Why You Might Need Surgery
A man’s prostate gland begins to enlarge (hypertrophy) around age 40. The prostate is a walnut-sized gland. It sits underneath the bladder and surrounds the urethra, a tube that carries urine out of a man’s body from the bladder.
An enlarged prostate, also known as benign prostatic hyperplasia (BPH), may begin to squeeze and partially cut off the flow of urine from the bladder. The condition is more common in older men.
The growth in the prostate is not caused by cancer. Many men assume they must deal with the effects of BPH as a natural part of aging. While it is true that BPH is common, it’s a condition that can be treated. In fact, there are several great treatment options. You need not ignore the symptoms any longer.
Your BPH Surgery Options
Surgery, including both minimally invasive procedures and more traditional surgical treatments, generally yields a high rate of success. However, surgery is not a typical first-line treatment for BPH. Surgery is usually reserved for men who have moderate to severe BPH symptoms as well as men whose symptoms have not improved with medication.
Although fairly common and safe, each of the surgeries most commonly used for treating BPH come with the potential for side effects and complications. Most of these side effects are rare. It’s nonetheless important to know all the potential outcomes before making a treatment decision.
Here are the most common BPH surgeries and the possible risks for each.
Transurethral Resection of the Prostate (TURP)
During a TURP procedure, your surgeon will insert a lighted scope into your urethra and remove tissue from all but the very outer portion of your prostate.
Symptoms typically disappear very quickly after a TURP procedure because it is so effective for treating BPH. You may need a catheter to help you drain your bladder for several days following the procedure.
You’ll need to recover at a hospital or at home for up to three days, and your activities may be limited for as long as two months. Your physical activity will also be limited for several weeks until you’ve healed.
Side effects of this surgery may include:
- bleeding during the surgery, which requires a transfusion
- improper fluid absorption
- salt imbalances caused by the fluid absorption issues
- impotence
- incontinence
Transurethral Incision of the Prostate (TUIP)
Instead of removing portions of your prostate, a surgeon will make several small incisions in your prostate during a TUIP procedure. This gives your prostate room to expand without cutting off the flow of urine through your urethra.
TUIP is typically used to treat milder cases of enlarged prostate glands. Even after TUIP, it is possible your prostate will continue to grow and you will need additional treatments later. Following the surgery, you may need to wear a catheter for up to a week to help drain your bladder.
A TUIP procedure is much less invasive than a TURP procedure. Your recovery time should be less. Your doctor will likely send you home following the procedure.
Side effects of this surgery include:
- backward ejaculation, a non-dangerous condition that occurs when semen flows into your bladder
- bleeding during surgery, which may require a transfusion
- wound site infection
- incontinence
- impotence
Open Prostatectomy
During this procedure, a cut is made from your belly button to your pubic bone. Your surgeon then removes tissue from your prostate.
This more invasive surgical procedure is typically only used for prostates that are very large. Unlike some other prostate surgeries, open prostatectomy almost eliminates your need for additional procedures because the results are so successful.
More invasive procedures, such as an open prostatectomy, have higher risks of complications from anesthesia, bleeding that requires a transfusion, and infection. Additional complications of an open prostatectomy include:
- impotence
- overactive bladder
- wound infection
- leaking of urine when feeling the urge to urinate (urge incontinence)
- partial or full incontinence
- infertility
Most men stay in the hospital for five to seven days. You will likely need to use a catheter to help empty your bladder for about one week.
What You Can Do to Reduce Your Risk of Complications
If you do need surgery to treat your BPH symptoms, you can take a few steps to help lower your risk of post-surgery complications. These steps include:
- Eat better and move more. A balanced diet and moderate exercise may help with your recovery. Start before your procedure, and as you’re able, keep it up after your procedure. In addition to keeping your body active, you may begin losing weight. Any amount of weight loss can help ease symptoms of BPH and possibly improve your recovery.
- Follow instructions. If your doctor has instructed you not to lift or move anything over a certain weight, listen to those instructions. You may complicate your recovery by doing too much work too soon.
- Keep follow-up appointments. Post-surgery recovery may require frequent visits for a brief time. This early window of time will help you and your doctor monitor your healing and discover any possible hidden complications.
When to Call Your Doctor
If you think you may be experiencing symptoms of an enlarged prostate, make an appointment to see your doctor. Urinary problems can be caused by several conditions. Your doctor will help you identify what is likely causing yours. Untreated urinary problems can also lead to serious complications. If your symptoms worsen rapidly and you’re unable to urinate at all, seek emergency medical treatment.
If you have an increased risk of BPH or if you’re worried about the risk of developing the condition, make yearly check-ups with your doctor for a prostate exam. This will help you and your doctor identify any potential problems early. The earlier you find a growing prostate, the earlier you can begin treatments. Earlier treatment may reduce your need for more invasive procedures later.
