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If your prostate symptoms are severe, your doctor may suggest heat treatment or surgery. Some men want one of these procedures right away. Others choose one after trying watchful waiting or medicine first.
Heat treatments
You won’t need to stay in a hospital for these treatments, which both use heat to destroy prostate tissue. They are less likely than prostate surgery to cause erection problems. But they don’t work as well as surgery. You may need another procedure later on if you start with one of these.
- Transurethral microwave therapy. A doctor puts a tube into your prostate through your urethra. The tube sends out microwaves. These waves destroy prostate tissue. This shrinks the prostate and relieves symptoms.
- Transurethral needle ablation. A doctor puts a needle through the urethra into the prostate. Radio waves heat the needle and destroy some prostate tissue.
Surgery
Surgery is often used in men who have severe prostate symptoms. There are many types of surgery for an enlarged prostate:
- Transurethral resection of the prostate. This is the most common enlarged prostate surgery. A surgeon will take out part of your prostate in the hospital. The procedure is done through the urethra, so there’s no scar. But there is a risk of side effects, including a decline in sexual function and a loss of urinary control (incontinence). But men with an enlarged prostate and severe symptoms face these risks without treatment.
- Transurethral incision of the prostate. This is done in the hospital. It is done with a device that is passed through the urethra. Using an electric current or laser, a surgeon makes one or two cuts in the prostate. This relieves pressure and improves symptoms. This surgery has a lower risk of erection problems than prostate resection. But you are more likely to need further treatment.
- Laser treatments. Depending on treatment type, you may need to stay in the hospital for one night. A surgeon will guide a laser through the urethra and into the prostate. He or she uses the laser’s heat to destroy prostate tissue. Laser treatments cause fewer erection problems than some other surgeries. But you face a higher risk for acute urinary retention.
- Open prostate surgery (prostatectomy). This is major surgery in the hospital. The surgeon cuts through the lower abdomen. Then he or she removes the inner part of your prostate. This surgery is usually only done on men with very large prostates.
This surgery poses a greater risk of incontinence than other treatments. It carries a small risk of sexual side effects. But it can give lasting relief of symptoms. More treatment is rarely needed.
These are only some of the treatment options. Experts are looking at new approaches, using different kinds of lasers and ultrasound.
What about side effects?
Many men are nervous about surgery or procedures because of possible side effects. Most procedures pose risks of sexual problems or incontinence.
The treatment your doctor suggests will partly depend on your symptoms and the size of your prostate. Talk with your doctor about what might work best for you.
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