Transurethral Incision of the Prostate (TUIP) for Benign Prostatic Hyperplasia
Surgery Overview
Transurethral incision of the prostate (TUIP)
may be done to treat
benign prostatic hyperplasia (BPH). The surgeon uses
an instrument inserted into the
urethra that generates an electric current or laser
beam to make incisions in the prostate where the prostate meets the bladder.
Cutting muscle in this area relaxes the opening to the bladder, decreasing
resistance to the flow of urine out of the bladder. No tissue is removed. It is
done under either
general or
spinal anesthetic.
The procedure usually
requires an overnight stay in the hospital.
Why It Is Done
TUIP may be a good option for men
with only slightly enlarged prostates.
TUIP may be chosen instead
of TURP by men who:
- Are at higher risk for complications from
surgery and anesthetic, including men with serious health problems. TUIP
involves less blood loss and can be done more quickly than
TURP.
- Want to avoid the risk of developing retrograde ejaculation,
a condition in which semen flows backward into the bladder. This side effect is
more common with TURP than with TUIP.
How Well It Works
Symptoms improve after TUIP in about
8 out of 10 men.1 Men notice about a 73% improvement
in their
International Prostate Symptoms Score (I-PSS)
scores.1 For example, if you have a score of 25
(indicating severe symptoms), it could be reduced to about 6 (indicating mild
symptoms).
Short-term improvement in BPH symptoms is about the
same for TUIP as for TURP. Studies comparing the two types of surgery suggest
that the outcomes are similar. But men who have had TUIP generally are less
likely to develop retrograde ejaculation than men who have TURP.
Risks
The possible risks of transurethral incision of
the prostate (TUIP) include the following:
- Retrograde ejaculation, in which semen flows
backward into the bladder, occurs in about 6 to 55 men out of 100.1 Retrograde ejaculation is not harmful.
- Erection problems in men who did not have one of these
problems before the surgery are reported in about 4 to 25 men out of
100.1
- Incontinence
occurs in fewer than 1 out of 100 men.1
- The need for a blood transfusion during surgery is
rare.
- For about 10 men out of 100, a second operation is needed
after 15 years.1
What To Think About
Surgery usually is not required to
treat BPH, but it may be a reasonable choice for some men. Choosing surgery
depends largely on your preferences and comfort with the idea of having
surgery. Things to consider include your expectations, the severity of your
symptoms, and the possibility of developing complications.
Men
who have severe symptoms often have great improvement in quality of life
following surgery. Men whose symptoms are mild may find that surgery does not
greatly improve quality of life. Men with only mild symptoms may want to think
carefully before having surgery to treat BPH.
Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Fitzpatrick JM (2007). Minimally invasive and
endoscopic management of benign prostatic hyperplasia. In AJ Wein, ed.,
Campbell-Walsh Urology, 9th ed., vol. 3. pp. 2803–2844.
Philadelphia: Saunders Elsevier.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Brian D. O'Brien, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Christopher G. Wood, MD, FACS - Urology, Oncology |
|---|
| Last Revised | June 25, 2010 |
|---|
Last Revised:
June 25, 2010
Fitzpatrick JM (2007). Minimally invasive and
endoscopic management of benign prostatic hyperplasia. In AJ Wein, ed.,
Campbell-Walsh Urology, 9th ed., vol. 3. pp. 2803–2844.
Philadelphia: Saunders Elsevier.
