TURP vs Laser Prostate Surgery: Which Treatment Is Better for BPH?
TURP vs Laser Prostate Surgery: Which Treatment Is Better for BPH? Urine stream that is weak, frequent urge to urinate, difficulty with urination, as well as waking up at night often, can be signs of benign prostatic hyperplasia, also known as enlarged prostate. Prostate enlargement becomes a much more frequent problem for men. Not all men suffering from BPH need to undergo surgical treatment. Many of them can manage the symptoms by changing their lifestyle, observation, or medicines. However, if symptoms become worse, or medications fail to work, the surgeon might suggest undergoing surgery in order to enhance urine flow. There are two types of surgical treatments of BPH – TURP (transurethral resection of the prostate) and laser surgery. Which procedure is better? It depends on the person. Size of the prostate, symptoms, urinary blockage, state of health of the patient, type of laser surgery, and experience of the surgeon are among the factors to consider. What Is BPH? BPH (Benign Prostatic Hyperplasia) is a condition where there is an enlargement of the prostate which is not cancerous. Since the prostate encloses a portion of the urethra, an enlarged prostate causes constriction of the urethra thus affecting normal urine flow. Symptoms include: Weak urine flow Difficulty starting urination Frequent urination in the daytime Urge to urinate Getting up many times during the night to urinate Leakage of urine after urination Incomplete emptying of the bladder Difficulty with urination These symptoms vary greatly among individuals. In some cases, men having an enlarged prostate can show severe urination difficulties despite having a medium-sized prostate, while those with an enlarged prostate may have few difficulties with urination. You can learn more about the condition, symptoms and causes in this guide to prostate enlargement and BPH. Does Every Man With BPH Need Surgery? No. Management of BPH is dependent on the symptoms and the impact of the disease on one’s quality of life. Some men might require no more than surveillance and adjustment of their lifestyle, but others may require medication. Surgical intervention usually becomes a consideration when the patient suffers from persistent symptoms that do not respond to medical therapy and BPH results in some complications. Surgical intervention may be considered by the urologist when there are problems associated with obstruction such as recurrent retention of urine, infections in the urinary tract, development of bladder stones, or blood in the urine. It is important to determine the reason for the symptoms of urine because trouble with urination does not necessarily mean the presence of BPH. When Is BPH Surgery Recommended? There is no single symptom or prostate size that automatically means surgery is required. However, surgical treatment may be discussed in situations such as: Persistent symptoms despite medication If medicines have been prescribed appropriately but urinary symptoms continue to affect sleep, work, travel or daily activities, surgery may become an option. Recurrent urinary retention Urinary retention occurs when the bladder cannot empty properly. BPH is one of the common causes of urinary retention in men. If you want to understand this complication in more detail, see this guide to urinary retention, its causes and treatment. Recurrent urinary infections Significant bladder outlet obstruction can contribute to incomplete bladder emptying and recurrent urinary problems. If infections repeatedly occur because of prostate obstruction, a urologist may consider treating the underlying obstruction. Bladder stones In some men, difficulty emptying the bladder can contribute to the formation of bladder stones. Treating the prostate obstruction may form part of the overall management. Significant bleeding BPH can sometimes be associated with blood in the urine. Persistent or significant bleeding requires proper evaluation to determine its cause and appropriate treatment. Problems affecting the urinary tract Long-standing obstruction can affect bladder function and, in more serious cases, kidney function. These situations require careful evaluation and may make surgical treatment more appropriate. What Is TURP? The abbreviation “TURP” is short for Transurethral Resection of the Prostate. TURP is one of the oldest surgical techniques that have been utilized to treat urinary obstruction due to BPH. When undergoing TURP, a special tool is introduced via the urethra. It is a resectoscope that has a cutting loop to cut away the prostate tissue causing obstruction. As the tool is introduced via the urinary tract, there is no need for making a conventional surgical incision externally. The main purpose is to create a broader opening through the prostate gland to facilitate the free flow of urine from the bladder. TURP has been applied for several decades and remains a crucial surgical procedure for BPH. What Is Laser Prostate Surgery? Laser prostate surgery employs laser energy in order to treat the prostate tissue causing obstruction to urination. It is important to note that there is no one form of laser surgery. Depending on individual characteristics and needs of the patient, different types of laser surgery may be performed. One of the laser surgeries performed is called Holmium Laser Enucleation of the Prostate (HoLEP). In the latter type of laser surgery, laser energy is applied in order to separate and excise prostate tissue. The particular type of laser surgery is important to consider when comparing TURP with laser surgery. TURP vs Laser Prostate Surgery: Key Differences Feature TURP Laser Prostate Surgery Access Through the urethra Through the urethra External incision No traditional external incision No traditional external incision Technology Cutting loop Laser energy Tissue treatment Resects obstructing tissue Enucleates or vaporises tissue depending on technique Procedure type Established BPH surgery Includes several laser techniques Suitability Depends on prostate and patient factors Depends on laser technique and patient factors Recovery Varies by individual Varies by technique and individual Both procedures aim to achieve the same broad objective: relieve obstruction and improve urinary flow. The difference is primarily how the obstructing prostate tissue is treated. What Are the Benefits of TURP? TURP remains an important
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