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The TURP is a surgical procedure to scrape away excess prostate
tissue that is blocking the urethra, and thereby open the
channel for urination. It is completed in the operating
room under a general anaesthetic or a spinal anaesthetic.
An instrument is passed through the urethra to the area
of the prostate to perform the operation. The average hospital
stay is 1-2 days. Flow-rates increase about 100%, and symptoms
usually decrease 80%. This is consider the standard to which
all other treatments are compared.
The side effects associated with TURP are retrograde ejaculation
(68%); this means semen will no longer flow from the penis,
but will instead flow into the bladder and discharge when
urinating. Also associated are impotence (16%), and the
possibility of requiring a repeat TURP in the future, when
tissue regrows (10% after 10 years).
A variety of different laser energies can be used to cut
or vaporize obstructing prostatic tissue like the electrical
energy in a standard TURP. The major advantage of laser
prostatectomy is the decreased risk of bleeding. Because
of this, laser prostatectomy can be done as an outpatient.
Laser energy causes intense heating in and around the
prostate. Because of this there may be an increased likelihood
of irritation or damage in structures near the prostate.
Follow up of patients treated with laser prostatectomy
will determine the risks and benefits of these treatments.
This technique is similar to ILC but instead of a laser a small needle is inserted into the prostate from the urethra. The tips of these needles generate heat when radio frequency energy is applied.
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This method inserts a small laser fiber into the prostate through an instrument placed in the urethra. Laser energy heats a selected part of the prostate. Two to four areas are usually treated in areas felt to be blocking the urine flow. These areas are damaged and after several months shrink. This procedure can be done as an outpatient. The procedure can be done under local or general anaesthetic.
Performed in an out-patient setting, a small microwave antenna
is passed through the urinary channel in the penis and into
the enlarged gland. No anaesthetic is required.
Thermotherapy has not yet been approved by OHIP in Ontario,
and the cost for the treatment at The Prostate Centre is
$2500.00. The risk of side effects are much lower than the
TURP, with an approximate 30% increase in flow rate, and
50% increase in symptom score.
Benign Prostatic Hyperplasia is (or will be) a part of life
for almost all men. It is important to remember that the
treatment of BPH does not prevent cancer, and yearly screening
for Prostate Cancer should continue even while being treated
for BPH. Treatment may depend on lifestyle, age, personal
finances etc., but your physician and yourself should be
able to tailor a decision to fit your needs.
- prostate education presentations
- pamphlets
- videos
- interactive computer programs
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