Learn about this procedure for treating an enlarged prostate, including how it's done and possible risks and benefits.
Transurethral incision of the prostate (TUIP) is a procedure to treat urinary symptoms caused by an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). TUIP is generally used in younger men with a small prostate who are concerned about fertility.
A combined visual and surgical instrument (resectoscope) is inserted through the tip of the penis into the tube that carries urine from your bladder (urethra). The prostate surrounds the urethra. The doctor cuts one or two small grooves in the area where the prostate and the bladder are connected (bladder neck) to widen the urinary channel and allow urine to pass through more easily.
TUIP is one of several minimally invasive treatment options for BPH. To determine the right BPH treatment choice for you, your doctor will consider how severe your symptoms are, what other health problems you have, and the size and shape of your prostate.
The prostate gland is located just below the bladder in men and surrounds the top portion of the tube that drains urine from the bladder (urethra). The prostate's primary function is to produce the fluid that nourishes and transports sperm (seminal fluid).
TUIP helps reduce urinary signs and symptoms caused by BPH, including:
TUIP might also be done to treat or prevent complications due to blocked urine flow, such as:
TUIP can offer several advantages over other methods of treating BPH, such as transurethral resection of the prostate (TURP) and open prostatectomy. The advantages can include:
TUIP is generally safe with few if any major complications. Possible risks of TUIP can include:
Several days before surgery, your doctor might recommend that you stop taking medications —such as warfarin (Jantoven) or clopidogrel (Plavix) — that can increase your risk of bleeding. You also are likely to be prescribed an antibiotic to prevent a urinary tract infection.
Arrange transportation because you won't be able to drive yourself home after the procedure that day or generally if you have a catheter in your bladder.
Recovery after TUIP is generally quick, and most men have few symptoms after surgery. Ask your doctor how much recovery time you might need.
You'll receive either a general anesthetic, which will put you to sleep, or an anesthetic that blocks feeling from the waist down (spinal block).
Your doctor might put numbing gel inside your urethra and might numb the prostate area with an injection given through your rectum.
Once the anesthetic is working, your doctor will insert a resectoscope into the tip of your penis and extend it to the prostate area. The resectoscope has a lens or camera, a cutting device, and valves to release fluid to wash the surgery area. Using the resectoscope, the doctor makes one or two cuts (incisions) on the inner surface of the prostate.
You might have TUIP on an outpatient basis or you might need to stay overnight in the hospital for observation.
You will likely have a urinary catheter in place because of swelling that blocks urine flow. The catheter is generally removed after 1 to 3 days. You'll also likely take antibiotics to prevent a urinary tract infection.
You might notice:
It might take several weeks for you to experience noticeable improvement in urinary symptoms. If you notice any worsening urinary symptoms over time, see your doctor. Some men need additional BPH treatment.