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.
What To Expect After Surgery
TUIP is a much less invasive procedure than transurethral resection of the prostate (TURP). You may be able to go home after surgery, or you may need to stay overnight in the hospital. You may not be able to urinate and may need to have a catheter to drain your bladder. For most men, this lasts for a week or less.
Why It Is Done
TUIP may be a good option for men who have only slightly enlarged prostates and who are bothered a lot by their symptoms.
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 for 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.footnote 1 Men notice about a 73% improvement in their International Prostate Symptom Score (IPSS) scores.footnote 1 For example, if you have a symptom score of 25 (severe), it could be reduced to about 7 (mild).
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. Men who have had TUIP generally are less likely to develop retrograde ejaculation than men who have TURP. But men who have TUIP are more likely to need a second surgery.footnote 2
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.footnote 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.footnote 1
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Incontinence occurs in fewer than 1 out of 100 men.footnote 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.footnote 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 think about include your expectations, the severity of your symptoms, and the possibility of 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. So men with only mild symptoms may want to think carefully before having surgery to treat BPH.
References
Citations
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Fitzpatrick JM (2012). Minimally invasive and endoscopic management of benign prostatic hyperplasia. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2655–2694. Philadelphia: Saunders.
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AUA Practice Guidelines Committee (2010). AUA guideline on management of benign prostatic hyperplasia. Chapter 1: Guideline on the management of benign prostatic hyperplasia (BPH). Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
Credits
Current as of:
February 11, 2020
Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Anne C. Poinier MD - Internal Medicine
Adam Husney MD - Family Medicine
J. Curtis Nickel MD, FRCSC - Urology
