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Surgical Procedures for Benign Prostatic Hyperplasia (BPH)
by Ricker Polsdorfer, MD
Most patients with urinary outflow obstruction begin treatment with medications. Surgical procedures are usually a second option when the condition is far advanced, urgent, or has not responded well to medications.
If the bladder is completely obstructed and you are unable to pass any urine at all, you must be treated immediately. A tube will be placed into the bladder to drain out the urine. The tube may be left in place until the passageway can be more permanently opened. The bladder can be drained with either of these procedures:
Minimally Invasive Interventions
In non-emergency situations when medication has not been effective, there are many new procedures available to open the channel through the prostate. These procedures are typically done on an outpatient basis. You will have some type of anesthesia, typically a combination of local anesthesia and oral sedation. The procedure may involve threading an instrument into your penis. Depending on the particular device, you will probably feel nothing more than that. Each procedure takes about an hour. There are significant differences between these minimally invasive treatments. Talk to your doctor before choosing this as a treatment option.
Examples of minimally invasive procedures include:
More Invasive Interventions
All of these interventions require some type of anesthesia, either regional or general. The procedure involves placing surgical tools through your urethra (the tube in your penis).
Examples of these more invasive procedures include:
Most Invasive Intervention
The most invasive surgery to treat BPH is prostatectomy. This involves the removal of the prostate gland.
American Urological Association (AUA) Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia. Available at:
...(Click grey area to select URL)
Accessed September 8, 2017.
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Prostate enlargement: benign prostatic hyperplasia. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/health-topics/urologic-disease/benign-prostatic-hyperplasia-bph/Pages/facts.aspx. Updated September 2014. Accessed September 8, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 9/17/2014
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