Say Goodbye to Frequent Nighttime Urination: New Advances in Minimally Invasive Treatments for Benign Prostatic Hyperplasia (BPH)
Update Date：2025/08/05，
Views：239
By Dr. Pei-Chang Chiang, Department of Urology
Frequent nighttime urination, weak urinary stream, and intermittent flow—these bothersome “male” issues are often warning signs of Benign Prostatic Hyperplasia (BPH). The prostate, an organ that surrounds the male urethra, tends to enlarge with age. As it grows, it can compress the urethra, leading to urinary symptoms.
In the early stages, medication may effectively relieve symptoms. However, if medication fails or complications arise—such as recurrent infections, bladder stones, or acute urinary retention—surgery becomes a more definitive treatment option.
Thanks to advances in medical technology, prostate surgery is no longer a one-size-fits-all solution. Instead, a wide array of personalized, minimally invasive procedures is now available—ranging from time-tested techniques to innovative approaches. In this article, we’ll introduce three emerging minimally invasive procedures:
• Thulium Laser Enucleation of the Prostate (TULEP)
• Rezum Water Vapor Therapy
• UroLift Prostatic Urethral Lift
We’ll explore their principles, unique advantages, and who they are best suited for, to help you and your doctor find the most appropriate treatment plan.
1. A Thorough Solution: Thulium Laser Enucleation of the Prostate (TULEP)
TULEP utilizes advanced laser technology to precisely and completely remove overgrown prostate tissue. Among today’s surgical options for BPH, it is considered a superior "diamond standard."
Imagine peeling an orange: the laser dissects along the natural boundary between the overgrown tissue (the pulp) and the outer capsule (the peel), removing the enlarged section in one piece before fragmenting and extracting it. This ensures a thorough clearance of obstructive tissue.
Key Benefits:
• Most complete tissue removal
• Excellent long-term symptom relief
• Lowest recurrence rate
• Especially effective for patients with significantly enlarged prostates
Compared to traditional transurethral resection (TURP), TULEP offers less bleeding, faster recovery, and lower complication rates. Though retrograde ejaculation may occur postoperatively, the overall improvement in urinary function and quality of life makes TULEP a highly effective and widely recommended option for many patients.
2. Gentle Thermal Therapy: Rezum Water Vapor Ablation
Rezum represents a function-preserving approach to BPH treatment. A small probe is inserted through the urethra to release controlled bursts of heated water vapor into the enlarged tissue. The heat causes the targeted cells to die naturally, and over time the body reabsorbs the treated tissue, reducing prostate volume.
Key Features:
• Minimally invasive; often performed as an outpatient procedure
• Preserves sexual function with minimal risk of retrograde ejaculation
• Best suited for small to moderately enlarged prostates
However, the initial healing period may involve temporary tissue swelling and worsened urinary symptoms, requiring the use of a catheter for several days to one or two weeks. Patients should be prepared for this brief but necessary recovery phase.
3. An Innovative Physical Approach: UroLift Prostatic Urethral Lift
UroLift is the only procedure that neither cuts, heats, nor removes prostate tissue. Instead, it uses a purely mechanical method: small permanent implants are placed via a scope to retract the enlarged prostate lobes, like tying back curtains, thereby opening up the urethra immediately.
Advantages:
• Immediate symptom relief
• No impact on erectile or ejaculatory function
• Fast recovery, often without the need for a catheter
However, UroLift has strict selection criteria. It’s not suitable for patients with large prostates or significant median lobe enlargement. Because it doesn’t remove tissue, there’s also a higher chance of needing retreatment in the long term.
Conclusion: Partner with Your Urologist to Regain Comfort and Confidence
BPH surgery has entered a new era of personalized care. There is no single “best” procedure—only the one that’s best for you. The ideal choice depends on factors like prostate size, overall health, expectations regarding quality of life (especially sexual function), and your preferences for recovery time.
Be proactive: don’t hesitate to voice your concerns. Discuss the pros and cons of each option with your urologist. Together, you can develop a treatment plan that helps you regain a smooth, confident life.