Benign prostatic enlargement (BPE) is a non-cancerous enlargement of the prostate gland that can cause bothersome urinary symptoms. Several surgical options exist — Dr Tan will recommend the most appropriate based on your prostate size, symptoms, and lifestyle.
TURP is the established surgical gold standard for BPE. A telescope is passed through the urethra to the prostate, and a wire loop uses electrical current to remove the obstructing prostate tissue from the inside — widening the urinary channel. No external incisions are made. TURP is an effective treatment and provides long-term relief of symptoms for most men.
02
Before your procedure
TURP requires a general or spinal anaesthetic. Fast for six hours beforehand.
Blood-thinning medications must be paused as directed. Urine should be infection-free before the procedure.
Pre-operative bloods and a review of your regular medications will be arranged at assessment.
03
Risks and benefits
Common
Retrograde ejaculation
Semen passes backwards into the bladder rather than out through the penis during orgasm in most men. This is permanent but not harmful — orgasm is preserved.
Common
Temporary blood in urine
Blood-stained urine is expected for 1–3 weeks after TURP. Good hydration helps. Heavy or persistent bleeding should be reported.
Uncommon
Urinary infection
A short course of antibiotics after discharge reduces but does not eliminate this risk. Symptoms of burning and fever should be reported promptly.
Rare
Incontinence or urethral stricture
Permanent urinary leakage is very rare after TURP. Narrowing of the urethra (stricture) can occasionally develop later and may need treatment.
04
Aftercare and recovery
1
Catheter
A urinary catheter is placed during surgery and typically removed 24–48 hours later, once the urine is running clear.
2
Hydration
Drink 2–3 litres of fluid per day for the first few weeks to flush the bladder and reduce the risk of clot formation.
3
Activity
Avoid strenuous exercise, heavy lifting, and long-haul travel for 4–6 weeks. Return to desk work is usually possible within 1–2 weeks.
4
Symptom improvement
Urinary flow typically improves significantly within 6 weeks. Urgency and frequency may take a few months to fully settle.
01
UroLift
UroLift is a minimally invasive procedure that lifts and holds the enlarged prostate lobes apart — like opening curtains — to relieve the obstruction without removing or destroying any tissue. Small permanent implants are placed through a telescope passed into the urethra. No heat, cutting, or ablation is used.
UroLift is particularly suited to men who wish to preserve ejaculatory function. It is performed under local or general anaesthetic, usually as a day case, with rapid recovery. It is most effective for smaller prostates without an obstructing middle lobe.
02
Before your procedure
Pre-procedure cystoscopy confirms suitability (no obstructing middle lobe). Urine must be infection-free.
UroLift can be performed under local anaesthetic — no fasting required for this approach. General anaesthetic is also available.
Blood-thinning medications may need to be paused — discuss with Dr Tan’s team.
03
Risks and benefits
Key benefit
Ejaculatory function preserved
Unlike TURP, UroLift preserves normal ejaculation in the vast majority of men — an important consideration for men of sexually active age.
Common
Temporary urinary symptoms
Burning, frequency, and urgency are common in the first 2–4 weeks. These settle as inflammation resolves.
Uncommon
Incomplete symptom relief
UroLift is generally less effective than TURP for very large prostates. A minority of patients may require further treatment.
Rare
Implant displacement
Very rarely, an implant may move and require endoscopic removal.
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Aftercare and recovery
1
Quicker recovery
Most patients go home the same day and notice improvement in urine flow within 2–4 weeks. Full benefit is typically felt by 6 weeks.
2
Catheter
A catheter is not always required. If placed, it is typically removed the same day or the next morning.
3
Return to activity
Most men return to normal activities — including work — within a few days. Avoid strenuous exercise for 2 weeks.
4
Follow-up
A review appointment is arranged at 4–6 weeks to assess symptom response and urine flow.
01
Rezum water vapour therapy
Rezum uses controlled pulses of water vapour (steam) delivered directly into the prostate tissue. The steam causes the cells to break down over a period of weeks, reducing the overall size of the prostate and relieving the obstruction. The procedure is performed through the urethra under local anaesthetic, usually as a day case.
Like UroLift, Rezum preserves ejaculatory function in most patients. It is also suitable for prostates with an obstructing middle lobe.
02
Before your procedure
Urine must be infection-free before the procedure. A urine culture is arranged beforehand.
Can be performed under local or general anaesthetic. Fasting requirements depend on the anaesthetic type chosen.
Blood-thinning medications may need adjustment — discuss with the team.
Rezum should not be performed in men with a cardiac pacemaker or implanted defibrillator. Please inform Dr Tan if you have any implanted device.
03
Risks and benefits
Key benefit
Ejaculatory function preserved
Rezum preserves normal ejaculation in the majority of patients — a significant advantage over TURP.
Common
Temporary worsening of urinary symptoms
Swelling from the steam treatment causes temporary urgency, frequency, and occasional difficulty passing urine in the first 2–4 weeks. This is expected and settles as the prostate reduces in size.
Common
Temporary catheter dependence
Many patients need a catheter for 5–7 days after Rezum due to temporary post-procedure swelling.
Uncommon
Delayed symptom improvement
Full benefit from Rezum may take 2–3 months as the treated tissue gradually reduces. Patients should be aware that results are not immediate.
04
Aftercare and recovery
1
Catheter management
A catheter is placed at the time of the procedure. Guidance on catheter care at home will be provided. The catheter is usually removed after 5–7 days.
2
Hydration
Drink 2 litres of fluid per day for the first 2–4 weeks to support healing and reduce urinary symptoms.
3
Gradual improvement
Symptom improvement is gradual over 1–3 months. Peak benefit is typically seen by 3 months.
4
Follow-up
Review appointments are arranged at catheter removal, 6 weeks, and 3 months to assess flow rate and symptom scores.
01
Robotic simple prostatectomy
For men with very large prostates (typically over 80 mL) that are not suitable for endoscopic treatment, robotic simple prostatectomy removes the inner obstructing portion of the prostate (the adenoma) while leaving the outer shell (capsule) intact. Unlike radical prostatectomy for cancer, this procedure does not remove the entire gland and is used solely for benign disease.
Robotic simple prostatectomy can provide durable symptom relief for very large prostates and is associated with generally lower blood loss and faster recovery compared with traditional open simple prostatectomy.
02
Before your procedure
Full pre-operative assessment including prostate volume measurement (usually by MRI or TRUS), blood tests, and cardiac assessment.
Prostate cancer must be excluded or adequately assessed before this procedure. PSA and biopsy results will be reviewed.
Fast for six hours before surgery. Blood-thinning medications are paused as directed.
03
Risks and benefits
Expected
Retrograde ejaculation
As with TURP, retrograde ejaculation (dry orgasm) is an expected outcome in the majority of men. This is permanent but not dangerous.
Common
Temporary urinary symptoms
Urgency, frequency and blood in the urine are common in the first 2–4 weeks and settle as healing progresses.
Uncommon
Bleeding
The robotic approach reduces blood loss compared to open surgery, but transfusion may occasionally be needed.
Rare
Urinary incontinence
Permanent urinary leakage is rare. Some temporary leakage after catheter removal is common and resolves with pelvic floor exercises.
04
Aftercare and recovery
1
Hospital stay
Most patients stay 1–2 nights. A catheter is in place for 5–7 days after discharge.
2
Pelvic floor exercises
Begin pelvic floor exercises after catheter removal to support urinary control. Most patients achieve good continence within 4–6 weeks.
3
Return to activity
Avoid strenuous exercise for 4–6 weeks. Return to desk work at 2–3 weeks. Driving can resume after 2 weeks.
4
Long-term results
Robotic simple prostatectomy can provide durable symptom relief. Long-term re-treatment rates are low.
Which procedure is most appropriate for my prostate size?
Is preserving ejaculatory function important to me — and which option best protects this?
How effective is each option long-term?
How long will I need a catheter?
When can I return to work and normal activities?
Could my symptoms be treated with medication instead?
Could I have prostate cancer alongside BPE?
Disclaimer
This information is for general education and is not a substitute for personal medical advice.
Content adapted from the British Association of Urological Surgeons (BAUS) and the American Urological Association (AUA) patient information resources.
Troubled by urinary symptoms from an enlarged prostate?