make sure medical problems such as diabetes, high blood pressure, and heart or lung problems are being treated well
Diabetes
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 ArticleHigh blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
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If you are a smoker, you should stop several weeks before the surgery. Your provider 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 surgeon 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 surgeon told you to take with a small sip of water.
- Your surgeon 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.
Outlook (Prognosis)
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).
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 ArticleSome 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 surgeon.
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
References
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.
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/.
Parsons JK, Dahm P, Köhler TS, Lerner LB, Wilt TJ. Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline amendment 2020. J Urol. 2020;204(4):799-804. PMID: 32698710 pubmed.ncbi.nlm.nih.gov/32698710/.
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Review Date: 4/1/2023
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.