When Does the Prostate Need Surgery?

In most men with enlarged prostate, medication or lifestyle changes are enough to control symptoms, and not every patient needs surgery. Surgery is considered when prostate enlargement disrupts normal urine flow or creates a risk of damage to the kidneys or bladder.

Prostate surgery becomes necessary when enlargement of the prostate gland causes serious problems in the urinary system or kidneys, or when it is resistant to other treatments. Below are several serious urinary problems caused by prostate enlargement:

• Acute and recurrent urinary retention: when pressure from prostate enlargement closes the urethra, the patient suddenly cannot urinate, and this happens repeatedly.

• Recurrent urinary tract infections: an enlarged prostate can cause urine to remain in the bladder and lead to repeated infections.

• Bladder stones: retained urine in the bladder can, over time, lead to mineral deposits and bladder stone formation, causing problems in the urinary system.

• Kidney damage: in severe cases, pressure from urinary retention can cause kidney swelling (hydronephrosis), damage the kidneys, and lead to kidney failure.

• Blood in the urine: if visible blood in the urine (hematuria) is not controlled with medication and other causes have been ruled out, surgery may be needed.

If urinary symptoms become more severe, if you feel urine remains after voiding, or if problems such as urinary infections occur, you need to see a urologist.

The type of surgery is chosen based on your personal condition, and the urologist may recommend transurethral resection of the prostate (TURP) or open surgery (prostatectomy).