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Prostate removal

Introduction

The purpose of this tool is to help you decide whether to have surgery to treat an enlarged prostate, also known as benign prostatic hypertrophy (BPH). When making a decision like this, you must balance:

• The reasons for doing the procedure
• The potential health risks, drawbacks, or limitations of the procedure
• Whether there are alternative procedures that may be more appropriate
• Cost

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. Surgery always carries risks, and you should be fully informed about the risks and benefits of this type of surgery. You should also be aware that research evidence is often limited, and the risks of surgery may not be completely understood. For this type of surgery, there is usually no exact “right” or “wrong” answer.

Your doctor may make certain recommendations to you. However, the final decision about whether to have the surgery rests with you.

What is the surgery?

The prostate gland is an organ at the base of the bladder in men. The gland produces a milky fluid that mixes with sperm to make semen. The tissues in the prostate gland may need to be surgically removed or destroyed as a way to treat an enlarged prostate (benign prostatic hypertrophy) or prostate cancer.

An enlarged prostate can cause many urination problems. These symptoms are usually not serious, but they can be disruptive and bothersome.

Click the icon to see an animation showing enlargement of the prostate gland.

In most cases, you will want to try “watchful waiting” or medication first, before considering surgery.

There are several ways to surgically treat or remove an enlarged prostate. The most common include:

• Transurethral incision of the prostate (TUIP) – In this method, an instrument is inserted into the penis to reach the prostate gland. A small cut is made in the prostate to improve the flow of urine and reduce your symptoms. This procedure is usually performed on an outpatient basis and usually does not require a hospital stay. It is often recommended for removing prostates fewer than 30 grams.
• Transurethral resection of the prostate (TURP) – In this method, an instrument is inserted into the penis to reach the prostate gland and remove the gland in pieces. You will remain in the hospital for 1 - 3 days. This method is often recommended for removing prostates bigger than 30 grams but fewer than 80 grams.

Click the icon to see an illustrated series showing TURP.

• Open prostatectomy – In this method, a larger cut is made in the lower abdomen between your belly button and penis, through which the prostate gland is removed. This is a much more involved procedure and usually requires a longer hospital stay and recovery period. This method is often recommended for removing prostates bigger than 80 grams.

Several newer methods use microwaves or lasers to destroy prostate tissue. You should discuss with your doctor which method is right for you. The purpose of this decision tool is to help you decide whether to have any type of surgery to treat an enlarged prostate, rather than using watchful waiting or medication.

Key points

• Surgery may be able to permanently eliminate the symptoms and problems you are having due to an enlarged prostate.
• These procedures can help up to 90% of the patients undergoing surgical treatment.
• These procedures are generally safe for most patients.
• Unfortunately, as with all surgical procedures, there are risks.
• Not all patients will be helped by the procedures.
• In a small minority of patients, their urination problems are caused by multiple factors that are not all addressed by the surgery.

How much time this decision tool will take

• 5 - 10 minutes

What this tool will provide

• A personalized list of factors for you to weigh
• Questions to ask your doctor
• Alternatives to this surgery
• Recommended reading

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.