Prostate Enlargement (BPH)
Treatment decisions regarding enlarged prostate are largely based on the degree of symptomatic bother and the size of the prostate. Mr. Sewell will discuss the different options with you and create a plan that takes your individual circumstances into account.
Sewell Urology offers a variety of surgical treatment options for prostate enlargement. Some information about these options is provided here:
1. Transurethral Resection of the Prostate (TURP): TURP is the most common surgical procedure for BPH. It involves removing the inner portion of the prostate that is causing the obstruction. During the procedure, a cystoscope (telescope for looking into the bladder) is inserted through the urethra, and a hot wire is used to remove the excess prostate tissue and prevent bleeding. TURP is usually performed under general or spinal anaesthesia, and it involves an overnight stay in hospital with a catheter. TURP remains the gold standard for prostate procedures.
2. Laser Surgery: Laser procedures, such as GreenLight Laser Photovaporisation of the Prostate (GL PVP), use laser energy to remove or vaporise the obstructing prostate tissue. This provides similar outcomes to TURP but with potentially less bleeding, so is ideal for patients who require anticoagulation (blood thinners).
3. Transurethral Incision of the Prostate (TUIP): TUIP involves making small incisions in the prostate gland and bladder neck to relieve the obstruction. This procedure is suitable for patients with smaller prostates or milder symptoms. TUIP is typically performed under spinal or general anesthesia and may be done as an outpatient procedure.
4. Simple Prostatectomy: In cases of significantly enlarged prostates, a simple prostatectomy may be necessary. This can be performed via a minimally-invasive approach (robotic-assisted simple prostatectomy, RASP), or via an open approach. Both the robotic and open approaches involve making and incision in the prostate to carefully dissect out and remove the excess prostate tissue. Open prostatectomy is generally reserved for larger prostates or if other surgical options are not suitable. These options involve a 2-3 day stay in hospital.
5. Minimally Invasive Procedures: Mr Sewell offers Urolift as an alternative to medication for enlarged prostate (BPH). This procedure involves the implantation of small anchors that hold the excess prostate tissue out of the way so that the obstruction to the urethra is reduced. It is done under sedation or general anaesthetic as a day case. Urolift is an excellent option for control of mild symptoms as it has a low risk of ejaculatory side effects, and does not preclude other treatment options in the future if symptoms recur.
If you wish to make an appointment to discuss treatment options for enlarged prostate (BPH), Mr Sewell will be happy to see you. Please visit our contact page for more information.