The therapeutic options for BPH range from medical
management to invasive surgery. Transurethral resection of the prostate (TURP)
remains the gold standard in managing BPH but advances in technology have
increased the number of minimally invasive surgery options, of which UroLift
and Rezum are two new options currently performed by Assistant Professor Chua Wei Jin at NUH.
Transurethral Resection of Prostate (TURP)
In TURP, the obstructing part of the prostate gland is removed using a
special instrument called the resectoscope that is inserted via the urinary
passage.
This procedure is done under General Anaesthesia or Regional Anaesthesia.
The amount of prostate tissue removed will depend on the size of the prostate
gland. This is an in-patient procedure with an average length of stay of 2 to 3
days.
Indications for TURP:
- Acute
/ Chronic Urinary Retention
- Recurrent
urinary tract infections
- Bladder
stone secondary to BPH
- Renal
insufficiency due to BPH
- Large
bladder diverticulum/diverticula
- Failed
medical therapy
UroLift
The UroLift system uses a revolutionary approach to treat BPH by lifting and holding the enlarged prostate tissue out of the way, so it no longer blocks the urethra. There is no heating, cutting or removal of prostate tissue.
UroLift can be performed as a day case with the procedure typically spanning less than 30 minutes. The procedure is free from possible serious adverse effects of traditional BPH surgery, such as stress urinary incontinence and transfusion, and provide a quick relief of BPH symptoms with shorter recovery time.
Rezum
Rezum is a transurethral thermal therapy that uses steam to treat BPH by delivering targeted, controlled doses of thermal energy directly to the prostate gland. The steam is dispersed between cells, releasing heat that gently kills the excess prostate cells. Over time, the body's natural healing response removes the dead cells, shrinking the prostate and opening up the urethra, thus relieving the BPH symptoms.
Rezum is similarly performed as a day case. Post procedure, patients need to be on a urinary catheter for 10 to 14 days. Most men experience symptom relief in 1 to 3 months and will be able to return to normal activities within 2 to 4 weeks after treatment.
Suitable patients for Urolift and Rezum:
- Moderate BPH symptoms
- Want to preserve sexual function
- Failed or does not wish to be on long term medication
- Not able to tolerate the side effects of medication
- Prostate volume 30 to 80mls
With regard to choosing between the UroLift and Rezum, your doctor will help you to decide based on your prostate anatomy. The patient will have a choice on his preferred procedure if the anatomy is favourable for both procedures.
Take Home MessageToday, patients need not suffer from bothersome BPH symptoms. It is not part of getting older. Such symptoms can be treated. The number of treatment choices are increasing each year. If patients are bothered by urinary symptoms, please see a doctor for a prostate check-up.