Surgical treatments

When surgery is considered

Surgery is offered when less invasive steps have not helped, or when complications appear. Recurrent infection, bladder stones, retention, and kidney problems can push the timeline forward.

Many men who have BPH surgery do it for quality-of-life reasons. The clinical team walks through the main choices with you.

Your prostate size, shape, and other health issues guide the selection.

TURP — the long-standing choice

Transurethral resection of the prostate, or TURP, has been a reference operation for decades. A resectoscope shaves tissue from inside the urethra.

It works well for medium-sized prostates. A catheter stays in for a few days, and many men go home within two to three days.

Known trade-offs include a risk of retrograde ejaculation and, in a small number, stress incontinence.

HoLEP — holmium laser enucleation

HoLEP uses a holmium laser to peel the obstructing tissue in one block. The tissue is then broken up and removed from the bladder.

It handles small to very large prostates. Hospital stay is short and bleeding risk is low.

Long-term symptom relief is often sustained in published cohorts, though individual outcomes depend on technique, prostate size, and surgeon experience. Sexual and continence outcomes depend on the same factors.

ThuLEP and B-TUEP

Thulium laser enucleation (ThuLEP) and bipolar transurethral enucleation (B-TUEP) are close cousins of HoLEP. They remove tissue in a similar way but use different energy sources.

A single-centre cohort comparing these techniques in older men with large prostates (over eighty millilitres) found durable symptom relief across groups, with small differences in operative time and postoperative recovery[¹]. Your surgeon will explain which they use and why.

Robotic or open simple prostatectomy

For very large prostates, a simple prostatectomy reaches the gland through a small cut below the navel. A robotic version uses small keyhole ports.

Hospital stay is a little longer. Recovery is still usually measured in weeks, not months.

It is reserved for men whose anatomy rules out enucleation, or where a surgeon prefers it for size.

What to ask your surgeon

Ask about the volume of BPH cases they do each year. Ask about their own complication rates.

Ask how the technique handles your prostate size. Ask about ejaculation and continence outcomes in plain terms.

Write the answers down. Decisions feel easier on paper.

Recovery at a glance

Hospital stays after these techniques are typically measured in days rather than weeks; exact length depends on recovery and local practice. A catheter usually stays in for a few days.

Blood in the urine can persist for up to a few weeks as the inside heals. Heavy lifting and long drives are on hold for at least a fortnight.

Follow-up visits compare your IPSS before and after. Numbers you track yourself are often a clearer guide.