Prostate resection - minimally invasive

Alternative Names: Laser prostatectomy; Transurethral needle ablation; TUNA; Transurethral incision; TUIP; Holmium laser enucleation of the prostate; HoLep; Interstitial laser coagulation; ILC; Photoselective vaporization of the prostate; PVP; Transurethral electrovaporization; TUVP; Transurethral microwave thermotherapy; TUMT

Minimally invasive prostate resection is surgery to remove part of the prostate gland, to treat an enlarged prostate. The surgery will improve the flow of urine through the urethra, the tube that carries urine from the bladder outside of your body. It can be done in several different ways. There is no incision (cut) in your skin.

See also:

• Benign prostatic hypertrophy
• Simple prostatectomy
• Transurethral resection of the prostate

Description of Procedure

These procedures are usually done in your doctor's office or at an outpatient surgery clinic.

The surgery can be done in many different ways, depending on the size of your prostate and what caused it to grow. Your doctor will consider the size of your prostate, how healthy you are, and what type of surgery you may want.

All of these procedures are done by passing an instrument through the opening in your penis. You will be given general anesthesia (asleep and pain-free), spinal or epidural anesthesia (awake but pain-free), or local anesthesia and sedation. Choices are:

• Laser prostatectomy: Laser prostatectomy takes about 1 hour. The laser destroys prostate tissue that blocks the opening of the urethra. You will probably go home the same day. You may need a Foley catheter placed in your bladder to help drain urine for a few days after surgery.
• Transurethral needle ablation (TUNA): The surgeon passes needles into the prostate. High-frequency sound waves (ultrasound) heat the needles and prostate tissue. You may need a Foley catheter placed in your bladder to help drain urine after surgery for 3 to 5 days.
• Transurethral microwave thermotherapy (TUMT): TUMT delivers heat using microwave pulses to destroy prostate tissue. Your doctor will insert the microwave antenna through your urethra.
• Transurethral electrovaporization (TUVP): A tool or instrument delivers high-voltage electrical current to destroy prostate tissue. You will have a catheter placed in your bladder. It may be removed within hours after the procedure.
• Transurethral incision (TUIP): Your surgeon makes small surgical cuts where the prostate meets your bladder to make the urethra wider or more open. This procedure takes 20 to 30 minutes. Many men can go home the same day. Full recovery can take 2 to 3 weeks.

Risks of Prostate resection - minimally invasive

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Blood loss
• Breathing problems
• Heart attack or stroke during surgery
• Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
• Reactions to medications

Other risks for this surgery are:

• Erection problems (impotence)
• No symptom improvement
• Passing semen back into your bladder instead of out through the urethra (retrograde ejaculation)
• Problems with urine control (incontinence)
• Urethral stricture (tightening of the urinary outlet from scar tissue)

Review Date: 3/28/2011
Reviewed By: Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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