Transurethral resection of the prostate - Alternatives to surgery
- Introduction
- When it's necessary
- Who can use it
- How it is performed
- Recovering from surgery
- Risks of surgery
- Alternatives to surgery
- Advantages-and-disadvantages
- Expertview
There are several alternatives to a transurethral resection of the prostate (TURP). Your options will depend on how severe your symptoms are and which treatments are available.
Active observation
If you have an enlarged prostate but do not find your symptoms particularly troublesome, you may decide to just wait and keep an eye on your symptoms.
This means you will not receive any immediate treatment, but will have the option of having a TURP in future, if your symptoms get worse.
If you do not have a TURP, lifestyle changes such as limiting your consumption of alcohol and taking regular exercise may be recommended to improve your symptoms.
Read more about the treatment of prostate enlargement.
Alternative techniques
There are a number of newer surgical techniques that may lead to fewer side effects, or a quicker recovery, than a TURP.
However, as these treatments are still fairly new they may not be available and their long-term effectiveness is not always clear.
These alternative techniques are explained below.
- Bipolar transurethral resection of the prostate - different instruments are used to perform the procedure, which allow saline water to be pumped into the urethra rather than a fluid called glycine. This is thought to lead to a lower risk of TURP syndrome (see risks of a TURP).
- Holmium laser enucleation of the prostate - a laser is used to remove excess prostate tissue using a similar route to a TURP. The procedure has shown good results in medium-term follow up (five to seven years) and is emerging as a promising alternative. It does not use glycine and hence there is no risk of TURP syndrome.
- KTP laser vaporisation - a small tube known as a cystoscope is inserted into your urethra. The cystoscope fires pulses of laser energy to burn away prostate tissue.
Open prostatectomy
This procedure may be more effective than a TURP if you have severe prostate enlargement.
However, open prostatectomy is now very rarely used, even for larger prostates, due to the development of other techniques such as holmium laser enucleation of the prostate (see above).
The procedure carries a higher risk of complications, such as erectile dysfunction and urinary incontinence. There is also a greater chance these complications will become permanent than if they occur following a TURP.
During an open prostatectomy, an incision is made in your abdomen and the outer portion of your prostate is removed.
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