Enlarged prostate

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BPH

Male reproductive anatomy

Prostatectomy - series

TURP - series

SAW PALMETTO

Saw palmetto has been used by millions of men to ease BPH symptoms and is often recommended as an alternative to medication. Experts suggest a fat-soluble saw palmetto extract with 85-95% fatty acids and sterols. However, a well-conducted study published in the February 9, 2006 edition of the New England Journal of Medicine found that the popular herb was no better than a dummy pill in relieving the signs and symptoms of BPH. Further studies are needed. If you use saw palmetto and think it works, ask your doctor if you should still take it.

SURGERY

Prostate surgery may be recommended if you have:

• Incontinence
• Recurrent blood in the urine
• Urinary retention
• Recurrent urinary tract infections

The choice of a specific surgical procedure is usually based on the severity of your symptoms and the size and shape of your prostate gland.

• Transurethral resection of the prostate (TURP): This is the most common surgical treatment for BPH. The TURP is performed by inserting a scope through the penis and removing the prostate piece by piece.
• Transurethral incision of the prostate (TUIP): This procedure is similar to TURP, but is usually performed in men who have a relatively small prostate. This procedure is usually performed as an outpatient without need for a hospital stay. Like the TURP, a scope is inserted through the penis until the prostate is reached. Then, rather than removal of the prostate, a small incision is made in the prostatic tissue to enlarge the opening of the urethra and bladder outlet.
• Open Prostatectomy: An open prostatectomy is usually performed using general or spinal anesthesia. An incision is made through the abdomen or perineal area (i.e., through the pelvic floor, including the region from the scrotum to the anus). Then, the prostate is removed. This is a lengthy procedure, and it usually requires a hospital stay of 5 to 10 days.

The majority of men who have prostate surgery have improvement in urine flow rates and symptoms. Possible complications include impotence, urinary incontinence, retrograde ejaculation (semen flowing back into the bladder rather than out the penis), infertility, and urethral stricture (narrowing). Rates of these complications vary, depending on the surgical procedure that you and your doctor decide is best.