Among those looking for Gangnam prostate surgery, many have been taking medication for a long time but still have a weak urine stream, or have experienced sudden urinary obstruction requiring a catheter. In this case, surgery is not simply a treatment to reduce the enlarged prostate, but a treatment that removes the tissue blocking the urethra to protect the bladder and kidneys and improve urination function.
First, there is a point to distinguish. The prostate surgery mentioned in this article is a surgery to treat obstruction caused by benign prostatic hyperplasia. It is completely different in purpose, scope, and recovery process from radical prostatectomy, which removes the entire prostate to treat prostate cancer.
Surgery should not be delayed just because you are taking medication
If symptoms are controlled with medication and there are no complications, the course can be monitored regularly. However, recurrent or unresolved urinary retention, recurrent urinary tract infections, bladder stones, recurrent hematuria originating from the prostate, upper urinary tract dilation, or decreased kidney function are signals that prompt active consideration of surgery.
Even if there are no such complications, surgery can be considered if the medication’s effect is insufficient or if it is difficult to take due to side effects, and if residual urine and urinary discomfort significantly reduce daily life. It is necessary to check together whether bladder function is deteriorating while continuing to add medications.
On the contrary, surgery is not performed solely based on imaging findings showing an enlarged prostate. If symptoms are mild and there are no issues with urine flow, residual urine, or kidney function, the size alone is not targeted for treatment.
Before surgery, the prostate and bladder are evaluated together
Before surgery, symptom scores, urine tests, uroflowmetry, post-void residual urine, prostate ultrasound, and kidney function are checked. PSA is evaluated according to age and risk level, and cystoscopy can be considered if hematuria or urethral stricture is suspected. Urodynamic studies may be selectively necessary when reduced bladder contractility is suspected or when symptoms and test results do not match.
Even if the prostate tissue is well removed, if the strength of the bladder muscle has already significantly declined, the urine stream and residual urine may not improve as much as expected. Therefore, it is necessary to check not only ‘how many cc the prostate is’ but also ‘whether the main cause of urinary discomfort is actually obstruction’.
The surgical plan takes into account anticoagulants and antiplatelet drugs, cardiovascular and respiratory diseases, diabetes, and any previous urethral or pelvic surgeries. Medications that thin the blood should not be stopped arbitrarily, and the prescribing medical staff and the surgical team must coordinate the plan.
TURP gradually removes the enlarged tissue
Transurethral resection of the prostate (TURP) is a surgery in which a resectoscope is inserted through the urethra without a skin incision to gradually remove the enlarged tissue that is pressing on the urethra. It has long been used as a standard for comparing surgeries for benign prostatic hyperplasia, and currently, bipolar devices using normal saline are also widely used.
The 2026 EAU guidelines recommend monopolar or bipolar TURP as the standard surgical option for patients with a prostate volume of 30–80 mL who have moderate to severe lower urinary tract symptoms. However, actual application may vary depending on prostate shape, bleeding risk, and the surgeon’s experience.
HoLEP removes tissue by separating it with a laser
Holmium laser enucleation of the prostate (HoLEP) is a surgery in which the enlarged tissue is separated from the prostatic capsule using a holmium laser, then fragmented inside the bladder and removed from the body. It can be applied relatively without limitation on prostate size, so it is considered even for large prostates.
The EAU recommends HoLEP as an alternative to TURP or open simple prostatectomy. Compared to TURP, mid- to long-term improvement in urination is similar, and advantages in terms of bleeding, catheterization, and hospital stay have been reported; however, surgical outcomes depend not only on the equipment but also on the surgeon’s skill.
For a small prostate, transurethral resection of the prostate can be performed, and in some cases, laser vaporization or other enucleation procedures can also be options. You should not judge based on the notion that ‘laser is always better’ or ‘old surgery is bad,’ but rather check the reason why a particular method is recommended for the size and structure of your own prostate.
The difference between procedures and surgery is not just anesthesia
Rezūm is a minimally invasive treatment that can be considered first when it is important to reduce recovery burden and impact on ejaculatory function without leaving a permanent implant. If the effects of medication are insufficient and further treatment is needed, but there are no clear surgical indications such as recurrent urinary retention, stones, or decreased kidney function, and the prostate structure is suitable, Rezūm can be compared before moving directly to tissue removal surgery.
Rezūm is also meaningful for patients who find general anesthesia or hospitalization burdensome, as it allows for local anesthesia and same-day discharge. However, because the treated tissue is gradually absorbed, immediate improvement is difficult to expect, and compared to TURP or HoLEP, which remove tissue more extensively, there may be differences in the degree of symptom improvement, long-term durability, and the possibility of retreatment.
In situations where obstruction must be sufficiently resolved, such as with repeated urinary retention or stones, cases with a very large prostate, or when quickly and clearly securing a passage is important, surgery may be more reasonable than undergoing a small procedure first. Conversely, if there are no complications, preserving ejaculation function is the top priority, and the anatomical conditions are suitable, minimally invasive treatments can be considered.
Knowing and Preparing for Hematuria and Changes in Ejaculation During Recovery
After surgery, a catheter may be maintained for a certain period. After removal, frequent urination, urgency, pain during urination, and light hematuria may appear temporarily, and the bladder needs time to adapt to the new passage. Fluid intake, exercise, driving, bathing, and resumption of sexual activity should follow the discharge instructions.
If there is a lot of blood or large clots, no urine comes out at all, or there is high fever, chills, or worsening pain, you should contact the surgical institution immediately. Before discharge, make sure to check the contact method for nights and holidays as well.
In sexual function counseling, questions about erection and ejaculation should be asked separately. The impact on erectile function after surgery for benign prostatic hyperplasia depends on the patient’s existing health and the surgical method, but after TURP and HoLEP, retrograde ejaculation may occur, where semen goes into the bladder instead of coming out. If there are plans for pregnancy or preserving ejaculation function is important, this must be communicated before deciding on the surgical method.
When choosing a prostate surgery in Gangnam, you should check the entire process from diagnosis to post-surgery follow-up rather than the hospital’s location or the equipment’s name. The starting point of the decision is to have the cause of your symptoms, whether it is obstruction, why this surgery is suitable, the expected improvements and side effects, and the possibility of retreatment explained based on the test results.
Referenced Medical Information
- European Association of Urology (EAU) 2026 Male Lower Urinary Tract Symptoms Treatment Guidelines
- European Association of Urology (EAU) Diagnostic Evaluation Guidelines
This article provides general health information about benign prostatic hyperplasia surgery and does not replace diagnosis or treatment. Surgery for prostate cancer requires separate evaluation and consultation.
