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Treating Prostate Enlargement Symptoms with Surgery

At University of Utah Health, our urologists have years of experience treating men with enlarged prostate issues — also known as benign prostatic hyperplasia (BPH). When other lines of treatment aren't effective in treating your BPH symptoms, surgery may be the best option. Our highly trained specialists offer an array of surgical procedures — from minimally invasive options to more advanced ones — to help get your prostate health back to normal. Your urologist may recommend surgery based on your:

  • diagnosis,
  • health history,
  • prostate size,
  • prostate configuration,
  • discomfort or severity of symptoms, and
  • age.

When to Consider BPH Surgery

Types of Prostate Surgery

Our urologists can perform the following surgeries:

  • HoLEP (holmium laser enucleation of the prostate) Your surgeon will use a laser to remove large portions of the prostate that are blocking urine flow. This also prevents tissue regrowth.
  • GreenLight laser photovaporization of the prostate — Your surgeon will insert a thin tube with a camera (cystoscope) into the urethra and use laser energy to vaporize prostate tissue that is blocking urine flow. It is also known as photoselective vaporization of the prostate (PVP).
  • Simple prostatectomy Your surgeon will remove prostate tissue through an incision (cut) in your lower abdomen (stomach). This works best for very large prostates.
  • TUIP (transurethral incision of the prostate) Your surgeon will make one or two small incisions (cuts) in your prostate gland using a scope inserted into your urethra. This allows urine to pass through the urethra more easily. It works best for small or moderately enlarged prostates.
  • TURP (transurethral resection of the prostate) Your surgeon will remove your prostate tissue using electrical energy through a small scope.
  • Rezum® water vapor therapy — Your surgeon will use thermal energy from sterile water vapor (steam) to destroy tissues in the prostate that are causing symptoms. Ablated tissues are eventually reabsorbed into your body through a natural healing process.
  • UroLift procedure — Your surgeon will use a camera to move your prostate out of the way of the urethra. Then we insert small implant devices to hold the prostate in place so it won’t block your urine flow. This is a minimally invasive procedure that doesn’t require any cutting, heat, or prostate tissue removal.

What to Expect During Enlarged Prostate Surgery

Your expectations during prostate surgery will depend on the type of surgery you get. Some minimally invasive procedures will be done with local anesthesia (you’ll be awake but the area of your body is numb where the surgery is performed). Other surgeries are done under full anesthesia (you’ll be asleep).

If you get full anesthesia, you will need to:

  • fast (stop eating or drinking) starting at midnight the night before surgery.
  • quit smoking (if you smoke) for four to six weeks before surgery.
  • avoid alcohol for 48 hours before surgery.

You may need to stop taking some medications, vitamins, and herbal supplements before surgery. Discuss all your medications (prescription, over-the-counter, and supplements) with your surgeon and follow their instructions to stop taking them, if directed.

Tell your surgeon if you have sleep apnea so the anesthesiologist can carefully monitor your breathing during surgery and while you recover.

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After Surgery

You may notice an initial increase in your symptoms right after surgery, such as:

  • urination frequency,
  • urgency to urinate, or
  • some blood in your urine.

These are normal and typically go away within a few days after surgery. Talk to your urologist if they get worse or do not go away within a week.

Associated Complications

Many surgical procedures for enlarged prostate will cause retrograde ejaculation (semen that goes backward into the bladder instead of going into the penis during orgasm) or anejaculation (not ejaculating during orgasm). While neither of these conditions are harmful, they may lead to male infertility. If you are planning a pregnancy with a partner or would like to conceive in the future, please discuss these risks with your urologist before undergoing surgery.

Recovering from Prostate Surgery

Your recovery time varies depending on the surgery you get. You will be taken to a recovery room for one to two hours immediately after your surgery. Most procedures are outpatient, which means you can go home the same day. However, your surgeon may recommend an overnight stay based on your health and the type of surgery.

After leaving the hospital, you will need to rest for at least one to two days at home before resuming some daily activities.

Avoid heavy lifting and strenuous activities for one to two weeks after the following procedures:

  • GreenLight laser prostatectomy,
  • TUIP (transurethral incision of the prostate),
  • TUMT (transurethral microwave therapy), and
  • UroLift

More invasive surgeries may require a longer recovery. Avoid heavy lifting or strenuous activities for three to six weeks after the following surgeries:

These past three months have been an incredible learning process for me. My doctor in Mexico [told] me about the HoLEP procedure…I want to thank [Dr. Gross] for taking me as a new patient…Thank you for the knowledge and skills you have developed to learn this technique. You are rather unique in your field.
Gene Newman HoLEP Surgery Patient

Schedule an Appointment to See a Urologist

Call U of U Health Urology at 801-213-2700 to schedule an appointment with one of our experienced urologists. 

You do not need a referral from your PCP to schedule an appointment with us. However, some insurance providers require that you get a referral before you see a specialist. Contact your insurance carrier with any questions you may have about your plan requirements.

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