Surgery via the urethra (Transurethral resection, TURP)
This method is also sometimes called prostate shaving. The operation is performed using fibre optics and a tube passed through the urethra. An electric coil is used to cauterise regions of the prostate. The procedure takes between 30 minutes to 1 hour. Inpatient hospital care of 3-5 days is necessary. It can be several months before the patient experiences the full effects. Around 80 percent of patients are satisfied with the results.
Advantages
- The operation removes the urethral constriction immediately and more than 80% of patients are cured.
- The need for subsequent treatment is relatively rare, around 10% after 5 years.
- A tissue sample is taken from the prostate for examination to rule out cancer.
Disadvantages
- Inpatient care of 3-5 days is required.
- Only available in some places, which often leads to a long waiting list.
- Competes for operating room times with cancer operations.
- High risk of complications; 15-25% experience serious complications.
- Risk of sexual dysfunction side effects such as dry ejaculation (more than 70%) and impotence (around 5%).
- High socioeconomic costs.
Open surgery
If the prostate is very large TURP is not sufficient. The doctor will then usually recommend an open operation, which is a major procedure. An incision is made in the abdominal wall and the enlarged section of the prostate gland that is constricting the urethra is removed. Inpatient hospital care of 3-5 days is necessary. More than 95 percent of patients are satisfied with the results of the operation and experience a marked improvement. But also in this case it may take several months before full effects are noticed. Problems that can occur after treatment:
- Impaired erectile function
- Urinary tract infection
- Constriction of the urethra
- Anaesthesia complications
- Bladder control difficulties (incontinence)
- Seminal fluid empties into the bladder (dry ejaculation)
Advantages
- The operation removes the urethral constriction immediately and more than 80% of patients are cured.
- The need for subsequent treatment is relatively rare, around 10% after 5 years.
- A tissue sample is taken from the prostate for examination to rule out cancer.
Disadvantages
- Inpatient care of 3-5 days is required.
- Only available in some places – there is often a long waiting list.
- Competes for operating room times with cancer operations.
- High risk of complications; 15-25% experience serious complications.
- Risk of sexual dysfunction side effects – dry ejaculation (more than 70%) and impotence (around 5%).
- High socioeconomic costs.