TUIP- Procedure, Benefits, Risks & Recovery

What is TUIP?

TUIP, or transurethral incision of the prostate, is a surgical procedure for the treatment of urinary symptoms due to an enlarged prostate gland, otherwise known as benign prostatic hyperplasia (BPH). 

BPH is the benign enlargement of the prostate gland due to hormonal changes in men. As the prostate enlarges, it restricts the urethra and blocks the flow of urine, which leads to urinary symptoms.

Also Read- TURP Surgery- Procedure, Benefits, Recovery, and Complications

Why is TUIP required?

TUIP surgery is an effective procedure for the treatment of lower urinary tract symptoms (LUTS) caused due to prostate enlargement. TUIP provides relief for symptoms like:

• Frequent, urgent need to urinate
• Difficulty in starting and maintaining a urine stream
• Slow and prolonged urination
• Nocturia, frequent urge to urinate at night
• Weak urine stream
• Frequent UTIs (urinary tract infections)

If left untreated, these symptoms can worsen and cause permanent damage to the urinary system, such as urinary retention, bladder/kidney stones, bladder/kidney damage, urinary incontinence, etc.

How does TUIP procedure work?

TUIP is also known as the transurethral resection of the bladder neck. It is performed using a resectoscope, i.e., a surgical instrument that has a camera lens, a light, and an electric loop. The resectoscope is inserted through the urethra without creating an incision externally on the body. Using the resectoscope, the surgeon cuts grooves in the bladder neck, i.e., the area where the bladder and prostate are connected to widen the urinary passage. As the urinary passage widens, the flow of urine becomes easier and urinary symptoms are relieved.

What are the benefits of TUIP over other BPH treatments?

TUIP has several advantages over other BPH treatments, such as:

• Lower risk of bleeding
• Minimum hospital stay
• Quicker recovery
• Lower risk of retrograde ejaculation/dry orgasm

Also Read- What Is The Best Treatment For An Enlarged Prostate?

What are the risk factors associated with TUIP surgery?

TUIP is a very safe procedure that often does not cause any side effects or complications, however, in rare cases, there are some side effects of TUIP, such as:

• Temporary difficulty in urinating
• Blood or blood clots in urine
• Temporary urinary incontinence
• Urinary tract infection
• Ineffective in relieving urinary symptoms

How to prepare for TUIP surgery?

Before TUIP surgery, the patient has to undergo complete prostate and urinary tract examination to ensure that the symptoms are due to prostate enlargement. 

The diagnostic tests required for BPH diagnosis for TUIP procedure include:

• Physical examination, including a digital rectal examination
• Complete medical history
• Blood tests, including a PSA test
• Uroflowmetry test and urodynamics

If you have a cardiovascular or bleeding disorder and are taking medicines for it, you should inform your urologist about it. If you are taking medicines for a bleeding/clotting disorder, you may need to stop taking them at least 10 days before the surgery.

What happens during TUIP surgery?

TUIP surgery is generally performed under general anesthesia, but it can be performed using spinal anesthesia as well. The surgeon inserts the resectoscope through the urethra and creates grooves in the bladder neck to widen the urinary passage. 

Then the bladder and urethra are flushed using the resectoscope. Finally, a temporary catheter is inserted to help the patient urinate during their hospitalization. Usually, the procedure is completed within 30 minutes.

What happens after the TUIP procedure?

While some patients can have TUIP surgery as an outpatient treatment, most patients are admitted to the hospital for overnight observation and are discharged within 24 hours of the surgery. Patients are generally catheterized for about 1-3 days after the surgery, or at least until they have reliably regained their urinary control.

Once the patient is discharged, they have to maintain their diet and water intake. Water helps to flush out any blood or residual drugs and helps the patient regain their urinary control faster. A proper healthy diet is necessary to prevent constipation and reduce the patient’s discomfort during recovery.

What can the patient do to improve recovery and prevent complications of TUIP?

• Avoid strenuous activity, such as heavy lifting, pushing, exercising, etc., for about 2 weeks after the surgery.
• Drink lots of water to help flush out blood, drugs, and toxins from the bladder.
• Eat a healthy diet to decrease constipation to avoid straining the operated area during bowel movements.
• Avoid sexual intercourse for about 4 weeks, or at least until you have approval from your urologist.

What is the difference between TUIP surgery and TURP surgery?

During TUIP, the surgeon creates two small grooves in the bladder neck to widen the urinary passage to make urination easier. However, in TURP the surgeon trims the excess part of the prostate gland to relieve the pressure on the urethra.

While both TUIP and TURP are used to treat urinary symptoms due to BPH, TUIP is preferred for patients with relatively normal-sized prostate glands, while TURP is performed for patients with large prostate glands.

TUIP is also associated with less surgery time, less hospitalization time, and a quicker recovery period as compared to TURP. TUIP has proven to have more favorable results than TURP over a long period of time.

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