Question

I have just been told that my prostate has enlarged and is pushing against my bladder. I may have to have it trimmed back and made smaller to enable me to urinate without difficulty. I have never heard of this operation and was wondering how it was done - what are it's effects at the time and after the operation?

Answer

It sounds like you're referring to a type of prostate surgery that is done through the penis opening (the urethra), that is known as a transurethral resection of the prostate (TURP). This is usually done in men who have a medium- to large-sized prostate which is causing obstructive-type symptoms; these usually include hesitancy or dribbling, a decreased force of the stream, urgency to urinate, getting up at night, etc. Your urologist probably did several tests to determine if your prostate was enlarged and most likely medicines were tried which did not help your symptoms. He or she may also have done a bladder test to check to see if you empty completely and if the prostate is obstructing the bladder outlet.

As for the actual procedure, a small camera is placed in the penis (you don't feel any of this) and the prostate is visualized on a TV screen. The surgeon then begins to "shave" or resect the enlarged gland, very much like coring an apple. This is continued until as much tissue as necessary has been removed. A catheter is then left in place and the bladder is irrigated (while in the hospital) for several days. The catheter is then removed and, generally speaking, most men are able to urinate quite well afterwards.

The possible complications include bleeding, infection, incontinence, erectile dysfunction, burning on urination, and inability to urinate after the catheter is removed. These complications only occur rarely, and are highly unlikely in younger, healthier men. Incontinence and erectile dysfunction are the least likely. Most men have a mild amount of discomfort when urinating the first few days after the procedure but this generally clears up pretty quickly. Usually men do very well with this procedure and it is still the "gold standard" for treatment for enlarged prostates that are causing symptoms.

Links

• Prostate Info