The Surgical Treatment of Benign Prostatic Hyperplasia

  • James C. UlchakerEmail author
Part of the Current Clinical Urology book series (CCU)


The surgical treatment options for bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH) have dramatically increased in number over the past 20 years. However, each of these new modalities continues to be measured against the gold standard treatment of transurethral resection of the prostate (TURP). Herein, we will present the current approaches to the surgical treatment for BPH. We will discuss open surgical options, as well as endoscopic and minimally invasive treatment options. Also, in 2010, the American Urological Association updated its BPH Practice Guidelines. These guidelines will be presented after each subsection in bold letters (McVary et al. J Urol 185:1793–1803, 2011).


Benign Prostatic Hyperplasia Bladder Neck Urethral Stricture Panel Consensus Holmium Laser 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185:1793–803.PubMedCrossRefGoogle Scholar
  2. 2.
    Serretta V, Morgia G, Fondacaro L, et al. Open prostatectomy for benign prostatic enlargement in Southern Europe in the late 1990s: a contemporary series of 1,800 interventions. Urology. 2002;60(4):623–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Varkarakis I, Kyriakakis Z, Delis A, et al. Long-term results of open transvesical prostatectomy from a ­contemporary series of patients. Urology. 2004;64(2):306–10.PubMedCrossRefGoogle Scholar
  4. 4.
    Zargooshi J. Open prostatectomy for benign prostate hyperplasia: short-term outcome in 3,000 consecutive patients. Prostate Cancer Prostatic Dis. 2007;10(4):374–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Mebust WK, Holtgrewe HL, Cockett AT, et al. Transurethral prostatectomy: immediate and ­postoperative complications: a cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol. 1989;141(2):243–7.PubMedGoogle Scholar
  6. 6.
    Roehrborn CG, Issa MM, Bruskewitz R, et al. Transurethral needle ablation (TUNA) for benign ­prostatic hyperplasia: 12-month results of a prospective multicenter study. Urology. 1998;51:415–21.PubMedCrossRefGoogle Scholar
  7. 7.
    Bruskewitz R, Issa MM, Roehrborn CG, et al. A ­prospective, randomized, 1-year clinical trial comparing transurethral needle ablation (TUNA) to transurethral resection of the prostate for the treatment of symptomatic benign prostatic hyperplasia. J Urol. 1998;159:1588–94.PubMedGoogle Scholar
  8. 8.
    Schulman CC, Zlotta AR, Rasor JS, et al. Transurethral needle ablation (TUNA): safety, feasibility and tolerance of a new office procedure for the treatment of benign prostatic hyperplasia. Eur Urol. 1993;24:415–23.Google Scholar
  9. 9.
    Campo B, Bergamasghi F, Corrada P, et al. Transurethral needle ablation (TUNA) of the prostate: a clinical and urodynamic evaluation. Urology. 1997; 49:847–50.PubMedCrossRefGoogle Scholar
  10. 10.
    Ramon J, Lynch TH, Eardley I, et al. Transurethral needle ablation of the prostate for the treatment of benign prostatic hyperplasia: a collaborative multicenter study. Br J Urol. 1997;80:128–35.PubMedGoogle Scholar
  11. 11.
    Rosario DJ, Woo H, Potts KL, et al. Safety and ­efficacy of transurethral needle ablation of the prostate for symptomatic outlet obstruction. Br J Urol. 1997;80:579–86.Google Scholar
  12. 12.
    Steele GS, Sleep DJ. Transurethral needle ablation of the prostate: a urodynamic-based study with two-year follow-up. J Urol. 1997;158:1834–8.Google Scholar
  13. 13.
    Millard RJ, Harewood LM, Tamaddon K. A study of the efficacy and safety of transurethral needle ablation (TUNA) for benign prostatic hyperplasia. Neurourol Urodyn. 1996;15:916–29.Google Scholar
  14. 14.
    Organ LW. Electrophysiological principles of ­radiofrequency lesion making. In: International symposium on radiofrequency lesion making proce­dures,Chicago, Illinois, 1976. Appl Neurophysiol. 1976;39:69–76.Google Scholar
  15. 15.
    Larson TR, Bostwick DG, Corica A. Temperature­correlated histopathologic changes ­following microwave thermoablation of obstructive tissue in patients with benign prostatic hyperplasia. Urology. 1996; 47:463–9.Google Scholar
  16. 16.
    Orandi A. Transurethral incision of the prostate. J Urol. 1973;110:229–31.Google Scholar
  17. 17.
    Orandi A. Transurethral incision of the prostate (TUIP): 646 cases in 15 years—a chronological appraisal. Br J Urol. 1985;57:703–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.Glickman Urologic and Kidney Institute, Cleveland ClinicClevelandUSA

Personalised recommendations