Grade 3 BPH Treatment

What happens in a Grade 3 BPH surgery?

Diagnosis

Prior to surgery, it is likely that your urologist will perform a series of simple tests and diagnostics to assess your overall health and determine if you are healthy enough to safely undergo a surgical procedure. These tests will also allow your urologist to determine if you would require any additional precautions either during or after surgery. It is also likely that your urologist will ask you about your entire surgical history, medical history and if you take any medications or supplements. It is important to answer all these questions to the best of your ability. Some of the diagnostics tests your urologist may perform include: 

• IPSS Test: Before any kind of physical or medical examination, it is likely that your urologist will perform a simple questionnaire called an International Prostate Symptom Score test. In this test, your urologist will ask you 7 questions regarding the symptoms you may be feeling. This test will allow your urologist to assess the severity of your prostate enlargement and determine the best suited method of treatment for you.
• Digital rectal examination: In this test, the urologist will insert a gloved and lubricated finger inside your rectum in order to physically feel the shape and size of your prostate gland. 
• PSA test: A PSA test is a simple blood test that your urologist may perform to assess the severity of your prostate enlargement. PSA levels in your blood are considered to be reliable indicators of some level of prostate enlargement.
• Urine flow study: During a urine flow test, your urologist may ask you to empty your bladder completely. The urologist can then use a special device to detect decreased urine flow associated with an enlarged prostate. 
• Cystoscopy: In a cystoscopy test, your urologist will insert a thin tube with a camera attached to it, called a cystoscope, in your urethra through the small opening at the tip of your penis. This cystoscope will allow your urologist to view the insides of your prostate and inspect its tissue lining.

Treatment

Before going forward with a surgery, your urologist may prescribe you some medications to reduce some of the urinary symptoms you may be facing. These medications generally include alpha blockers and 5-alpha reductase inhibitors. However, in most cases of grade 3 BPH, surgery is usually the only effective form of treatment. Some of the most commonly performed surgical procedures to treat grade 3 BPH include: 

• TURP: A Transurethral Resection of the Prostate surgery is a commonly performed surgical procedure that is often considered to be an effective treatment for all grades of BPH. Depending on your overall health, your surgeon will use either general or spinal anaesthesia and once you are under its influence, the procedure will begin. In a TURP procedure, the surgeon uses a thin, flexible, tube-like surgical instrument called a resectoscope. The urologist inserts this resectoscope in the small opening at the tip of your penis and passess it through the urethra to reach the prostate gland. The resectoscope is also fitted with a small surgical tool that your urologist will use to remove enlarged pieces of the prostate gland. Once the resectoscope is in place, the surgeon will remove the excess tissue which will later be removed through the urethra. After some of the pressure being exerted on the urethra is removed, the resectoscope is removed and you will be moved to a recovery area.
• HoLEP: Holmium Laser Enucleation of the Prostate is a more advanced method of BPH treatment. A HoLEP procedure follows almost the exact same procedure as a TURP procedure. The surgeon will administer either general or spinal anaesthesia and once you are sedated, insert a resectoscope into your urethra through the small opening at the tip of your penis. Once the resectoscope reaches the prostate gland however, instead of a small surgical tool, a HoLEP procedure utilises a holmium laser to enucleate pieces of enlarged prostate tissue. The removed tissue will later on be removed through the urethra. Once the procedure is complete, the urologist will remove the resectoscope and you will be moved to a recovery area for post-operative observation. 
• TUIP: A Transurethral Incision of the Prostate is a more minimally invasive treatment for enlarged prostate that is often recommended to younger men who are concerned about fertility. In a TUIP procedure, the surgeon inserts a resectoscope into your urethra through the small opening at the tip of your penis. Once the resectoscope is in place however, instead of slowly chipping away pieces of enlarged prostate tissue with a surgical tool or laser, the surgeon makes 1-2 very small incisions at the area where the bladder and prostate gland connect. These incisions help in widening the urethra and reduce urinary symptoms caused by BPH. Unlike other procedures, chances of retrograde ejaculation, a common complication after a BPH surgery, are minimal. 

Benefits of Grade 3 BPH treatment

Ignoring symptoms of BPH or delaying surgery will likely cause your urinary symptoms to worsen and lead to complications. However, a timely treatment of BPH can bring several benefits such as: 

• After a BPH surgery, one of the main benefits is the relief it provides from symptoms of BPH. 
• A timely treatment can significantly reduce the chances, or even stop, your BPH from aggravating and become worse.
• Getting timely treatment for BPH means you will be able to return to your daily life faster.