Transurethral Incision of the Prostate
Overview
Transurethral incision of the prostate, often called TUIP, is a surgical method that helps relieve problems with urination linked to benign prostatic hyperplasia (BPH). In this procedure, a urologist places a thin instrument called a resectoscope through the urethra, which allows both viewing and surgical action.
The urologist guides the instrument to the area where the prostate meets the bladder, known as the bladder neck. The urologist makes small cuts in this spot. These incisions help widen the urinary channel so urine can flow with less resistance.
Key Points:
- TUIP is most often chosen for men with a smaller prostate who want to maintain fertility.
- It is less invasive than open prostatectomy or other surgery types like TURP (transurethral resection of the prostate).
- The choice between TUIP and other treatments depends on prostate size, symptoms, and overall health.
Table: Comparison of Procedures
| Procedure | Invasiveness | Common Candidates |
|---|---|---|
| TUIP | Minimally invasive | Younger men, small prostate |
| TURP | Moderately invasive | Enlarged prostate |
| Open Prostatectomy | Most invasive | Very large prostate |
Reasons for the Procedure
Doctors often choose transurethral incision of the prostate (TUIP) to address issues linked to benign prostatic hyperplasia (BPH), or an enlarged prostate. BPH can lead to bothersome urinary symptoms that affect daily life. Common issues include:
- Frequent and urgent need to urinate
- Difficulty starting urination
- Interrupted or weak urine flow
- Waking often at night to urinate
- The sense of incomplete bladder emptying
- Recurring urinary tract infections
TUIP can also help prevent or manage problems that result when urine flow is blocked, such as:
| Complication | Possible Result |
|---|---|
| Repeated infections | Ongoing bladder or kidney problems |
| Unable to urinate | Bladder damage |
| Bladder stones | Pain and urinary difficulties |
| Blood in urine | Additional medical concerns |
One of the main benefits of TUIP is its lower risk of bleeding, making it appropriate for people who use blood thinners or have bleeding disorders. Another advantage is that hospital stays are usually short—some may even return home the same day, especially if their health makes longer surgery risky.
TUIP also has a reduced chance of causing retrograde ejaculation, a condition where semen enters the bladder instead of leaving the body. Although this side effect is not harmful, it may affect fertility.
Possible Complications and Side Effects
Doctors consider transurethral incision of the prostate (TUIP) a safe option, but some risks remain. The most common issues include temporary problems with urination, where a catheter may be needed for a short time. Urinary tract infections can develop, especially if a catheter stays in for several days; doctors usually treat these with antibiotics. Other possible risks are:
- Bleeding that is mild and short-lived.
- Retrograde ejaculation (semen enters the bladder instead of leaving the penis).
- Incontinence or trouble controlling the bladder (rare).
- Discomfort or pain during recovery.
- Need for another treatment if TUIP does not relieve symptoms.
| Risk | Notes |
|---|---|
| Urinary infection | Higher with prolonged catheter use |
| Bleeding | Usually minor |
| Re-treatment | May be needed if symptoms return |
| Sexual changes | Retrograde ejaculation possible |
Steps to Get Ready
Eating, Drinking, and Medicines
A doctor may ask the person to stop taking certain blood-thinning medications, like warfarin or clopidogrel, a few days before the procedure to lower the risk of bleeding. Medical staff often give antibiotics before surgery to help prevent infections. Patients might also need to avoid eating or drinking for several hours before the procedure, especially if general anesthesia will be used.
Extra Tips and Things to Keep in Mind
Arrange for someone to drive you home after the outpatient procedure, as anesthesia may make it unsafe to drive. If a catheter is placed, it may need special care. Recovery is usually fast, but it helps to ask the doctor about any time needed off work or activities.
What You Should Know About the Experience
What Happens in the Operating Room
The patient usually receives anesthesia, either to keep them asleep or to numb the lower half of the body. Sometimes, staff add extra numbing gel to the urethra for comfort. Doctors may also use an injection to numb the area near the prostate.
The surgeon places a thin tool called a resectoscope into the tip of the penis and moves it toward the prostate. This device lets the doctor see the area and make precise incisions. The urologist makes small cuts in the inside surface of the prostate, near the bladder neck, using the resectoscope’s built-in instruments. The team might use fluid during the process to help keep the area clean.
| Step | Details |
|---|---|
| Anesthesia | General or spinal for comfort |
| Numbing | Gel or injection for added pain relief |
| Tool used | Resectoscope (camera and cutter combined) |
| Incisions made | 1–2 small cuts in the prostate |
| Surgery site | Near the bladder neck |
What Happens After Surgery
After the operation, some patients can go home the same day, but others might need to stay in the hospital overnight for monitoring. Medical staff typically place a catheter to drain urine from the bladder because swelling may block normal urine flow. The catheter stays in place for 1 to 3 days. Doctors usually prescribe antibiotics to lower the risk of a urinary tract infection. These are some things a person might notice:
- Blood in the Urine: This is usually mild and only lasts a few days.
- Burning or Discomfort: Many feel burning, especially at the tip of the penis and near the end of urinating.
- Urge to Urinate Often: People may wake up more at night or feel more urgent urges for a few days.
- Incontinence: Some find it hard to hold urine, but this usually gets better with time.
- Infection: The risk increases the longer a catheter remains in place.
Most patients can return to their normal activity after the recovery period. Recovery time can vary, but many resume daily routines within a short time after catheter removal, as advised by their doctor.
Outcomes
Most people may begin to notice some improvement in their urination after a few weeks. Follow-up appointments are important if symptoms get worse. In some cases, further treatment for enlarged prostate may be needed to manage ongoing symptoms.
Many patients experience less discomfort and a quicker recovery compared to more invasive prostate surgeries. However, outcomes can vary depending on individual health and prostate size.
