By: Dr. Gary Bellman on May 7, 2017, 7:15 pm
Surgical Options for Enlarged Prostate - Benign Prostatic Hyperplasia (BPH)
Los Angeles & SFV Urologist Dr. Gary Bellman has treated thousands of men with BPH at his SoCal Urology Institute practice. The following information is an informational guide to the various surgical procedures available to treat an enlarged prostate
, as well as Dr. Bellman's comments on their effectiveness.
The UroLift® System
, received FDA approval in 2013 as a minimally invasive surgical procedure to treat BPH. This surgical option is considered a minimally invasive procedure due to its simplicity. Indeed, the Urolift® procedure doesn't require cutting, heating, or any removal of prostate tissue. Instead, the Urolift procedure for treatment of BPH can be done in an office visit at the SoCal Urology Institute or at a hospital, under general or local anesthesia.
During the Urolift procedure, Dr. Bellman, will insert what is known as the "delivery system." This is comprised of a rigid sheath, and a cystoscope. This is inserted through the urethra, and is used to determine the exact area of the prostate tissue, which needs to be pulled back to release the compression on the urethra. A small needle is then inserted into the sheath, which is used to stitch back the tissue, relieving pressure on the urethra.
The number of stitches (also called implants) will vary depending upon how large the obstructive tissue is. Then, the delivery, and instruments are removed, as the process is complete.
The Urolift system has an outstanding record for successfully treating BPH. According to the FDA in fact, the procedure is successful in 98% of patients, with results ranging from complete elimination of BPH systems, to increases urine flow, and an improved quality of life.
Benefits of Urolift System for Enlarged Prostate
Men suffering from BPH realize benefits of choosing the Urolift System to treat their enlarged prostate including:
Effective relief of symptoms of BPH
Fast recovery times
Preserved sexual function
Lack of side effects such as retrograde ejaculation or ED
Can be done as an outpatient procedure
The goal of the UroLift System treatment is to relieve symptoms of BPH so you can get back to your life and resume your daily activities. Men who do not want to start or continue their BPH medication, or who do not want to undergo major surgery, should consider the UroLift procedure as a safe and effective option. Dr. Bellman will need to do a few simple examinations to determine if you are a candidate for the procedure based on your specific symptoms and anatomy.
Green Light Laser/ Green Light Procedure
Another minimally invasive surgical option used with great success by Dr. Bellman to treat BPH, or enlarged prostate is the Green Light Laser Procedure
. This surgery is done under general anesthesia, using a laser to remove excess prostate tissue, which is compressing the urethra. In the Green Light Laser Procedure, Dr. Bellman will use a high-powered laser light combined with fiber optics to vaporize the overgrowth of prostate cells quickly and accurately.
The procedure involved inserting a cystoscope through the urethra until it reaches the prostate. A tiny, fiber optic device is guided through the cystoscope, before sending high intensity light pulses to the excess prostate tissue. The procedure is essentially bloodless, making it a good option for men with BPH who are also taking blood thinners.
Benefits of Green Light Laser for BPH
Green Light Laser Procedures often give men with BPH quick relief from symptoms, along with ease and comfort when urinating. Side effects from this procedure are typically minimal, and most men are able to return home within a few hours of the procedure. Many men find they can return to normal activities within three days after a Green Light Laser procedure. However, activities which aggravate the urogenital area should be avoided.
Transurethral Resection of the Prostate (TURP)
Transurethral Resection of the Prostate (TURP) is the most common surgery performed to treat BPH. During this procedure, patients undergo general anesthesia, and prostate tissue is removed. Although this is not considered to be a minimally invasive surgery, like the Urolift Procedure, or Green Light Laser Procedure, TURP is often considered the "gold standard" for long-term results.
After the excess prostate tissue has been removed, the body will need time to heal. In addition, the remaining prostate tissue may actually swell and become inflamed before the desired shrinking effect occurs. Some patients may experience an uncomfortable recovery period that includes short-term problems?such as bleeding, infection, erectile dysfunction, and urinary incontinence. In addition, patients will?have a catheter that is attached to a urine bag inserted into their bladder for several days after the procedure.
Symptom relief may not occur immediately, but the good news is that it lasts for a long time in many patients once it does occur. However, there can be long-term side effects after TURP such as dry orgasm (retrograde ejaculation), erectile dysfunction or incontinence (leaking of urine).
Laser Resection of the Prostate
The TURP procedure may also be performed with a laser in procedures called photoselective vaporization of the prostate (PVP) or holmium laser enucleation (HOLEP). Laser therapy lessens the bleeding risks of traditional TURP. However, because prostate tissue is still removed, there can be tissue swelling and an uncomfortable healing time. Typically, a catheter has to be inserted into the bladder after the procedure.
This surgical procedure is not considered to be minimally invasive, like the Urolift or Green Light Laser Procedure, but results may be long lasting.
Transurethral Needle Ablation (TUNA)
Transurethral Needle Ablation (TUNA) is another surgical option for treating enlarged prostate. The procedure involves the use of a needle-shaped device which delivers heat to the tissues of the prostate which are compressing the urethra.
In this surgical procedure, the needle like device in inserted through the urethra, via a catheter to protect healthy tissue from being burned. The heat targets the excess prostate tissue, destroying it, so that the urethra is no longer being compressed. With flow restored, urine can pass through the bladder easily, reducing or relieving symptoms of BPH.
The TUNA procedure does not require an overnight stay in the hospital, and while it is effective for many men, other surgical options have better rates of success in relieving symptoms. However, most men benefit from a short recovery time, and minimal complications when compared to the TURP procedure.
The TUNA procedure is not appropriate for men with large prostates, and most men will need another surgery later to continue to experience relief from BPH symptoms.
**Please keep in mind, the size of your enlarged prostate, severity of your symptoms, your desire to retain or maintain sexual function, your age, presence of other health problems, and your lifestyle are all factors to be considered. Before you make any decision, however, be sure to review all of your alternatives, talk with loved ones who may be impacted by your decision, and select a surgeon who is knowledgeable, receptive to your questions, and experienced in your chosen procedure.
Expert Los Angeles Urologist Dr. Gary Bellman, M.D.
has over 20 years of experience and has treated thousands of men with enlarged prostate (BPH)
at his SoCal Urology Institute practice. Dr. Bellman will explain all the options available to you and put you at ease, offering great care to best suit your comfortability.