An operation to remove an enlarged prostate (benign prostatic hyperplasia, or BPH) may help you have less trouble passing urine. It might also help reduce the risk of urinary tract infections and other medical problems caused by the enlarged prostate. But it’s important to talk to your doctor before deciding whether this or other treatment is right for you.
There are several different surgical techniques to choose from, and your choice will depend on factors like how big your prostate is and what your doctor’s experience with the technique is. You might also consider other options, such as noninvasive treatments.
The prostate is a walnut-sized gland that sits between the bladder and penis. It contains bundles of nerves that control erections, and cutting them during surgery could lead to a loss of sexual function. Nerve-sparing surgery (also called ‘noninvasive robotic prostatectomy’ or ‘robotic transurethral resection of the prostate, or TURP) is designed to avoid this problem by carefully releasing the nerve bundles that lie near the prostate before cutting the tissue.
In a nerve-sparing procedure, your surgeon will use a robot-guided instrument with a camera and loop of wire that is passed into your urethra. The camera lets your surgeon see the area and the loop of wire, which can be used to cut away any part of the prostate that is causing symptoms or blocking the urethra. Your doctor will probably also take out some lymph nodes that are nearby the prostate, which can help to check for cancer cells and to decide if you need any other treatment.
If you have an enlarged prostate, it can block the urethra, which can cause problems including difficulty passing urine and erectile dysfunction. The most common procedure to treat an enlarged prostate is called a transurethral resection of the prostatic (TURP). Your surgeon will make a single cut in your tummy (retropubic) through which they will remove the enlarged part of your prostate. This is usually done using general or spinal anaesthetic, which means you will be asleep during the operation.
You might need to stay in hospital for two to seven days after your surgery. You’ll need to have a catheter in place to drain your urine. Once you are able to empty your bladder, the catheter will be removed and you’ll be able to go home.
Your doctor might use a laser to remove the enlarged part of your prostate, which can reduce complications such as a narrowing of the urethra or erectile dysfunction. But this isn’t available everywhere, and alternative procedures may be better for you.
Your doctor might advise a radical prostatectomy, which is an operation to remove the entire prostate. If you have a small tumour, your surgeon might be able to do this through keyhole surgery. They will insert a tube into the urethra and, with the help of a camera, guide a loop of wire or a hollow metal rod down to your prostate. They will then use the device to remove your prostate, leaving a scar on your tummy.
