For patients with benign prostate enlargement (BPE), currently there is a wide range of surgical procedures available, whereby TURP (transurethral prostate resection) is the most common treatment method in Germany. Worldwide, TURP was the most frequently performed surgery for men over 65, rapidly being replaced by laser prostatectomy and other less invasive procedures.
The surgeon can control the procedure through an optic device, and can perform the procedure safely. The enlarged and obstructive prostate tissue will be removed; however, the so-called prostate capsule will remain intact. The removed tissue, so-called resection chips is carried by the irrigating fluid into the bladder, and then flushed out at the end of the operation. They are then sent to a pathological department or institute, where it is evaluated to either rule out or detect the presence of malignant prostate cells. Since the prostate capsule has remained intact, even patients who have undergone TURP, must participate in preventive screening for the early detection of possible prostate cancer.
The risks of this surgical procedure, is divided into an early and late complication stage (during recovery period). In the early complication stage, there may be excessive bleeding, which generally subsides however without the need for a further procedure to stop the bleeding. In rare cases, a return to the operating room for coagulation of the prostatic bleeding is necessary. Late complications may at times be urethral dysfunction caused by the injury to the sphincter muscle and scarred constrictions of the urethra. Retrograde ejaculation was also often noted, which means that the produced semen will not pushed through the penis, but rather flows back into the bladder and remains there until the patient urinates again. Most patients report this not to be problem, since libido, erection, and ejaculation are functioning normal. For retrograde ejaculation as a result of the surgery, treatment with medications may restore normal ejaculation.
Modern surgery techniques have greatly minimized the risk of TURP syndrome. TURP syndrome occurs when your bloodstream absorbs too much of the irrigating solution, causing abnormally low concentrations of sodium in your blood. Currently, TURP syndrome only occurs in rare cases due to current surgical techniques and is readily treated. TURP syndrome can lead to a change in the body fluid distribution and strain on the cardiovascular system. Especially the advanced and improved techniques minimizing the complication rate are making TURP in Germany a standard method in the treatment of benign prostate enlargement (BPE).
State-of-the-art laser technique at the West German Prostate Center:
Especially in view of the still existing possibility that excessive bleeding may occur after TURP and the thereby necessitated prolonged stay in the hospital, parallel to the classical transurethral resection (TURP), laser therapy is performed, it is less evasive, meaning it causes fewer and less severe side effects than TURP. The laser does not penetrate the tissue deeply, so surrounding tissue is not affected. The West German Prostate Center is equipped with the Greenlight laser as well as the diode laser. With the highly innovative diode laser, obstructive prostate issue will be removed by vaporization. This procedure is suited best for patients with a large prostate.