Alternatives

There are several alternatives to a transurethral resection of the prostate (TURP). Your options will depend on how severe your symptoms are and which treatments are available.

Active observation

If you have an enlarged prostate but don't find your symptoms particularly troublesome, you may decide to just wait and keep an eye on your symptoms.

This means you will not receive any immediate treatment but will have the option of having a TURP in future if your symptoms get worse.

If you do not have a TURP, lifestyle changes such as limiting your consumption of alcohol and taking regular exercise may be recommended to improve your symptoms.

Read more about treating prostate enlargement.

Alternative procedures

Newer techniques

There are a number of newer surgical techniques that are generally as effective as TURP and may lead to fewer side effects, a shorter stay in hospital and a quicker recovery.

However, as these treatments are still fairly new, they may not be available, and their long-term effectiveness is not always clear.

Some of the main modern techniques are:

• bipolar transurethral resection of the prostate – different instruments and fluids are used to perform the procedure, which is thought to lead to a lower risk of TURP syndrome (see risks of TURP)
• holmium laser enucleation of the prostate (HoLEP) – a laser attached to a resectoscope is used to cut away excess prostate tissue
• transurethral resection or vaporisation of the prostate (TUVP) – a thin tube called a cystoscope is inserted into the urethra (the tube that passes urine out of the body), and a laser attached to the cystoscope fires pulses of energy to cut or burn away prostate tissue
• sling procedure – where mini-slings are inserted to pull the excess prostate tissue away from the urethra
  • prostatic urethral lift (PUL) implants – a surgeon inserts implants that hold the enlarged prostate away from the urethra so that the urethra is not blocked; this helps to relieve symptoms like pain or difficulty when peeing

Open prostatectomy 

An open prostatectomy is a bigger operation where a cut (incision) is made in your tummy to access and remove the outer part of your prostate.

This procedure may be more effective than a TURP if you have very severe prostate enlargement, although it's rarely used nowadays because of modern alternatives such as HoLEP and because it carries a higher risk of long-term complications, such as erectile dysfunction and urinary incontinence.

Page last reviewed: Mon May 2021 Next review due: Wed Feb 2020