BPH surgery is an option in cases where symptoms are severe or the man is completely incapable of urinating, or in cases where medication was not effective.
Transurethral Resection of the Prostate (TURP)
TURP involves removing prostatic tissue through the urethra in order to reduce the size of the prostate. It is the most common surgical intervention for BPH:
- It is mainly performed under spinal anesthetic.
- A special tube equipped with a light and a camera (resectoscope) is introduced into the urethra to reach the prostate.
- The urologist can observe the inside of the urethra, prostate and bladder.
- The excess prostate tissue in the region that surrounds the urethra is removed.
- A catheter is placed in the bladder to allow urine to flow out.
- The catheter is removed as soon as there is no more blood in the urine (usually after 24 hours).
- Bladder irrigation is often necessary depending on the extent of the bleeding in the urine after the operation.
- If there is little bleeding and the patient’s medical state allows, he may be able to leave with the catheter at the end of the day. Otherwise, an overnight stay in the hospital may be necessary.
- Retrograde ejaculation
- Erectile dysfunction (rare)
- Incontinence (rare)
Some men may possibly need to undergo a second procedure (10% of men after 10 years).
Types of TURP
- Monopolar Standard TURP
- This procedure consists in resecting the tissue using an electric current.
- The length of the intervention is limited to less than 45 minutes, and depends on fluid (glycine) absorption.
- This technology is restricted to prostates under 80 g in order to minimise bleeding.
- This procedure has a higher risk of hemorrhage.
- This is the most commonly performed TURP.
- Laser Resection with Holmium
- A holmium laser can be used to cut (enucle) or vaporise the prostate.
- Especially useful for larger prostates over 80 g.
- The length of the procedure is longer than for laser surgery.
- This procedure has a lower risk of hemorrhage.
- The necessary technology is expensive and less easily accessible.
- GreenLight Photoselective Vaporisation of the Prostate (PVP)
- A powerful green laser is used to vaporise the prostate.
- The vaporisation is called photoselective because the red tissue of the prostate selectively absorbs the green light of the laser.
- This procedure has a low risk of hemorrhage.
- The procedure is rather lengthy.
- The necessary technology is expensive.
Before Undergoing TURP
TURP with PlasmaButton is recommended by Dr. Marois. The surgeries are performed in the only accredited private hospital in Canada, at the Centre Métropolitain de Chirurgie. One day of postoperative hospitalization is planned.
An evaluation appointment is required at one of our two offices. Cystoscopy and prostate ultrasound are required before the surgery.
You must be assessed by an internist doctor to stratify your preoperative risk.
A blood work, an ECG and a preoperative meeting with a nurse are also necessary. She will be able to answer any additional questions you may have about the surgery.
Lastly, we need to obtain the approval of a Centre Métropolitain de Chirurgie anesthesiologist to ensure your health does not involve any significant risk factors to be operated at the Centre Métropolitain de Chirurgie.
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