The prostate gland, located below the bladder and in front of the rectum, is an important part of the male reproductive system. It produces fluids that help protect the sperm. The prostate undergoes two phases of growth--one in early puberty and another that begins around age 25. An enlarged prostate, a condition known as benign prostatic hyperplasia (BPH), affects about half of all males in their 60s, according to the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). Because the urethra (the tube that carries urine from the bladder) runs through the prostate, BPH can cause symptoms such as urinary urgency and frequent urination that can become severe enough to require surgery.
Transurethral Resection of the Prostate (TURP)
The NKUDIC reports that approximately 90 percent of all prostate surgeries performed are transurethral resection of the prostate, known as TURP procedure. This procedure is performed by inserting a resectoscope, an instrument that contains a light and an electrical loop to cut tissue, through the penis. TURP removes the enlarged portion of the prostate to remove the tissue that's causing the obstruction of the urethra.
The TURP procedure is minimally invasive and requires a short recovery. But this procedure can result in a condition called retrograde ejaculation, which is the backward flow of semen into the bladder instead of out of the penis during climax.
Transurethral Incision of the Prostate (TUIP)
Transurethral incision of the prostate is a procedure that doesn't remove any of the prostate tissue. Instead, several cuts are made in the prostate gland to alleviate the pressure on the urethra and allow urine to flow freely. This procedure is simpler to perform, according to the Mayo Clinic, but can only be used on patients whose prostate is still relatively small. The risk of causing retrograde ejaculation is less with TUIP, although it can still happen.
Prostatectomy
When the prostate gland is greatly enlarged or when there are additional complications that have occurred due to the enlarged prostate--such as bladder damage that needs to be repaired--a TURP or TUIP may not be an option. In these cases the prostate may need to be removed, a procedure called a prostatectomy, through an open incision. Any surgery requiring an open incision has associated risks connected with the anesthesia--such as irregular heartbeat, decreased blood pressure, increased body temperature and difficulty breathing. There is also the risk of developing a post-surgical infection.
The complete removal of the prostate can result in impotence caused by nerve damage or a change in blood flow to the penis. Incontinence, the leakage of urine, is also a common side effect--although fewer than 5 percent of patients experience total incontinence (the inability to control urine), according to the Prostate Cancer Treatment Guide.
