What You Should Know About BPH Surgery Complications

Medically reviewed by Andrew Gonzalez, MD on August 14, 2017Written by Kimberly Holland

Why you might need surgery

The prostate is normally a walnut-sized gland that sits underneath your bladder and surrounds the urethra, a tube that carries urine out of your body from the bladder. A man’s prostate gland begins to hypertrophy (enlarge) around age 40.

An enlarged prostate, also known as benign prostatic hyperplasia (BPH), may begin to cut off the flow of urine from the bladder. The condition is more common in older men. BPH-associated growth of the prostate is not caused by cancer.

While it’s true that BPH is common, it’s a condition that can be treated. You should consider the possible complications when picking among your options.

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 common surgeries for treating BPH come with potential 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. It’s also important to be aware of the recovery expectations for BPH surgery.

Here are the most common BPH surgeries and the possible risks of 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 the surgery 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 also 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.

Possible complications

Side effects of this surgery may include:

  • bleeding during the surgery, which requires a transfusion
  • improper fluid absorption
  • salt imbalances caused by fluid absorption issues
  • impotence (erectile dysfunction)
  • incontinence
  • urethral stricture (narrowing) leading to a “split stream” of urine
  • post-TURP syndrome

Post-TURP syndrome is a rare but serious condition that occurs when too much fluid is absorbed during the TURP procedures. The initial symptoms include dizziness, headache, and a slow heart rate. Symptoms can progress to include shortness of breath, seizures, and coma.

Transurethral incision of the prostate (TUIP)

During a TUIP procedure, a surgeon will make several small incisions in your prostate instead of removing portions of your prostate. 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. It’s 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.

Possible complications

Side effects of this surgery include:

  • retrograde ejaculation, a nondangerous condition that occurs when semen flows into your bladder
  • bleeding during surgery, which may require a transfusion
  • surgical site infection
  • incontinence
  • impotence

Open prostatectomy

During this surgery, the surgeon makes a cut 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 men whose prostate is very large. Unlike some other prostate surgeries, open prostatectomy almost eliminates your need for additional procedures because the results are so successful.

Possible complications

More invasive procedures such as an open prostatectomy have higher risks of complications. This is due to anesthesia and the possibility of infection or bleeding that requires a transfusion. Additional complications of an open prostatectomy include:

  • impotence
  • overactive bladder
  • wound infection
  • leaking of urine when feeling the urge to urinate
  • partial or full incontinence
  • infertility

Most men stay in the hospital for five to seven days after surgery. You will likely need to use a urinary catheter to help empty your bladder for about one week.

What you can do to reduce your risk of complications

If you need surgery to treat your BPH symptoms, you can take a few steps to help lower your risk of 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. It will keep your body active, and 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 greater than a certain weight, listen to those instructions. You may complicate your recovery by doing too much work too soon.

Keep follow-up appointments: Recovery may require frequent visits with your doctor 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 have 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 can’t urinate at all, seek emergency medical treatment.

If you have an increased risk of BPH or are worried about your risk of BPH, 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 also reduce your need for more invasive procedures later.

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