The Benign Prostate Hyperplasia (BPH) Symptom Score Index can help your doctor understand how severe enlarged prostate symptoms are.
If your total score is less than seven, your symptoms are considered mild. Higher scores indicate more severe symptoms. Your doctor can discuss your scores with you -- and what they indicate about your need for treatment.
Use the following point scale to answer each of the questions. Total the score from all the questions.
0 = Not at all
3 = About...
The hospital stay after TURP is
commonly 1 to 2 days.
Following surgery, a
catheter is used to remove blood or blood clots in the
bladder that may result from the procedure. When the
urine is free of significant bleeding or blood clots, the catheter can be
removed and you can go home.
Strenuous activity, constipation, and
sexual activity should be avoided for about 6 weeks. Symptoms such as frequent
urination will continue for a while because of irritation and inflammation
caused by the surgery. But they should ease during the first 6 weeks.
TURP is now the most
common surgery used to remove part of an enlarged prostate. Open
prostatectomies (in which an incision is made into the abdomen) generally are
needed only when the prostate is very large.
How Well It Works
For men who have moderate to severe
symptoms of prostate enlargement, TURP is more effective than watchful waiting
in relieving urinary symptoms. Studies have found that:
Men who had TURP had a lower symptom score
compared with those who used watchful waiting.1
Symptoms get better for 7 to 10 out of 10 men
who have the surgery.2
On the average, men experience an 85% improvement in their
American Urological Association (AUA) symptom index
scores.2 For example, if you had a score of 25, after
this surgery it might be reduced to about 4. Men who are very bothered by their
symptoms are most likely to notice great improvement in their symptoms after
TURP. Men who are not very bothered by their symptoms are less likely to notice
a significant change.
The risks of transurethral resection of the
prostate (TURP) include problems with sexual performance, incontinence, and
problems from surgery.
Problems with sexual performance
Ejaculation into the bladder (retrograde
ejaculation) is very common, occurring in about 25 to 99 men out of
100.2 This does not affect sexual
Erection problems may develop in men
who did not have problems before the procedure. The risk of this may depend on
how sexual performance is defined and measured, how sexually active the man was
before the surgery, and how old he is. Many men in the age group who are likely
to have BPH also have some problems with getting an erection. Subsequent
erection problems are reported by about 3 to 35 men out of 100.2 Medicine can help some men achieve
an erection after they have had TURP.
A small number of men (about 1%) say they are
completely unable to hold back their urine after the surgery.2
Some men find that they can still hold in their
urine after the surgery, but they tend to leak or dribble.
Problems related to having surgery
About 5 out of 100 men have severe bleeding and need a blood transfusion.3
syndrome occurs in about 2 out of 100 men who have TURP.2 This syndrome occurs when the body absorbs too much of the
fluid used to wash the area around the prostate while prostate tissue is being
removed. The symptoms of TURP syndrome include mental confusion, nausea,
vomiting, high blood pressure, slowed heartbeat, and visual disturbances. TURP
syndrome is temporary (usually lasting only the first 6 hours after surgery)
and is treated with medicine that removes excess water from the body
About 2 or 3 men out of 100 need to have another
operation after 3 years.2
because of a complication of the surgery is needed less than 10% of the
What To Think About
Surgery usually is not required to
treat BPH, although some men may choose it because their symptoms bother them
so much. Choosing surgery depends largely on your preferences and comfort with
the idea of having surgery. Things to consider include your expectation of the
results of the surgery, the severity of your symptoms, and the possibility of
having complications from the surgery.
Men who have severe
symptoms often have great improvement in quality of life following surgery. Men
whose symptoms are mild may find that surgery does not greatly improve quality
of life. Men with only mild symptoms may want to think carefully before
deciding to have surgery to treat BPH.
Webber R (2006). Benign prostatic hyperplasia, search
date May 2005. Online version of BMJ Clinical Evidence.
Also available online: http://www.clinicalevidence.com.
Fitzpatrick JM (2007). Minimally invasive and
endoscopic management of benign prostatic hyperplasia. In AJ Wein, ed.,
Campbell-Walsh Urology, 9th ed., vol. 3. pp. 2803-2844.
Philadelphia: Saunders Elsevier.