Transurethral prostate incision

In this procedure the urethra is also chosen as the natural access route. In contrast to the prostate resection described above, the prostate gland itself is left in place. Instead, small incisions are made in the capsule and tissue of the prostate, as well as in the bladder neck.

This method is particularly suitable if there is a narrowing in the area of the bladder neck, but the prostate itself is rather small. Although the procedure causes fewer complications immediately after the operation, in the long term there is a risk that further enlargement of the prostate will result in new constrictions. The main area of application is young, sexually active men with a prostate that is only slightly enlarged.

Open surgical prostatectomy

As the name suggests, the operation is performed open, through the abdominal wall and then through the bladder, or between the bladder and the pubic bone. This procedure is hardly ever used any more, except in cases of extremely enlarged prostate or other individual factors, such as the presence of diverticula or a hernia. As one can imagine, the complication rate is somewhat higher than with urethral access due to the ultimately cumbersome access route. However, the improvement of symptoms and long-term complications are about the same.

Laser therapy

Lasers can be used in various ways to treat prostate enlargement. Since the way in which a laser acts on a tissue and the depth of penetration strongly depends on its wavelength, it is possible to cut as well as melt the tissue with the laser. During vaporization, the prostate is melted down and the constriction is removed.

However, the procedure has the disadvantage that it is no longer possible to take cut samples for pathological examinations. This is particularly bad if it can only be determined during the operation whether it is a benign prostate enlargement or a tumor. The cutting laser procedure is suitable for this purpose, as it allows for the gentle removal of tissue, but does not melt it down immediately. Thus, samples can also be taken with a laser-assisted procedure. The laser has also established itself particularly in forms of prostate enlargement, where open surgery was previously necessary.