2 Current practice

2 Current practice

NICE guidance on lower urinary tract symptoms in men: management recommends a number of surgical procedures for men with voiding symptoms presumed secondary to BPH with prostates smaller than 100 g, where symptoms are severe or if drug treatment and conservative management options have been unsuccessful or are not appropriate:

  • monopolar or bipolar transurethral resection of the prostate (TURP)

  • monopolar transurethral vaporisation of the prostate (TUVP)

  • holmium laser enucleation of the prostate (HoLEP; at a centre specialising in the technique, or with mentorship arrangements in place)

  • transurethral incision of the prostate (TUIP) as an alternative for men with prostates estimated to be smaller than 30 g.

Increasingly there are new surgical technologies and techniques to ease symptoms associated with BPH (for example, in February 2015 NICE published medical technologies guidance on the TURis system for transurethral resection of the prostate, which is an alternative to monopolar TURP). However, inpatient TURP remains the current standard surgical intervention. TURP is associated with potential permanent side effects including erectile dysfunction, retrograde ejaculation and urinary incontinence. It also necessitates the use of a catheter for several days after the procedure, which may be uncomfortable.

This page was last updated: 27 April 2017