Benign prostate enlargement affects more than 23 million American men and half of all men over 60 have it. In many, the symptoms are uncomfortable enough to require surgery. Senator John McCain underwent the procedure with no complications.
Benign prostatic hyperplasia, or BPH, is a condition in which an enlarged prostate can squeeze the urethra, the tube that carries urine, much like pinching a straw.
During a procedure called transurethral resection of the prostate, or TURP, a scope is used to cut away those portions of the prostate pressing against the urethra, relieving symptoms.
"What remains, then, is the bladder draining through a much wider opening [with] much less resistance," explains New York City urologist, Dr. Robert Salant. He performs TURPs and considers the operation the gold standard: effective, long-lasting, and having relatively few risks.
Postsurgical side effects include loss of bladder control or incontinence, which affects about one in 100 patients, and impotence, which occurs less than 1% of the time. But Salant says an unsettling condition known as retrograde ejaculation occurs in 65 to 90% of patients.
"During sexual activity, when a man ejaculates, no material comes out through his penis," Dr. Salant explains. "It goes backward into the bladder, retrograde fashion. It's not dangerous, but something quite bothersome to men who are sexually active."
Salant says some patients are so dismayed by that possibility they choose not to have a TURP, opting instead for medication or minimally invasive procedures like laser surgery.
But for others, TURP is the only option. In McCain's case, doctors not only performed a TURP, but also removed bladder stones. His office says he came through the surgery just fine. It lasted about an hour and 10 minutes.
He will remain hospitalized for one to two nights and he is expected to make a full recovery.
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