I have a prostate problem and have been advised to see a specialist to see if surgery is necessary. What is involved?

Your consultant will talk through the situation with you and consider, often following further investigations, what the most appropriate course of treatment is and if surgery is necessary.

In the case of benign prostatic hyperplasia (BPH), a procedure known as a TURP (transurethral resection of the prostate) may be undertaken to remove part of the prostate. This is done through the urethra (the water pipe) to avoid any scars.  Sometimes a procedure known as a TUIP (transurethral incision of the prostate) is undertaken, which is aimed at overcoming blockages in men with a smaller prostate. Recently in some areas there has also been more minimally invasive laser treatments including Green Light Laser or Holmium laser treatment. For more information about surgical treatments for BPH see the  benign prostatic hyperplasia (BPH) pages.  Surgery can also involve open or minimal access (keyhole) prostatectomy – the surgical removal of part or all of the prostate, which may also be the suggested treatment for prostate cancer.

Any procedure may have some risk or side effects. Your treatment will depend on the nature and state of your prostate disease, and, for some conditions, surgery may be the most effective treatment. Sometimes you may be offered a combination of surgery and medicines. Sometimes a minor operation may be necessary to diagnose the nature of the problems prior to treatment options being determined. Your doctor will discuss these options with you.

In the case of prostatitis when the cause is a bacterial infection, your doctor may consider prescribing you antibiotics. In some cases, medications may be prescribed to deal with the symptoms of benign prostatic hyperplasia (BPH). One key group of medicines, known as 5-alpha reductase inhibitors, can be used to block the natural hormone testosterone that makes the prostate enlarge. In some cases, medicines called alpha-blockers are used. These relax the smooth muscle in the prostate gland by blocking so-called alpha-receptors, allowing urine to flow more easily. At times, your doctor may suggest a combination of these.

With prostate cancer, you may be prescribed a course of hormonal therapy in the early stages, prior to any radiotherapy that you may be offered. Usually this is for 3 months for patients with localised disease, but in cases where the patient may have locally advanced disease or their PSA reading is very high, the oncologist (cancer doctor) may suggest that the hormone treatment be continued for a number of years.

In the case of advanced prostate cancer, treatment is often in the form of hormone therapy, utilising a group of drugs to reduce the production of testosterone, as testosterone can promote the growth of prostate cancer cells. Your treatment will depend on the nature and state of your prostate disease, and, for some conditions, surgery may be the most effective treatment. Sometimes you may be offered a combination of surgery and medicines. Sometimes a minor operation may be necessary to diagnose the nature of the problems prior to treatment options being determined. Your doctor will discuss these options with you.

In the case of prostatitis when the cause is a bacterial infection, your doctor may consider prescribing you antibiotics. In some cases, medications may be prescribed to deal with the symptoms of benign prostatic hyperplasia (BPH). One key group of medicines, known as 5-alpha reductase inhibitors, can be used to block the natural hormone testosterone that makes the prostate enlarge. In some cases, medicines called alpha-blockers are used. These relax the smooth muscle in the prostate gland by blocking so-called alpha-receptors, allowing urine to flow more easily. At times, your doctor may suggest a combination of these.

With prostate cancer, you may be prescribed a course of hormonal therapy in the early stages, prior to any radiotherapy that you may be offered. Usually this is for 3 months for patients with localised disease, but in cases where the patient may have locally advanced disease or their PSA reading is very high, the oncologist (cancer doctor) may suggest that the hormone treatment be continued for a number of years.