Transurethral Incision of the Prostate (TUIP)

BPH Procedures

Indications

TUIP is an alternative to drug therapy or more invasive surgery for BPH treatment. This procedure is typically done for patients with small prostates and “high riding bladder necks”.  These patients are often younger. This treatment might be right for you if any of the following apply:

  • You do not want to take another daily pill
  • You have tried BPH medication but are unhappy with the side effects

Testing

You made need the following tests prior to TUIP:

  • Cystoscopy
  • Uroflow
  • Prostate Ultrasound
  • Urodynamics (Less common)
  • Urinalysis

Procedure

Transurethral incision of the prostate (TUIP) is used if you have a smaller prostate gland but still have blockage. Instead of cutting and removing tissue, this procedure widens the urethra. The surgeon makes small cuts in the bladder neck, where the urethra joins the bladder, and in the prostate. This reduces the pressure of the prostate on the urethra making urination easier. The hospital stay is 1-2 days. A catheter is left in your bladder for 1-3 days after surgery.

After the procedure

The prostate and urethra will require a few days of recovery before you can urinate on your own. During this time, you may be catheterized to allow the urinary tract and prostate to heal. There will be some irritation and sensations of needing to urinate.  Some blood in the urine is not uncommon and urgency with incontinence may be present for a few days after the procedure. Any procedure in which a catheter is inserted or remains in place can increase the risk of urinary tract infections.

You should notice an improvement in your urination a few weeks after the procedure.  This may continue to improve for a few months as the prostate shrinks.

Benefits

  • Straightforward procedure with minimal operative time
  • Minimal risk of bleeding

Results

5-year results comparing TUIP to PVP

  • I-PSS score reduction of 53% for TUIP and 62% for PVP
  • QOL improvement of  49% for TUIP and 57%  for PVP

Holmium:YAG Transurethral Incision Versus Laser Photoselective Vaporization for Benign Prostatic Hyperplasia in a Small Prostate

Ahmed M. Elshal, Mohamed A. Elkoushy, Hazem M. Elmansy, John Sampalis, Mostafa M. Elhilali

The Journal of Urology, Vol. 191, Issue 1, p148–154

Published online: July 9, 2013

Complications

TUIP is generally safe with few if any major complications. Possible risks include:

  • Retrograde Ejaculation
  • Mild Hematuria
  • New onset or worsening urinary symptoms  
  • Frequent or urgent need to urinate, and painful urination
  • Postprocedural urinary retention.  You might have trouble urinating for a few days after the procedure
  • Urinary tract infection. This type of infection is a possible complication after any prostate procedure. An infection is increasingly likely to occur the longer you have a catheter in place
  • Stricture.  All transurethral procedures have a small risk of developing a stricture within the penile urethra.  TUIP may also cause a stricture at the bladder neck. These conditions may require another procedure.

Contraindications

TUIP might not be a treatment option if you have:

  • A large prostate
  • Narrowing of the urethra (urethral stricture)
  • Abnormal prostatic anatomy with intravesical median lobe
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