TUIP Surgery in Singapore | Enlarged Prostate Treatment

If you’re experiencing urinary difficulties due to an enlarged prostate, you’re not alone. Many men in Singapore face challenges with urination as they age, affecting their quality of life and daily activities. TUIP (Transurethral Incision of the Prostate) surgery offers an effective solution for men with smaller prostates who need relief from bothersome urinary symptoms. This minimally invasive procedure provides significant symptom improvement while preserving important functions, making it a valuable treatment option for suitable candidates. Our urologist in Singapore provides expert evaluation and care to ensure optimal outcomes tailored to each patient’s needs.

TUIP, or Transurethral Incision of the Prostate surgery in Singapore, is a minimally invasive surgical procedure designed to treat urinary symptoms caused by benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate. Unlike procedures that remove prostate tissue, TUIP involves making one or two small incisions in the prostate gland and bladder neck. These strategic incisions relieve the pressure on the urethra, allowing urine to flow more freely.

The procedure is performed through the urethra using an endoscope, eliminating the need for external incisions. TUIP is particularly effective for men with smaller prostates (typically less than 30 grams) who experience significant urinary obstruction. The technique works by releasing the tension in the prostatic urethra and bladder neck, creating a wider channel for urine passage.

Studies show that TUIP provides symptom relief comparable to more invasive procedures while offering advantages such as shorter operative time, reduced blood loss, and lower risk of certain complications. The procedure has been successfully used for decades and remains an important option in the surgical management of BPH.

Ideal Candidates

• Men with prostates smaller than 30 grams experiencing moderate to severe urinary symptoms
• Patients who have not responded adequately to medication therapy
• Those experiencing urinary retention requiring catheterisation
• Men with recurrent urinary tract infections due to incomplete bladder emptying
• Patients seeking to preserve sexual function, particularly retrograde ejaculation
• Younger men who wish to maintain fertility
• Those with bladder neck obstruction or high bladder neck
• Patients preferring a less invasive surgical option with quicker recovery

Contraindications

• Prostates larger than 30 grams (other procedures may be more appropriate)
• Presence of prostate cancer requiring treatment
• Active urinary tract infection (must be treated first)
• Severe bleeding disorders or anticoagulation that cannot be safely stopped
• Urethral strictures preventing instrument passage
• Neurogenic bladder dysfunction
• Severe medical conditions making anaesthesia unsafe

A thorough evaluation by an MOH-accredited urologist is essential to determine if TUIP surgery is the appropriate treatment option. Your urologist will perform a comprehensive assessment including prostate size measurement, urine flow studies, and other diagnostic tests to ensure you’re a suitable candidate for this procedure.

Standard TUIP Technique

The standard TUIP technique involves making one or two precise incisions through the bladder neck and prostate. Using a resectoscope equipped with an electrocautery knife, the surgeon creates incisions at the 5 o’clock and 7 o’clock positions. These incisions extend from just inside the bladder neck through the prostatic urethra to the verumontanum. The depth reaches the surgical capsule, effectively releasing the constricting tissue.

Modified TUIP Approach

Some surgeons employ a modified approach with a single deep incision at the 6 o’clock position. This variation can be equally effective while potentially reducing operative time. The choice between single and double incision techniques depends on the patient’s anatomy and the surgeon’s assessment during the procedure.

Technology & Equipment Used

TUIP surgery utilises a resectoscope, a specialised endoscopic instrument inserted through the urethra. Modern resectoscopes feature high-definition cameras providing good visualisation of the surgical field. The procedure employs electrocautery or laser energy to create precise incisions. Continuous irrigation maintains clear visibility throughout the operation. Modern bipolar technology may be used to reduce the risk of TUR syndrome, a rare but serious complication.

Pre-Treatment Preparation

Before your TUIP surgery, you’ll undergo several preparatory steps. Blood tests, urine analysis, and possibly a urine culture will be performed to ensure no infection is present. You may need to stop certain medications, particularly blood thinners, several days before surgery. Your urologist will provide specific instructions based on your medical history.

Fasting is required from midnight before the procedure. Arrange for someone to drive you home after surgery as you won’t be able to drive immediately following anaesthesia. Pack an overnight bag in case admission is required, though many patients go home the same day.

During the Procedure

TUIP surgery typically takes 20-30 minutes to complete. You’ll receive either spinal anaesthesia or general anaesthesia based on your preference and medical suitability. Once anaesthesia takes effect, the surgeon inserts the resectoscope through your urethra. Using the camera for guidance, they locate the bladder neck and prostate.

The surgeon then creates the planned incisions using the electrocautery knife. Throughout the procedure, sterile fluid continuously irrigates the surgical area. You won’t feel any pain during the surgery. The surgeon carefully monitors the depth and extent of incisions to ensure good results while avoiding complications.

Immediate Post-Treatment

After surgery, you’ll be monitored in the recovery area as the anaesthesia wears off. A urinary catheter will be in place to drain urine and irrigate the bladder, preventing blood clots. Most patients experience mild discomfort rather than significant pain. The catheter typically remains for 24-48 hours, though some patients may have it removed sooner.

You’ll receive instructions on catheter care and prescribed medications including antibiotics and pain relief if needed. Some blood in the urine is normal initially. Most patients can go home the same day or after an overnight stay.

First 24-48 Hours

During the initial recovery period, rest is important. Drink plenty of water to help flush the bladder and prevent clot formation. You may experience some burning during urination and urgency after catheter removal. These symptoms are normal and gradually improve. Avoid strenuous activities and heavy lifting.

Take prescribed antibiotics as directed to prevent infection. Mild pain medication can help manage any discomfort. Some patients experience temporary difficulty controlling urination, which typically resolves within days. Continue drinking 2-3 litres of fluid daily unless otherwise instructed.

First Week

Gradually increase your activity level while avoiding strenuous exercise. Most patients can return to desk work within 3-5 days. Continue drinking plenty of fluids to maintain good urine flow. You may notice improved urinary stream almost immediately, though full benefits develop over several weeks.

Your first follow-up appointment typically occurs within a week. The urologist will assess your progress and address any concerns. Avoid driving for at least 48 hours after surgery and until you’re comfortable and not taking strong pain medication. Sexual activity should be avoided for 2-3 weeks.

Long-term Recovery

Complete healing takes 6-8 weeks. Most men experience significant improvement in urinary symptoms within the first month. You can gradually return to all normal activities including exercise and sports after 4 weeks. Regular follow-up appointments help monitor your progress and prostate health.

Long-term success rates are good, with most patients maintaining symptom improvement for many years. Unlike some other prostate procedures, TUIP has a low retreatment rate. Annual prostate checks remain important to monitor for any changes.

TUIP surgery offers numerous evidence-based benefits for suitable patients. The procedure effectively relieves urinary symptoms including weak stream, hesitancy, intermittency, and incomplete emptying. Most patients experience significant improvement in their International Prostate Symptom Score (IPSS) following surgery.

A major advantage of TUIP is the preservation of antegrade ejaculation in most patients, making it particularly suitable for younger men concerned about fertility. The risk of retrograde ejaculation is significantly lower compared to TURP (Transurethral Resection of the Prostate). The procedure also maintains erectile function in the vast majority of cases.

TUIP involves minimal blood loss and shorter operative time compared to tissue-removing procedures. This translates to quicker recovery and earlier return to normal activities. The procedure can be repeated if necessary and doesn’t preclude other treatment options in the future. Many patients appreciate avoiding long-term medication with its associated side effects and costs.

Common Side Effects

Temporary blood in urine (haematuria) occurs in most patients but typically resolves within days. Mild burning or discomfort during urination is common initially. Some patients experience temporary urgency or frequency as the bladder adjusts. These symptoms usually improve within 1-2 weeks.

Urinary tract infections occur in approximately 5% of patients despite antibiotic prophylaxis. Temporary difficulty with urinary control affects some men but generally resolves quickly. Minor bleeding may persist for several days but rarely requires intervention.

Rare Complications

Serious complications are uncommon with TUIP surgery. Urethral stricture (scarring) develops in less than 2% of cases. Bladder neck contracture is similarly rare. TUR syndrome, caused by absorption of irrigation fluid, is rare with modern techniques and equipment.

Persistent bleeding requiring blood transfusion affects less than 1% of patients. Injury to the external sphincter causing permanent incontinence is rare with experienced surgeons. Re-operation rates are low, with studies showing 90% of patients maintaining symptom relief at 5 years.

Our experienced urologists use meticulous surgical technique and modern equipment to minimise all risks. Careful patient selection and adherence to post-operative instructions further reduce complication rates.

The cost of TUIP surgery in Singapore varies based on several factors. These include the complexity of your case, choice of hospital facility, anaesthesia type, and whether overnight admission is required. The surgeon’s fee, operating theatre charges, and anaesthesia fees comprise the main components.

Most surgical packages include pre-operative assessments, the procedure itself, standard medications, and initial follow-up visits. Additional costs may apply for extended hospital stays, treatment of complications, or additional diagnostic tests. The use of modern technology such as laser systems may affect pricing.

While considering cost, remember that TUIP offers long-term symptom relief, potentially eliminating the ongoing expense of medications. The procedure’s durability and low retreatment rate provide good value. Our clinic provides transparent cost estimates during consultation, helping you make an informed decision.