Surgical intervention may be required for benign prostatic hyperplasia when drug therapy has not worked, the patient cannot tolerate medication or if the prostate is very large. By far the most common indication for intervention is when the symptoms trouble a patient enough that he wants something done. Another common reason for intervention is the development of urinary retention which is the inability to urinate which may require a catheter to be placed through the penis into the bladder.
A newer surgical technique to treat BPH has been developed called Greenlight laser photoselective vaporization of the prostate (PVP). In this operative procedure, a laser fiber is used to vaporize the enlarged portion of the prostate. This is generally done as an outpatient (same day surgery) procedure. The catheter is generally left in overnight at the discretion of the surgeon. Generally, patients experience a stronger urinary stream immediately following surgery, however irritating urinary symptoms can persist for a period of time. During the first one to three months after surgery, patients may experience ongoing frequency and urgency of urination and occasionally slight burning with urination. This generally occurs as the operative site just below the bladder continues to heal. Once the healing is complete, these symptoms abate.