Surgical Procedures to Treat BPH

Surgical prostatectomy: Transurethral resection of the prostate (TURP) is the most common procedure. Both open prostatectomies and TURPs have very low mortality rates. The most common post-surgical problem is retrograde ejaculation, occurring in about 70% of patients. Impotence (about 5%) and incontinence (2-4%) are side effects about which men are most likely to be concerned. About 15-20% of men will require reoperation after 10 years.

Transurethral incision of the prostate: This may be effective in patients with bladder outlet obstruction primarily at the bladder neck and with a small prostate gland. It is effective in this well-defined group of patients and causes significantly lower complication rates and shorter hospital stays than prostatectomy operations.

Stent placement: Stents are used most commonly in men who are poor surgical risks. They are effective but frequently cause dysuria or urgency, and a small group of patients may require removal because of persistent symptoms or poor placement.

Microwave treatment: This treatment is still being studied. It seems to be effective in some patients, but it causes a high rate of postoperative urinary retention, about 35%, which may persist for a week or longer. Long term effects have not been well studied.

Laser prostatectomy: This treatment is also still being studied. The patient may require catheterization after the procedure, and it may be several weeks before the effects become completely evident. The long term effects are not yet known.