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Minimally Invasive Surgeries

What are Minimally Invasive Surgeries?

Minimally invasive surgeries can be done in your doctor's office or an outpatient center. Choosing the right surgery for you may depend on:

  • The size of your prostate.
  • How healthy you are.
  • Your personal choice.

There are several types of minimally invasive procedures to choose from, they include:

  • Prostatic Stent
  • High Intensity Focused Ultrasound (HIFU)
  • Holmium Laser Enucleation of Prostate (HoLEP)
  • Interstitial Laser Coagulation (ILC)
  • Transurethral Electroevaporation of The Prostate TUVP
  • Transurethral Microwave Thermotherapy (TUMT)
  • Transurethral Needle Ablation (TUNA)
  • Photoselective Vaporization (PVP)
  • UroLift
  • Catheterization

What Are the Benefits, Risks, and Side Effects of Minimally Invasive Surgeries?

Getting relief from your symptoms is the biggest benefit of having minimally invasive surgery. In addition, some men have fewer problems controlling their urine after they have one of these types of surgeries. However, by having a minimally invasive surgery, you may be at a higher risk for needing another surgery in the future. Side effects from minimally invasive surgery may include:

Who Are Good Candidates for Minimally Invasive Surgeries?

Men who are having trouble urinating are good candidates for a minimally invasive surgery. In addition, you may be a good candidate for this type of surgery if you:

  • Have symptoms that are moderate to severe.
  • Have urinary tract obstruction, bladder stones and/or blood in your urine.
  • Can't empty your bladder completely.
  • Have bleeding from your prostate
  • Urinate very slowly
  • Have taken medications and they did not work

What is A Prostatic Stent?

The stent is a spring-like device. It is placed inside the urethra. The stent holds the urethra open. There are many kinds of stents.

What Are The Benefits, Risks and Side Effects of Prostatic Stent?

This treatment does not require anesthesia. But it may lead to incontinence. The stent may become dislodged. Stones may form on the stent. There may be blockage. The stent may be hard to remove. Minor side effects include having to urinate often and right away, dribbling of urine, discomfort, and light bleeding.

Who Are Good Candidates For Prostatic Stents?

Men with many medical problems may be good candidates. Men for whom surgery is high-risk may also be good candidates.

Prostatic stents are used for men who would otherwise use a catheter or transurethral microwave thermotherapy (TUMT). You should not get the stent if your urethra is narrow. You should not get a stent if you have urinary infection, bladder stones, weak bladder or cancer. And you should not get a stent if you will soon have urethra treatments for kidney stones.

What is High Intensity Focused Ultrasound (HIFU)?

With high-intensity focused ultrasound (HIFU), an ultrasound probe is placed in the rectum. The sound waves heat the prostate to very high temperatures. This high temperature kills prostate tissue causing it to shrink.

What Are The Benefits, Risks and Side Effects of HIFU?

The recovery time for HIFU is usually only a few days. Your health care provider sets the temperature for the needed effect. But this treatment requires anesthesia. As with any surgery, anesthesia poses a risk. There is also a risk that you may need a catheter after the treatment. Side effects include not being able to urinate and blood in the urine.

Who Are Good Candidates for HIFU?

Men with larger prostates who wish to avoid more invasive surgery may be good candidates for this treatment.

What is Interstitial Laser Coagulation (ILC)?

In Interstitial Laser Coagulation (ILC), the surgeon uses a "cystoscope" (metal tube through which a visual lens and laser can be passed). The surgeon uses a laser to pierce into the prostate. The laser energy burns the tissue.

What Are The Benefits, Risks and Side Effects of (ILC)?

Studies to date have shown limited long term benefits. This treatment requires anesthesia. As with any surgery, anesthesia poses a risk. But you can usually go home the same day.

Who Are Good Candidates for Interstitial Laser Coagulation (ILC)?

Men with larger prostates who wish to avoid more invasive surgery may be good candidates for this treatment.

What is Transurethral Electroevaporation of The Prostate (TUVP)?

With transurethral electroevaporation of the prostate (TUVP), the surgeon uses a resectoscope. It passes through the penis into the urethra. An electrode moves across the prostate surface. It sends an electrical current that vaporizes prostate tissue. The vaporizing effect goes below the prostate surface. Blood vessels are coagulated and sealed.

What Are The Benefits, Risks and Side Effects of TUVP?

There is little bleeding and fluid absorption. You stay one night in the hospital. But you can usually return home without a catheter. This treatment requires anesthesia. As with any surgery, anesthesia poses risks.

Who Are Good Candidates for TUVP?

Men with larger prostates who wish to avoid more invasive surgery may be good candidates for this treatment.

What is Transurethral Microwave Thermotherapy (TUMT)?

In TUMT, microwaves heat part of the prostate.
In TUMT, microwaves heat part of the prostate.
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.

Transurethral microwave thermotherapy (TUMT) uses microwaves to destroy prostate tissue. A urologist inserts a catheter through the urethra to the prostate, and a device called an antenna sends microwaves through the catheter to heat selected portions of the prostate. The temperature becomes high enough inside the prostate to destroy enlarged tissue. A cooling system protects the urinary tract from heat damage during the procedure.

What Are The Benefits, Risks and Side Effects of TUMT?

TUMT is a minimally invasive surgery that does not require anesthesia. The surgeon numbs the skin and gives you a pain pill. TUMT only takes an hour. It may relieve bladder obstruction. It is low-risk treatment.

This treatment has advanced recently. It now uses higher energy devices. It is reliable. There is no blood loss or fluid absorption. You can usually go home the same day. Many urologists have the technology. Outcomes are better long term.

But, there is still a risk of adverse outcomes from the procedure. And urinary tract symptoms occur in about 25% of men. The long term effectiveness is still unclear.

Who Are Good Candidates for TUMT?

Good candidates may include men with too many medical problems for invasive surgery. Men with weak hearts may be good candidates because there is no blood loss. So are men who want to avoid anesthesia.

What is Transurethral Needle Ablation (TUNA)?

During transurethral needle ablation (TUNA) a specially adapted visual instrument (cystoscope) is inserted through the tip of your penis into the tube that carries urine from your bladder (urethra). Using the cystoscope, your health care provider will guide a pair of tiny needles into the prostate tissue. Low-level, high-frequency radio waves are passed through the needles to create heat. The heat kills prostate tissue and shrinks the prostate.

What Are The Benefits, Risks and Side Effects of TUNA?

With TUNA, your health care provider will only use local anesthesia. It is done in the health care provider's office. It only takes 30-45 minutes. It is an effective short-term treatment. Serious complications are rare. There is little bleeding. There are very few sexual side effects. But BPH symptoms may return. And there may be adverse outcomes from the procedure. There may be a burning feeling.

Who Are Good Candidates for TUNA?

Good candidates may include men with too many medical problems for invasive surgery. Men with weak hearts may be good candidates because there is no blood loss. So are men who want to limit anesthesia.

What is Photoselective Vaporization (PVP)?

Photoselective vaporization of the prostate (PVP) uses a high-powered laser. The laser vaporizes the obstructing prostate tissue.

What Are The Benefits, Risks and Side Effects of PVP?

PVP is becoming very popular. Most men can have a PVP without adverse events. PVP is replacing more invasive surgery. It is done in the office or as an outpatient at the hospital. There is little bleeding. There are few side effects. After PVP, you can often stop medical therapy.

Who Are Good Candidates for PVP?

Good candidates include men with too many medical problems for invasive surgery. Men with weak hearts are good candidates because there is no blood loss. So are men who want to limit anesthesia.

What is UroLift?

UroLift opens the blocked urethra. It lifts and holds the enlarged prostate out of the way. Small implants are delivered through a needle. The goal is to relieve symptoms.

What Are The Benefits, Risks and Side Effects of UroLift?

With UroLift, health care providers do not have to cut into your body, destroy the prostate or remove any tissue. With UroLift men may have fewer sexual side effects than with other minimally invasive surgeries.

Who Are Good Candidates for UroLift?

Most men with enlarged prostates and urinary symptoms may be good candidates for this treatment. In some men, symptoms that remain after treatment are from another source. Men who have this treatment can still have other treatment if they need it.

What Is Catheterization?

This treatment places a tube called a catheter into the bladder. The tube drains urine. Catheters can be "clean," placed and removed every six to eight hours. Or they can be "indwelling," left in the bladder for short or long period of times. Catheters can be placed into the bladder through the urethra. Or the provider may make a small puncture in the bladder above the pubic bone. This is called a suprapubic tube. Clean catheterization can be done by you or a caregiver. Clean catheterization is when you remove the catheter once the flow of urine has stopped, no tubes are left in the bladder.

What Are The Benefits, Risks and Side Effects of Catheterization?

Catheters' benefits are temporary. Infection is the biggest risk of having a catheter in place for long periods. Bacteria can stick to the surface of the catheter. This makes it hard for the immune system or antibiotics to work. After a few years, there is a higher risk of bladder cancer. This is probably due to the long-term irritation from the catheter sitting in the bladder. Clean intermittent catheterization (CIC) has lower risk of infection and cancer than an indwelling catheter.

Who Are Good Candidates for Catheterization?

Good candidates for a catheter include men waiting for medication to work or for surgery. Catheters are also used during treatment for an infection. They may be a good choice for men with multiple medical problems and a short life expectancy. The risk and discomfort of surgery may outweigh the risk of infection or cancer. Catheterization is chosen over medications or surgery for men with bladder control problems and a blocked prostate.

Other Groups' Resources

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)

Prostate Enlargement: Benign Prostatic Hyperplasia


MedlinePlus

Enlarged Prostate (BPH) (English)
Agrandamiento de la próstata (Español)

 

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