Prostate Enlargement Surgery: Risks, Recovery, and Anesthesia Options

Benign Prostatic Hyperplasia (BPH)

Hello, Dr.
Tsai.
May I ask what type of surgery is performed at this hospital for benign prostatic hyperplasia? Is there any risk involved? How many days do patients typically need to stay in the hospital after the surgery, and how long does recovery take? Will a urinary bag be needed post-surgery, and for how long? Is the procedure done under local anesthesia? Thank you! A concerned uncle who is afraid of pain.

kni, 60~69 year old female. Ask Date: 2004/12/08

Dr. Cai Bingkun reply Urology

Hello, our hospital currently performs transurethral resection of the prostate (TURP) surgery, which typically requires a hospital stay of three to four days.
This procedure is performed under spinal anesthesia, and a urinary catheter will be left in place for three days postoperatively.
Every surgery carries its own risks, but we conduct thorough preoperative assessments to minimize these risks as much as possible.

Reply Date: 2004/12/08

More Info

Hello! Thank you for your questions regarding prostate enlargement surgery, also known as benign prostatic hyperplasia (BPH) surgery. This procedure is commonly performed to relieve symptoms caused by an enlarged prostate, such as difficulty urinating, frequent urination, and urinary retention. Let’s break down your concerns regarding the types of surgery, associated risks, recovery time, and anesthesia options.

Types of Surgery
There are several surgical options for treating prostate enlargement, including:
1. Transurethral Resection of the Prostate (TURP): This is the most common procedure. It involves removing part of the prostate gland through the urethra. It is minimally invasive and typically requires a short hospital stay.

2. Laser Surgery: This technique uses laser energy to remove or destroy prostate tissue. It can be performed as an outpatient procedure and often results in less bleeding and quicker recovery.

3. Open Prostatectomy: This is a more invasive procedure where the prostate is removed through an incision in the abdomen. It is usually reserved for very large prostates or when other methods are not suitable.

4. UroLift: This is a newer, minimally invasive procedure that involves placing small implants to hold the prostate tissue away from the urethra, allowing for easier urination.

Risks of Surgery
As with any surgical procedure, there are risks involved. Common risks associated with prostate surgery include:
- Bleeding: Some bleeding is expected, but significant bleeding may require a blood transfusion.

- Infection: There is a risk of urinary tract infections or other infections post-surgery.

- Urinary Incontinence: Some patients may experience temporary or, in rare cases, permanent urinary incontinence.

- Erectile Dysfunction: There is a risk of erectile dysfunction after surgery, particularly with TURP and open prostatectomy.

- Retrograde Ejaculation: This is a common side effect where semen enters the bladder instead of exiting through the penis during ejaculation.

The overall risk of serious complications is relatively low, generally around 1-2%, but it’s essential to discuss your specific risks with your surgeon.

Recovery Time
Post-surgery recovery varies depending on the type of procedure performed:
- TURP and Laser Surgery: Most patients stay in the hospital for 1-2 days. Full recovery can take about 4-6 weeks, during which you may experience some discomfort and changes in urination.

- Open Prostatectomy: This may require a longer hospital stay (3-5 days) and a more extended recovery period of 6-8 weeks.

- UroLift: Recovery is typically quicker, with many patients returning to normal activities within a few days.

Use of Catheters
After surgery, it is common to have a catheter placed to help drain urine from the bladder. The catheter is usually removed within a few days after surgery, but some patients may need to use it for a longer period, depending on their recovery.

Anesthesia Options
Regarding anesthesia, most prostate surgeries are performed under general anesthesia, but some procedures, like TURP, can also be done with spinal or regional anesthesia. Your anesthesiologist will discuss the best option for you based on your health and the specific procedure.

Conclusion
In summary, prostate enlargement surgery is a common and generally safe procedure with various options available. While there are risks involved, many patients experience significant relief from symptoms and improved quality of life post-surgery. It’s crucial to have a thorough discussion with your healthcare provider about your specific situation, including the type of surgery recommended, potential risks, and recovery expectations. Don’t hesitate to ask any further questions or express your concerns, as understanding the process can help alleviate anxiety. Best wishes for your upcoming procedure!

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