Transurethral resection of the prostate (TURP)
Performed endoscopically, with monopolar or bipolar technology.
Benign prostatic hyperplasia
Surgeries to treat BPH
The technique is chosen for each prostate and for each patient.
Assessment and indication
Every decision starts with understanding the case.
Benign prostatic hyperplasia, or BPH, is noncancerous enlargement of the prostate gland. It can compress the urine duct and cause a weak stream, a delay in starting to urinate, a feeling of incomplete emptying of the bladder and frequent trips to the bathroom, including at night.
Not every man with BPH needs surgery. Before recommending a procedure, I evaluate the intensity of symptoms, the impact on routine, treatments already carried out, the size and anatomy of the prostate and general health conditions.
01
When considering a procedure
Surgery may be considered when symptoms remain significant despite clinical treatment, when the patient does not tolerate or does not wish to continue taking medications or when complications related to urinary obstruction arise.
Recurrent urinary retention, repeated infections, bladder stones, prostate-related bleeding or repercussions on the urinary tract may make intervention necessary. The indication is defined after relating the symptoms to the tests and excluding other causes.
02
How do I evaluate
I talk about the way the patient urinates, the frequency of symptoms and what bothers them most. Physical examination, laboratory tests and assessment of urinary flow and urine residue in the bladder are selected as appropriate.
The size and shape of the prostate help choose the technique. When the finding may change the planning, imaging tests and endoscopic evaluation of the urinary tract may also be necessary.
03
What are the possibilities?
Endoscopic enucleation
Removal of the part of the prostate that causes the obstruction. It can be done with a holmium laser (HoLEP), thulium laser (ThuLEP) or bipolar energy.
Prostate vaporization
Includes GreenLight laser and bipolar vaporization techniques.
Less invasive procedures
Rezum, UroLift and iTIND can be considered for specific patient profiles.
Simple prostatectomy
It can be performed open, laparoscopically or robotically, especially in very large prostates.
Embolization of the prostate arteries
It is an option for selected situations, evaluated together with an interventional radiologist.
04
How do I choose the technique
Some techniques remove or vaporize the tissue that obstructs the passage of urine; others try to push it away or reduce its volume. Different procedures also present differences in recovery, preservation of ejaculation and the possibility of a new intervention in the future.
When choosing treatment, I consider the degree of obstruction, the size and anatomy of the prostate, the patient's health conditions and the aspects that matter to him. I explain the benefits, limits and alternatives before the decision.
05
Recovery and follow-up
Anesthesia, length of stay, use of a probe and return to activities vary depending on the procedure. These guidelines are presented during planning and adjusted during postoperative follow-up.
After surgery, I evaluate the improvement of symptoms and urinary recovery. Obstruction treatment does not replace prostate health monitoring when it remains indicated.
Consultation and planning
The indication is defined for each patient.
During the consultation, I evaluate the diagnosis, explain the alternatives and organize treatment and follow-up according to the needs of the case.