Transurethral incision of the prostate (TUIP)
Transurethral incision of the prostate (TUIP)
Transurethral incision of the prostate (TUIP) is a type of prostate surgery done to relieve urinary symptoms caused by prostate enlargement, also known as benign prostatic hyperplasia (BPH).
During TUIP, a combined visual and surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The urethra is surrounded by prostate tissue. No prostate tissue is removed during TUIP. Instead, the doctor cuts one or two small grooves in the area where the prostate and the bladder are connected (bladder neck) in order to open up the urinary channel. This allows urine to pass through more easily.
When deciding whether TUIP or another treatment is a good option 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.
Before doing any enlarged prostate procedure, your doctor may want to do a test that uses a visual scope to look inside your urethra and bladder (cystoscopy). This allows the doctor to check the size of your prostate and examine your urinary system. Your doctor may also want to do other tests, such as blood tests or tests to measure urine flow.
Why it's done
TUIP is used to ease urinary symptoms caused by an enlarged prostate. Symptoms can include:
TUIP may also be done to treat or prevent complications due to blocked urine flow, such as:
TUIP is an option only when the prostate gland is relatively small — less than about 1 ounce (30 milliliters) in size. If you have a larger prostate or you have severe urinary symptoms, a different procedure may be a better option.
Other enlarged prostate procedures include transurethral resection of the prostate (TURP), transurethral needle ablation (TUNA), transurethral microwave therapy (TUMT), laser surgery such as holmium laser enucleation of the prostate (HoLEP) or laser photovaporization of the prostate (PVP), and open prostatectomy.
TUIP is less likely than TURP or open prostatectomy to cause serious bleeding and surgery-related complications. Other enlarged prostate treatments, including holmium laser enuclation of the prostate (HoLEP), appear to be more effective than is TUIP at easing urinary symptoms in the long run.
Risks of TUIP can include:
How you prepare
Follow your doctor's instructions on what to do before your treatment. Here are some things that you may need to do:
Your doctor may also give you other steps to follow.
What you can expect
TUIP typically takes 20 to 30 minutes. 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).
During the procedure
Once the anesthetic is working, your doctor will insert a combined visual and surgical instrument (resectoscope) into the tip of your penis and extend it to the prostate area. The resectoscope is equipped with a lens or camera, a cutting device, and valves to release fluid to wash (irrigate) the surgery area. The resectoscope is about 12 inches (30.5 centimeters) long and 1/2 inch (1 centimeter) in diameter. It has a light, valves for controlling irrigating fluid, and an electrical loop to cut tissue and seal blood vessels. Irrigating fluid is used to lubricate the urethra and rinse away blood.
Using the resectoscope, the doctor makes one or two incisions on the inner surface of the prostate where the bladder joins the prostate (bladder neck).
After the procedure
These steps can help you recover after your procedure.
In most men, TUIP improves the ability to urinate and eases related symptoms. It may be a few weeks to months before you notice the full benefits of treatment.
Your doctor will want to have regular follow-up appointments to check the condition of your prostate and to discuss any symptom changes.
If the procedure doesn't do enough to lessen your symptoms, you may need to consider additional treatment steps. A number of men who undergo TUIP need a follow-up procedure to treat prostate enlargement, particularly after several years have passed.
After TUIP, it's important to have a digital rectal exam once a year to check your prostate and screen for prostate cancer, as you would normally. If you notice any worsening urinary symptoms, make an appointment to see your doctor.
Last Updated: 2011-05-10
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