Surgical Treatment of Benign Prostatic Hyperplasia

Benign Prostatic Hyperplasia (BPH) refers to the enlargement of the prostate that occurs with age, particularly in men aged 50 and above. The prostate, situated just under the bladder neck where the urethra connects the penis to the bladder, can become enlarged, leading to a narrowed urethra and obstructed urine flow.

While the association of enlarged prostates with sex hormones may contribute to BPH, the exact cause remains unclear. Symptoms of BPH include increased frequency of urination, especially at night, weak urinary stream, urinary incontinence, and hesitancy during urination. Severe cases may result in bladder stones and even chronic kidney disease.

If you experience difficulties with urination, such as straining, incomplete bladder emptying, or a burning sensation, seeking medical attention is crucial. These symptoms may indicate BPH and can worsen without proper medical care. Acute retention of urine, the inability to void, can occur.

Surgical Treatment Options for Benign Prostatic Hyperplasia

1. Transurethral Resection of the Prostate (TURP)
   If symptoms persist despite medication, TURP may be advisable. This procedure uses a resectoscope to guide the removal of enlarged prostate tissues obstructing the urinary tract. However, TURP has drawbacks, including intra- and postoperative bleeding, as well as risks of electrolyte imbalance leading to hypotension and coma. A large bore urinary catheter is typically inserted for at least three days after the procedure, potentially causing pain, discomfort, and scarring, leading to urethral stenosis.
2. Green Light Photoselective Vaporization of the Prostate (PVP) Laser Procedure
   It is increasingly replacing TURP due to its recognition as a safe and effective procedure. Patients usually experience minimal pain and can go home within a few hours or may stay in the hospital overnight and be discharged the next day. While this method has fewer side effects, some patients may experience a mild burning sensation and a small amount of blood in the urine post-procedure, which typically resolves over time. Patients can generally resume normal activities within two weeks. However, its drawback is the higher cost over other surgical treatment approaches.