Prostate Surgery - Minimally Invasive
Minimally invasive prostate resection is surgery to remove part of the prostate gland, to treat an enlarged prostate. The surgery will improve the flow of urine through the urethra, the tube that carries urine from the bladder outside of your body. It can be done in several different ways. There is no incision in your skin.
Types of procedures
The procedure is typically done in your doctor’s office or at an outpatient surgery clinic. The surgery can be done a variety of different ways, depending on the size of your prostate and what caused it to grow. Your doctor will consider the size of your prostate, how healthy you are, and what type of surgery you may want.
All of the procedures listed below are done by passing an instrument through the opening in your penis. Prior to the procedure, you will given general anesthesia or spinal or epidural anesthesia (awake but pain-free), or local anesthesia and sedation. Choices are:
- Laser prostatectomy: Laser prostatectomy takes approximately 1 hour. The laser destroys prostate tissue that blocks the opening of the urethra. You will most likely go home the same day. You may need a Foley catheter placed in your bladder to help drain urine for a few days after surgery.
- Transurethral needle ablation (TUNA): The surgeon passes needles into the prostate. High-frequency sound waves ultrasound heats the needles and prostrate tissue. You may need a Foley catheter placed in your bladder to help drain urine after surgery for 3 to 5 days.
- Transurethral microwave thermotherapy (TUMT): TUMT delivers heat using microwave pulses to destroy prostate tissue. Your doctor will insert the microwave antenna through your urethra.
- Transurethral electrovaporization (TUVP): A tool or instrument releases a high-voltage electrical current to destroy prostate tissue. You will have a catheter placed in your bladder. It may be removed within hours after the procedure.
- Transurethral incision (TUIP): Your surgeon makes small surgical cuts where the prostate meets your bladder to make the urethra wider or more open. This procedure takes 20 to 30 minutes. Most men can go home the same day. Full recovery can take 2 to 3 weeks.
Before the procedure
Prior to the procedure, you will have many visits with your doctor. They will request that you have several tests administered as well as a complete physical exam. They will also want to make sure medical problems, such as diabetes, high blood pressure, and heart or lung problems are being treated well.
If you are a smoker, you should stop several weeks before the surgery. Always let your doctor or nurse know what drugs, vitamins, and other supplements you are taking, even ones you purchased without a prescription.
During the weeks leading up to your surgery
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and other drugs like these.
- Ask your doctor which drugs you should still take on the day of your surgery.
On the day of your surgery
- Do not eat or drink anything after midnight the night before your surgery.
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nursery will tell you when to arrive at the hospital or clinic.
After the procedure
You will most likely go home the day of the surgery, or the day after. You may still have a catheter in your bladder when you leave the hospital or clinic.
A prostate resection will generally relieve your symptoms. However, you have a greater likelihood of needing a second surgery in 5 to 10 years than if you have transurethral section of the prostate (TURP). Some of these less invasive surgeries may cause fewer problems with controlling your urine or sexual performance than the standard TURP. Talk with your doctor to find the best procedure for you.
Following your surgery, you may temporarily have
- Blood in your urine
- Burning with urination
- Need to urinate more often
- Need to urinate suddenly
Risks for this surgery are
- No symptom improvement
- Passing semen back into your bladder instead out through the urethra
- Problems with urine control
- Urethral stricture (tightening of the urinary outlet from scar tissue)
da Vinci® Prostatectomy