There have been a number of advancements in surgical interventions since 1909 when the first cold-cut prostatic punch surgery was performed. Basically, there are two different approaches to surgical management: standard procedures and minimally invasive techniques. In these BPH treatments, the hyperplastic prostate tissue is removed to reduce the constriction. This is the most effective form of treatment for patients with LUTS. A surgical procedure is chosen if patients are suffering from symptoms despite medicinal therapy or if complications develop.
- Open prostatectomy (suitable mainly for very large glands)
- TURP – Transurethral resection of the prostate
- TUIP – Transurethral incision of the prostate (alternative for relatively small glands)
Minimally Invasive procedures
- Transurethral microwave thermotherapy (TUMT)
- Transurethral needle ablation of the prostate (TUNA)
- Laser prostate surgeries
- Holmium Laser Enucleation or Ablation (HoLEP, HoLAP)
- Green light laser vaporization (KTP laser vaporization or photo-selective vaporization of the prostate (PVP))
- TURis Plasma Vaporization
Though TURP (Transurethral Resection of Prostate), termed as ‘gold standard’ for BPH treatment, has been the most effective therapy option to date, it has its drawback when it comes to safety such as possible complications due to TUR syndrome that is the most feared complications of TURP. The subsequent advancement, especially the usage of laser technology in saline medium, got rid of the TUR syndrome close to nil. But, this came with a cost.