An enlarged prostate means that gland has grown bigger. Prostate enlargement happens to almost every men as they age. For most of the men, the bathroom runs are frequent during the night. Symptoms may include trouble in starting a stream of urine, leaking, etc. 

There are 2 surgical treatments of an enlarged prostate which are:

  • TURP (Transurethral resection of the prostate)
  • HoLEP (Holmium laser prostate surgery)

TURP

Transurethral resection of the prostate is a surgery which are used to treat the urinary problems which is caused due to an enlarged prostate. A resectoscope which is a (combined visual and surgical instrument) is inserted through the tip of the penis and into a tube which carries the urine from your bladder. The doctor will trim away the excess the prostate tissue which is blocking the urine flow. TURP is considered an option for the men who have moderate to severe urinary problems which haven’t responded to the medication. TURP is considered an effective treatment for an enlarged prostate. 

There are a number of minimally invasive procedures which are becoming effective due to improvement in surgical tools. These procedures cause fewer complications and the recovery method is also quick. 

Why TURP is done

TURP helps in reducing the urinary symptoms which are caused by BPH (benign prostatic hyperplasia), which includes:

  • Difficulty to start urination
  • Starting and stopping again while urinating
  • Urinary tract infections
  • Increase in frequency of urination at night
  • Slow urination
  • Feeling you can’t empty your bladder
  • Blood in urine
  • Bladder stones
  • Recurring urinary tract infections
  • Not able to control urination
  • The Bladder of kidney damage

Risks of TURP surgery

There are certain risks with TURP which are given below:

Difficulty while urinating: You may face trouble while urinating for a few days after the surgery is done. Until you can urinate on your own, the doctor will insert a tube into your penis which will carry the urine out of your bladder.

Dry orgasm: A long term effect of prostate surgery is the release of the semen during the ejaculation into your bladder rather than out of your penis. It is also known as retrograde ejaculation, basically, dry orgasm is not harmful and it will not have any effect on sexual pleasure. It can interfere with your ability to bear a child.

Bleeding: This is a rare case when a man loses blood during TURP surgery which might require a blood transfusion. Men having larger prostates are at higher risk of having blood loss.

Urinary tract infection: The infection is a possibility after the surgery. An infection is likely to occur the longer you will have a catheter in place. Some guys who have TURP have a higher risk of getting urinary tract infections.

Erectile dysfunction: The risk of getting erectile dysfunction is low but it can occur after any prostate treatments.

Retreatment: Some of the guys require follow-up treatment after the TURP because the symptoms can return after some time. Retreatment is also needed because TURP causes narrowing of the bladder neck.

How to prepare for TURP

Food and medications

Days before the surgery, the doctor will recommend you to stop taking the medications which can increase the risk of the bleeding:

  • Blood thinners like warfrian and clopidogrel
  • Stop taking pain relievers like ibuprofen, aspirin and naproxen sodium

Other precautions

You should arrange transportation because you won’t be driven after the procedure is done because you will have a catheter in your bladder. You also can’t do any heavy work for upto six weeks after the surgery. Your doctor will tell you the recovery time you will need.

What can you expect in TURP procedure

TURP surgery will take about 60 to 90 minutes. Before the surgery, the doctor will give you general anesthesia which will make you unconscious during the procedure.

During the procedure

The resectoscope will be inserted into the tip of the penis and will get extended through your urethra. The doctor will not make any cuts on outside of the body. The doctor will use the resectoscope to trim your tissue from the inside of your prostate gland. The small pieces of the tissue are cut from the inside your prostate. They are removed at the end of your operation. 

After procedure

You will be in hospital for one or two days. You will have a urinary catheter in the place because the swelling will block the urine flow. The catheter is placed for atleast 24 to 48 hours, you will be able to urinate on your own.

You will also notice:

  • Blood in urine: It’s quite normal to see the blood after surgery. You should contact your doctor if the blood in your urine is thick. 
  • Irritating urinary symptoms: Urination can be painful and you will have a sense of urgent urination. The painful urination will take around six weeks to improve.
  • Your doctor will recommend:
  • Drink the high amount of water which will help to flush out the bladder
  • Eat high-fiber foods
  • Don’t do sex for four to six weeks
  • Avoid driving for some time

 HoLEP

Holmium laser prostate surgery is a treatment for enlarged prostate. It’s also known as holmium laser enucleation of the prostate, in the procedure the doctor will use a laser to remove the tissue which is blocking the urine flow through prostate. A separate instrument is used to cut the prostate tissue into fragments. 

HoLEP is similar to open surgery but it does not require any incisions. It’s the best option for men with an enlarged prostate. HoLEP surgery will remove the entire portion of the prostate which will cause the blockage of urine flow. The treatment will provide a solution for men with an enlarged prostate. HoLEP also helps to preserve the removed tissue which is then examined in the laboratory for other conditions. HoLEP will offer faster recovery and less than 2% of people having HoLEP require subsequent treatment for urinary symptoms. 

Conclusion

These two surgeries will provide the best treatment for an enlarged prostate. There are some side effects. Your doctor will recommend the surgery depending on the size of your prostate and other health problems you have.