Transurethral incision of the prostate (TUIP) is a simple surgical procedure that can relieve the symptoms of an enlarged prostate gland.
The prostate gland is part of a man's reproductive system. It is normally a little bigger than a walnut. It is located between the base of the bladder and the beginning of the penis. It surrounds the upper part of the urethra. (The urethra carries urine from the bladder out through the penis.) The prostate makes the fluid that nourishes and carries sperm.
To relieve the symptoms caused by the enlarged prostate, the urologist (a surgeon who specializes in problems of the kidneys and bladder) makes cuts (incisions) in the prostate gland. This relieves the pressure the enlarged gland puts on the urethra.
When the prostate gland is enlarged it is called benign prostate hyperplasia, or BPH. When the prostate gets bigger than normal, it may put pressure on the urethra and cause problems with urination. You may have trouble passing urine, and you may feel the need to urinate more often, sometimes even at night. The need to urinate can come on suddenly, which can make travel, work, and some social situations difficult or awkward. In severe cases BPH can completely block your ability to pass urine. This can cause kidney damage if not treated promptly.
TUIP is a possible treatment if your prostate gland is not severely enlarged. Examples of alternatives to this procedure include:
You may choose surgery if you are having trouble with side effects from the medicine, such as dizziness and nasal congestion, or if the medicine does not relieve your symptoms. Ask your healthcare provider about your choices for treatment.
Plan for your care and recovery after the operation, especially if you are going to have general anesthesia. Find someone to give you a ride home from the hospital. Although you should not expect severe tiredness or discomfort, it’s always a good idea to arrange for someone to help you with meals for a day or two after the procedure.
Ask for the instructions for using and caring for a catheter and urine collection bag after the surgery. It’s best to learn about this before your surgery, when you are most alert and able to understand and remember the directions.
Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.
On the day of surgery, do not eat or drink anything before the surgery, not even coffee, tea, or water.
If you take some medicines daily, ask your healthcare provider if you should take any of your medicines before surgery. If you take blood thinners, daily aspirin, or anti-inflammatories such as ibuprofen or naproxen, ask your provider if you need to stop them before surgery. If you do need to stop taking your medicines, ask your provider when you can start taking them again. If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery.
Follow any other instructions your healthcare provider gives you.
You will be given either a general or spinal anesthetic. The general anesthetic will relax your muscles, put you to sleep, and keep you from feeling pain. The spinal anesthetic will make you feel numb from the chest down. You will probably be given medicine with the spinal anesthetic to make you sleepy.
Once you are numb, the surgeon will pass a scope through the urethra and into the bladder. The scope is a thin, lighted tube with lenses like a microscope. With the scope the surgeon will be able to see the area where the enlarged prostate is causing problems. Fluid will be passed into the bladder to stretch the bladder and help your provider see the area better.
The surgeon will make 2 deep cuts in the prostate gland to relieve the pressure on the urethra. Once that is done, while you are still numb, a catheter (tube) will be inserted into the penis and the urethra and then into the bladder. The catheter will help the bladder drain and flush out any blood clots that may have formed. The urethra will swell after the surgery and the catheter will help it stay open.
When you begin to wake up, you will be moved to the recovery room. You might go home the same day you have the surgery, or you may stay overnight at the hospital.
You will likely have some pain or discomfort in the area over the bladder, as well as at the base of the penis. The catheter in the urethra can be irritating. It normally needs to stay in for 2 to 3 days. Do not try to remove the catheter. Your healthcare provider will remove the catheter.
Drink a lot of water and for 4 to 6 weeks avoid activities that put strain on your abdomen, such as straining to have a bowel movement or heavy lifting.
Ask your provider how to care for yourself, when you can go back to work, and when you should come back for a checkup.
Many men notice that their bladder symptoms are better within 2 to 3 weeks after the surgery: They do not feel the need to urinate as often and they have few or no urination “emergencies.†The improvement in symptoms tends to last a long time, but the symptoms will come back to a few men and they may need to have the procedure again after several years.
The risks of complications from this procedure are low. Some possible risks include:
You should ask your healthcare provider how these risks apply to you.
After surgery, follow your provider’s instructions for taking care of yourself. If you have not been given specific instructions about when to call your provider, here are some guidelines:
Call your provider right away if:
Call during office hours if:
