A minimally-invasive or surgical procedure might be recommended if:
Your symptoms are moderate to severe
Medication hasn't relieved your symptoms
You have a urinary tract obstruction, bladder stones, blood in your urine or kidney problems
You prefer definitive treatment
On the other hand, a minimally-invasive or surgical procedure might not be an option if you have:
An untreated urinary tract infection
Urethral stricture disease
A history of prostate radiation therapy or urinary tract surgery
A neurological disorder, such as Parkinson's disease or multiple sclerosis
The type of procedure that's right for you depends on the size and shape of your prostate. Procedures to treat benign prostatic hyperplasia (BPH) include:
Surgery. Transurethral resection of the prostate (TURP) is a surgical procedure that removes excess prostate tissue. A lighted scope is inserted into your urethra, and the surgeon removes all but the outer part of the prostate. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure. After TURP you might temporarily need a catheter to drain your bladder.
Prostatic urethral lift. Special tags are used to compress the sides of the prostate to increase the flow of urine. The procedure might be recommended if you have lower urinary tract symptoms. PUL also might be offered to some men concerned about treatment impact on erectile dysfunction and ejaculatory problems.
Steam treatment. This convective water therapy procedure uses steam to destroy prostate tissue and make the prostate smaller. The procedure can be done in your doctor's office and has a low risk of complications or sexual side effects. This procedure might be a good choice if you are on blood thinners.
Laser therapy. A high-energy laser destroys or removes overgrown prostate tissue. Laser therapy generally relieves symptoms right away and has a lower risk of side effects than does nonlaser surgery. Laser therapy might be used in men who shouldn't have other prostate procedures because they take blood-thinning medications. Examples of laser therapy procedures include transurethral laser ablation (a "greenlight" laser procedure) and holmium laser enucleation of the prostate (HoLEP). HoLEP, in particular, might be recommended if you have a larger prostate.
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