When a patient does not respond to medications, or in cases where drug treatment is not appropriate, there are several outpatient surgical treatments available to treat BPH. These treatments include:
- Transurethral Resection of the Prostate (TURP)
During this commonly used procedure, the provider passes an instrument through the urethra and removes excess prostate tissue in order to relieve an obstructed urine flow. The tissue is sent to the lab to check for prostate cancer. This surgery requires anesthesia and a hospital stay.
- Transurethral Microwave Thermotherapy (TUMT)
In transurethral microwave thermotherapy, an instrument called an antenna is inserted through the urethra into the prostate gland. Microwaves are then used to heat the inside of the prostate. The heat caused by the microwaves becomes high enough inside the prostate to destroy some of the excess tissue.
Cooling fluid is circulated around the microwave antenna to prevent heat from damaging the wall of the urethra. To prevent the temperature from getting too high outside the prostate, a temperature sensor is inserted into the rectum during the procedure. If the temperature in the rectum becomes too high, the treatment is stopped automatically until the area cools to an acceptable level. As the prostate heals, it shrinks and reduces the blockage of urine flow.
- Transurethral Incision of the Prostate (TUIP)
This procedure is similar to TURP but, instead of removing tissue, the urethra is widened. The provider will make several small incisions in the bladder neck, where the urethra joins the bladder, and in the prostate gland itself, which relieves pressure without trimming away tissue. This procedure is often done on smaller prostates.
- Transurethral Needle Ablation (TUNA)
This procedure delivers low-level radio frequency energy through two needles to burn away a well-defined area of the enlarged prostate.
- Transurethral Vaporization of the Prostate (TUVP)
This procedure uses electrical current to vaporize excess prostate tissue.
- Laser Surgery
In this procedure, side-firing laser fibers are used to vaporize prostate tissue that obstructs the flow of urine. The provider passes the laser fiber through the urethra into the prostate and then delivers several bursts of energy lasting from 30 to 60 seconds. The laser energy destroys prostate tissue and causes shrinkage. The laser surgery does require anesthesia and usually a stay in the hospital. Advantages of laser surgery may be that it causes little blood loss and often allows for a quicker recovery time.
- Water-induced Thermotherapy (WIT)
This treatment uses a special catheter to treat urinary symptoms of BPH. The catheter uses hot water circulated through an inflated balloon to heat the inside of the prostate, destroying adjacent tissue. Over time, the treated tissue is either absorbed into the body or expelled through urine.