Transurethral Prostatectomy (TURP): The Gold Standard of BPH Treatment
This procedure is considered the “gold standard” of benign prostatic hyperplasia (BHP) treatment — the one against which other therapeutic measures are compared. It involves removal of the core of the prostate with a resectoscope — an instrument passed through the urethra into the bladder. A wire attached to the resectoscope removes prostate tissue and seals blood vessels with an electric current. A catheter remains in place for one to three days, and a hospital stay of one or two days is generally required. TURP causes little or no pain, and full recovery can be expected by three weeks after surgery. In carefully selected cases (patients with medical problems and smaller prostates), TURP may be possible as an outpatient procedure.
Improvement after surgery is greatest in those with the worst symptoms. Marked improvement occurs in about 93% of men with severe symptoms and in about 80% of those with moderate symptoms. The mortality from TURP is very low (0.1%). However, impotence follows TURP in about 5% to 10% of men, and incontinence occurs in 2% to 4%.
Other types of surgery
Current surgical options include monopolar and bipolar transurethral resection of the prostate (TURP), robotic simple prostatectomy (retropubic, suprapubic and laparoscopic), transurethral incision of the prostate, bipolar transurethral vaporization of the prostate (TUVP), photoselective vaporization of the prostate (PVP), prostatic urethral lift (PUL), thermal ablation using transurethral microwave therapy (TUMT), water vapor thermal therapy, transurethral needle ablation (TUNA) of the prostate and enucleation using holmium (HoLEP) or thulium (ThuLEP) laser.