Prostate resection - minimally invasive

Definition

Minimally invasive prostate resection is surgery to remove part of the prostate gland. It is done to treat an enlarged prostate. The surgery will improve the flow of urine through the urethra, the tube that carries urine from the bladder outside of your body. It can be done in different ways. There is no incision (cut) in your skin.

Alternative Names

Greenlight laser prostatectomy; Transurethral needle ablation; TUNA; Transurethral incision; TUIP; Holmium laser enucleation of the prostate; HoLep; Interstitial laser coagulation; ILC; Photoselective vaporization of the prostate; PVP; Transurethral electrovaporization; TUVP; Transurethral microwave thermotherapy; TUMT; Urolift; BPH - resection; Benign prostatic hyperplasia (hypertrophy) - resection; Prostate - enlarged - resection

Description

These procedures are often done in your health care provider's office or at an outpatient surgery clinic.

The surgery can be done in many ways. The type of surgery will depend on the size of your prostate and what caused it to grow. Your doctor will consider the size of your prostate, how healthy you are, and what type of surgery you may want.

All of these procedures are done by passing an instrument through the opening in your penis (meatus). You will be given general anesthesia (asleep and pain-free), spinal or epidural anesthesia (awake but pain-free), or local anesthesia and sedation. Choices are:

Why the Procedure Is Performed

An enlarged prostate can make it hard for you to urinate. You may also get urinary tract infections. Removing all, or part, of the prostate gland can make these symptoms better. Before you have surgery, your doctor may tell you changes you can make in how you eat or drink. You may also try some medicines.

Prostate removal may be recommended if you:

Risks

Risks for any surgery are:

Other risks for this surgery are:

Before the Procedure

You will have many visits with your provider and tests before surgery:

If you are a smoker, you should stop several weeks before the surgery. Your provider can help.

Always tell your provider what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.

During the weeks before your surgery:

On the day of your surgery:

After the Procedure

Most people are able to go home the day of surgery, or the day after. You may still have a catheter in your bladder when you leave the hospital or clinic.

Outlook (Prognosis)

Most of the time these procedures can relieve your symptoms. But you have a higher chance of needing a second surgery in 5 to 10 years than if you have transurethral resection of the prostate (TURP).

Some of these less invasive surgeries may cause fewer problems with controlling your urine or ability to have sex than the standard TURP. Talk to your doctor.

You may have the following problems for a while after surgery:

References

Abrams P, Chapple C, Khoury S, Roehrborn C, de la Rosette J; International Consultation on New Developments in Prostate Cancer and Prostate Diseases. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol. 2013;189(1 Suppl):S93-S101. PMID: 23234640 www.ncbi.nlm.nih.gov/pubmed/23234640.

Burke N, Whelan JP, Goeree L, et al. Systematic review and meta-analysis of transurethral resection of the prostate versus minimally invasive procedures for the treatment of benign prostatic obstruction. Urology. 2010;75(5):1015-1022. PMID: 19854492 www.ncbi.nlm.nih.gov/pubmed/19854492.

Djavan B, Eckersberger E, Handl MJ, Brandner R, Sadri H, Lepor H. Durability and retreatment rates of minimally invasive treatments of benign prostatic hyperplasia: a cross-analysis of the literature. Can J Urol. 2010;17(4):5249-5254. PMID: 20735902 www.ncbi.nlm.nih.gov/pubmed/20735902.

Han M, Partin AW. Simple prostatectomy: Open and robot-assisted laparoscopic approaches. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 106.

Hoekstra RJ, Van Melick HH, Kok ET, Ruud Bosch JL. A 10-year follow-up after transurethral resection of the prostate, contact laser prostatectomy and electrovaporization in men with benign prostatic hyperplasia; long-term results of a randomized controlled trial. BJU Int. 2010;106(6):822-826. PMID: 20184573 www.ncbi.nlm.nih.gov/pubmed/20184573.

Welliver C, McVary KT. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 105.