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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 prostate

Minimally 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.

Description

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:

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.

Your provider may recommend prostate removal if you:

Risks

Risks for any surgery are:

Other risks for this surgery are:

Before the Procedure

You will have many visits with your providers and tests before surgery:

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:

On the day of your surgery:

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).

Some 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:

Related Information

Enlarged prostate
Transurethral resection of the prostate
Simple prostatectomy
Prostate resection - minimally invasive - discharge
Enlarged prostate - what to ask your doctor
Transurethral resection of the prostate - discharge

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.

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