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Prostate Problem Guide
An Introduction To Surgical BPH Treatment
Although drug treatment and minor minimally invasive surgery can be the solution for many men suffering from BPH (a swollen or enlarged prostate), for others surgery is necessary and there are currently three main surgical procedures carried out for BPH treatment.
The first is known as a transurethral resection of the prostate (TURP). This is the commonest form of surgery used in BPH treatment and involves the removal of the inner core of the prostate. The procedure is performed under general anesthetic (or using a spinal anesthetic) and a wire cutting loop is inserted through the penis and urethra to remove tissue from the prostate. Patients will normally stay in hospital for one or two days for this procedure and, following surgery, will need to uses a catheter to drain the bladder for two or three days.
In cases where the prostate is not too enlarged a more limited form of surgery known as transurethral incision of the prostate (TUIP) may be used. In this procedure instead of removing tissue from the prostate a series of cuts are made in the prostate to relieve pressure on the urethra. This procedure is again carried out under anesthesia and patients will remain in hospital for between one and three days.
In the case of both TURP and TUIP patients will normally require about two to four weeks for recovery and may experience moderate levels of pain or discomfort following surgery. The most commonly seen side effects of surgery are erection difficulty, which appears in about 3% to 13% of patients, and urinary retention, which appears in about 1% to 21% of patients. Some degree of urgency and frequency of urination will also be seen in most patients.
ANANDRON®: trade or brand name for Nilutamide, an anti-androgen; in the USA, this is called Nilandron®.
EPIDIDYMIS: tightly coiled, thin-walled tube that conducts sperm from the testes to the vas deferens and provides for the storage, transmission, and maturation of sperm; inflammation of the epididymis is called epididymitis.
NEOADJUVANT HORMONE BLOCKADE (NHB): use of ADT prior to other therapies such as radiation therapy, surgery or possibly chemotherapy to reduce tumor volume and/or prostate gland volume with the goal to allow these other therapies to work better; also called NHT (Neoadjuvant Hormone Therapy).
TRANSURETHRAL: through the urethra.
The final form of surgery used today is the open prostatectomy. Carried out under general anesthetic, an incision is made in the lower abdomen to allow the surgeon to gain access to the prostate and the inner core of the prostate is then removed.
Patients will normally remain in hospital for several days and will also be required to use a catheter for a time at home after surgery. Recovery from open surgery typically takes about three to six weeks during which time patients may experience a moderate degree of pain or discomfort. The main side effect of open surgery is incontinence which will be seen in about 6% of patients.
Surgery is an excellent form of BPH treatment and can reduce BPH symptoms considerably for most men. It is not however 100% effective and some symptoms will often remain even after surgery.
One point to remember is that BPH treatment does not act as a treatment for prostate cancer. BPH treatment involving the removal of tissue from the prostate only removes tissue from the inner core of the prostate. Prostate cancer however normally first appears on the outer tissue of the prostate from where it will often spread. It is important therefore that BPH patients continue to have regular checkups and screening for prostate cancer.
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