There are two surgeries performed to provided definitive relief of the symptoms of BPH.
Bladder neck incision
Bladder neck incision is an endoscopic procedure performed under general anaesthetic. The trigone, bladder neck and prostate gland are cut to relieve the obstructive effect of the prostate on outflow of urine.
This is a minimally invasive procedure with good long-term relief of symptoms for well-selected patients.
Retrograde ejaculation occurs in 25% of men following bladder neck incision surgery, resulting in sub-fertility.
Transurethral Prostatectomy (TURP)
TURP is the gold standard treatment for prostatic bladder neck obstruction. The contemporary procedure is performed with modern equipment enabling a short hospital stay, for most patients this is 24 hours.
This technology is effective in removing large amounts of prostate tissue in a shorter period of time than laser ablation, meaning shorter anaesthetic times and faster recovery.
TURP removes the periurethral adenoma, now called the transition zone of the prostate.
Following TURP, retrograde ejaculation is inevitable and you will be counselled with regards to post-operative fertility prior to surgery.
Green light laser treatment for prostate enlargement is suitable for certain selected patients. Its disadvantages include prolonged anaesthetic time for large prostate glands and an inability to remove prostatic stones which often predispose to prostatic infection.
Additionally, green light laser surgery vaporises tissue and therefore does not provide information about whether or not prostate cancer is present in the transition zone of the prostate gland.
Green light laser prostatectomy causes retrograde ejaculation similar to transurethral prostatectomy surgery generally.