The prostate gland is found only in males and plays a role in semen production.
The prostate gland is found only in males. It is a small gland that sits just below the bladder and surrounds the upper part of the urethra, the tube that carries urine from the bladder out of the body. One of the prostate’s main functions is to help produce semen, the fluid that nourishes and transports sperm.
As men age, the prostate often enlarges—a condition known as benign prostatic hyperplasia (BPH). An enlarged prostate can press against the urethra, causing problems with urination such as difficulty starting to urinate, a weak urine stream, frequent urination, or the feeling of not completely emptying the bladder. To treat these symptoms, several medical procedures may be recommended depending on the severity of the condition.
TURP is a surgical procedure to remove parts of the prostate gland that are pressing against the urethra. It is the most common surgery used to treat urinary problems due to an enlarged prostate and is usually recommended when medications are no longer effective.
The procedure is performed under spinal or general anesthesia. The surgeon does not make any incisions. Instead, a special instrument called a resectoscope is inserted through the tip of the penis into the urethra. The resectoscope is approximately 12 inches long and about 0.5 inches in diameter. It includes a light, camera, and a wire loop that carries an electrical current.
During the surgery, the surgeon uses the wire loop to remove the overgrown tissue in small pieces. These pieces are carried by irrigating fluid into the bladder, and they are flushed out at the end of the procedure. The electrical current in the loop also cauterizes blood vessels to minimize bleeding.
After TURP, a catheter is usually left in place for 1–2 days to help drain the bladder while it heals. Most patients can go home within a couple of days. TURP is highly effective for relieving symptoms, though some men may experience temporary side effects like bleeding, urinary incontinence, or retrograde ejaculation.
HoLEP is an advanced procedure used to treat BPH. It uses a holmium laser to cut and remove excess prostate tissue, and it is particularly effective for very large prostates that may not be suitable for TURP.
During the procedure, a resectoscope is inserted through the urethra. The laser is used to precisely cut out the overgrown lobes of the prostate. Unlike TURP, which removes tissue in small chips, HoLEP allows entire sections of the prostate to be separated cleanly and pushed into the bladder.
Once the tissue is inside the bladder, it is broken up into smaller pieces using a device called a morcellator and then removed. This method reduces bleeding and allows for a more complete removal of tissue, potentially leading to longer-lasting results.
Recovery after HoLEP is generally quick, and patients often experience significant improvements in urinary flow and bladder emptying. Side effects are similar to TURP and may include temporary burning, urgency, or blood in the urine.
This minimally invasive treatment uses laser energy to remove or vaporize excess prostate tissue through a technique performed via a thin instrument called a cystoscope.
The cystoscope is inserted into the urethra. A high-energy laser fiber is passed through the scope, and the laser delivers focused light pulses to destroy prostate tissue. This method is typically done using GreenLight or Thulium lasers, which are designed to vaporize tissue with minimal bleeding.
The procedure is effective at relieving urinary symptoms with less risk of bleeding, making it suitable for patients on blood-thinning medications. Recovery is usually faster compared to TURP, with many patients returning home the same day or after an overnight stay.
The Prostatic Urethral Lift (PUL), also known by the brand name UroLift, is a newer, minimally invasive procedure used to treat BPH. Unlike TURP or HoLEP, PUL does not remove tissue but instead uses implants to physically lift and hold the enlarged prostate tissue away from the urethra.
The implants are placed using a delivery device inserted through the urethra. Once in place, the tiny sutures compress the lobes of the prostate and open the urethral passage. This improves urine flow and reduces symptoms like straining, urgency, and weak stream.
Since there is no cutting, heating, or removal of tissue, the risk of side effects such as sexual dysfunction or retrograde ejaculation is lower compared to more invasive procedures. Most patients can return to normal activities within a few days.
