Surgery for Male Urinary Dysfunction

At NYU Langone, doctors often recommend surgery for men with certain types of male urinary dysfunction, including benign prostatic hyperplasia and stress incontinence that’s caused by prostate surgery. Rarely, surgery is required to treat neurogenic voiding dysfunction.

The goal of surgery is to improve bladder function. There are several types of prostate surgery, and the one that’s best for you often depends on your symptoms and the size of the prostate.

Prostate Surgery

If you have benign prostatic hyperplasia or neurogenic voiding dysfunction, your doctor may recommend a surgical procedure designed to improve urine flow by removing prostate tissue. Our surgeons are experts in both established and leading-edge surgical techniques.

Each of these procedures causes the quantity of semen during orgasm to diminish or disappear in most men. 

Transurethral Resection of the Prostate

In transurethral resection of the prostate, your surgeon inserts an instrument into the urethra to shave prostate tissue with electrocautery, a process that involves an electrically activated wire loop, to remove the part of the prostate that is blocking urine flow. 

Using general or spinal anesthesia in the hospital, doctors perform this procedure to relieve severe symptoms of benign prostatic hyperplasia. It typically requires one to three days in the hospital. 

Greenlight Laser Photovaporization 

In greenlight laser photovaporization, high-powered laser energy is used to vaporize the part of the prostate that is blocking urine flow. Performed with general or spinal anesthesia, this surgery typically causes fewer side effects than transurethral resection, such as bleeding, and allows for a quicker recovery. 

This surgery can be performed either as an outpatient procedure or with an overnight hospital stay, during which a urinary catheter may be used.  

Holmium Laser Enucleation of the Prostate

In a high-tech procedure known as holmium laser enucleation of the prostate, your NYU Langone surgeon uses a laser to remove the prostate tissue that is blocking urine flow, without damaging the surrounding tissue. Performed under general anesthesia in the hospital, this procedure involves removing, or enucleating, prostate tissue that is blocking urine flow by cutting, or morcellating, it into small, easily removable pieces using a laser.  

Men who undergo this procedure can expect to recuperate at home and return to work in less than a week. Temporary side effects—including blood and burning with urination, an increase in the frequency and urgency of urination, and mild urine leakage—can last for up to four weeks. 

During recovery, you can perform most of your usual activities, except for sexual or strenuous activities.  

Surgery for Urinary Dysfunction

If you have stress incontinence, your doctor may recommend a procedure that helps improve control of the bladder or urethra.  

Male Sling Surgery

In a minimally invasive male sling procedure, a sling made from synthetic material keeps pressure on the urethra, so that it doesn’t open unless you want to release urine. It’s effective in men with stress incontinence. 

During the procedure, your NYU Langone surgeon makes a small incision underneath the scrotum and surgically implants a strip made of a synthetic material under the urethra. Performed using general anesthesia, the procedure takes about an hour to complete. 

Most people go home the same day, although some need to stay in the hospital overnight. You may feel pain or numbness in the perineum—the area between the anus and the scrotum—or in the upper thighs for up to two weeks afterward.

Artificial Urinary Sphincter

An artificial sphincter, a mechanical device that’s surgically implanted in the body, can help control urinary function in men with stress incontinence. Performed using general anesthesia, this procedure involves implanting a silicone rubber device with an inflatable cuff that fits around the end of the urethra where it joins the bladder. 

A balloon is surgically placed in front of the bladder and a control pump is inserted through an incision in the scrotum. When inflated, the cuff keeps urine from leaking. To urinate, you deflate the cuff by squeezing the control pump in the scrotum, allowing urine to drain from the bladder through the urethra and out of the body. 

This procedure typically requires a one-night stay in the hospital and up to two weeks of recuperation at home. The cuff is typically activated four to six weeks after surgery.

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