Surgical Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms

Patient Guideline Summary

Publication Date: June 26, 2020

Objective

Objective

This patient summary means to discuss key recommendations from the American Urological Association (AUA) for the surgical management of benign prostatic hyperplasia. It is limited to adults 18 years of age and older and should not be used as a reference for children.

Overview

Overview

  • Benign prostatic hyperplasia is a medical condition where the prostate gland enlarges, eventually leading to the inability to urinate.
  • We will use the abbreviation BPH throughout this summary to refer to benign prostatic hyperplasia.
  • The prostate gland is the only human organ that keeps growing. As a result, most men suffer difficulty passing urine as they age.
  • Testosterone is the only necessary factor causing BPH.
  • Symptoms include a reduced flow of urine, inability to empty the bladder, and, finally, obstruction of urine flow.
  • This patient summary focuses on surgical management.
  • Surgery is indicated when medical treatment fails, medications are causing problems, or complications are not resolving.
    • Important complications include:
      • recurring infections
      • recurring bladder stones
      • declining kidney function
      • bleeding

Diagnosis

Diagnosis

  • To prepare for surgery, your prostate will be examined by ultrasound, cystoscopy, MRI, or CT.
  • Your bladder function will be measured.
  • Your general health will be evaluated to ascertain your surgical risk.
  • Let your surgeon know if you plan to father children after surgery.

Treatment

Treatment

  • There are three types of surgery for BPH:
    • Transurethral surgery (TURP)
    • Simple (open) prostatectomy
    • Minimally invasive surgical therapies (MIST)
  • Each of these has variations. The choice of procedure will depend on the size and shape of your prostate, your surgeon’s experience with the types and variations of the available choices, and your individual circumstances and preference.
  • There is always a chance that one procedure will not be enough, so follow-up after surgery is necessary.

Abbreviations

  • AUA: American Urologic Association
  • BPH: Benign Prostatic Hyperplasia
  • CT: Computed Tomography
  • MIST: Minimally Invasive Surgical Therapies
  • MRI: Magnetic Resonance Imaging
  • TURP: Transurethral Surgery

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.