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Minimally Invasive Treatment Options for BPH

Comparison of laser, vapor, and resistance ablation methods as alternatives to TURP in benign prostatic hyperplasia.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Minimally Invasive Treatment Options for BPH?

In benign prostatic hyperplasia (BPH), minimally invasive interventions play an important role in patients refractory to medical therapy or unable to tolerate it. While classical TURP (transurethral resection) remains the gold standard, modern options include laser enucleation (HoLEP), vapor ablation (Rezum), mechanical retraction (UroLift), transurethral needle ablation (TUNA), and photoselective vaporization (PVP).

HoLEP: enucleation of prostatic adenoma with holmium laser; low blood loss and low recurrence. Rezum (water vapor ablation): preserves retrograde ejaculation, preferred in younger patients. UroLift: stretches prostatic lobes with retraction needles; minimal anesthesia, ejaculation and erectile function are preserved.

Method selection depends on prostate volume, patient comorbidities, ejaculation and erectile function priorities, anesthesia suitability, and clinical experience.

Symptoms

Weak urinary stream and post-void dribbling
Nocturia, frequency, and urinary urgency
Sense of incomplete emptying and post-micturition dribbling
Bladder outlet obstruction progressing to urinary retention
IPSS score of 20 or higher

Risk Factors

Advanced age and changes in testosterone metabolism
Non-adherence to medical therapy or side effects
Large prostate volume (>80 mL): favors HoLEP
Anticoagulant use: laser methods are preferred
Priority for ejaculation preservation: Rezum or UroLift

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Symptoms refractory to medical therapy (alpha blocker + 5-ARI)
  • Recurrent acute urinary retention
  • Complications such as urinary tract infection, bladder stones, or renal failure
  • If TURP is planned in patients on anticoagulants
  • Young patients prioritizing ejaculation and erectile function preservation

Treatment Methods

01
HoLEP: ideal for prostate >80 mL; short hospital stay, low recurrence
02
PVP (GreenLight laser): safe for patients on anticoagulants; minimal bleeding
03
Rezum (water vapor): small to medium prostate; minimal retrograde ejaculation
04
UroLift: in small prostate without median lobe; can be performed in office setting
05
TURP: still standard option for moderately enlarged prostate
06
Open adenomectomy / robotic HoLEP: for very large prostate (>150 mL)

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.