When should surgery be considered to treat Benign Prostate Hypertrophy (BHP)?

Surgical options for BHP are visited when there are symptoms of incontinence (leak), repeated urinary tract infections, urinary retention, etc. The choice of surgery depends on the age of the patient, the size of the prostate and the symptoms suffered by the patient. There are various surgical options available. The most common one is surgery done by a trans urethral procedure (via the urethra or the tube that carries urine to the exterior via the penis). These procedures are done under anesthesia, and are relatively pain free except for some post operative discomfort.

1. Trans urethral resection of the prostate (TURP) – For this procedure, the prostate can be resected, and removed through a scope inserted through the urethra
2. Trans urethral incision of the prostate (TUIP) – The prostate can be incised when it has not enlarged too much. In this method a simple incision is sufficient to relieve the symptoms of blocked urine. This procedure is an outpatient procedure and normally does not require hospital stay.
3. Balloon dilatation of the passage can be done via the urethra. This stretches the urethra and improves flow of urine.
4. Open surgery - via the abdomen or the perineum (floor between the scrotum and the anus) is done for large prostates that are not operable via the urethra. This procedure may require a hospital stay for about 5 days.
5. Newer methods involve the use of laser to reduce the size of the prostate.

Possible complications following prostate surgery include, impotence, sterility, incontinence, stricturesin the urethra and retrograde ejaculations (semen flowing back into the bladder instead of out through the penis).