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At age 80, my dad is getting ready to have a prostate procedure that is supposed to make it easier for him to urinate. He keeps calling it a "ream job". That expression (in that context) gives me the creeps. What is the medical term? Thanks, Jo Anne.


The procedure is technically called a "Transurethral Resection of the Prostate" or "TURP".  It involves carving out the channel inside the prostate.  The entire prostate is not removed; just the blocking tissue from the inside out.  No incisions are needed.  There is some bleeding immediately afterwards and this is controlled with a temporary catheter.  It is considered a "Minimally Invasive" type of procedure and is generally well tolerated. Like any surgery, there are potential problems and complications such as scarring, excessive bleeding, leakage and infection, but the vast majority of patients who fail medical therapy of their prostate trouble do quite well with this surgery.  It is quite dependent on the skill and experience of the surgeon, so it's reasonable to ask the urologist how many he has done and how large a prostate he can comfortably do with this technique.  As a general guide, most urologists can typically handle a prostate up to 50-75 grams in size.  More skilled surgeons can usually go up to maybe 100 grams, but only the most skilled can comfortably manage a prostate larger than 100 grams.  With the advent of newer technologies such as medical management and lasers, newer surgeons often do not receive the extensive training and experience some of us "old-timers" did.  If the estimated size of the prostate is more than 75 grams in size and the urologist is not comfortable with that large a prostate, he may offer some alternatives.  At that point, consider the alternatives as well as a second opinion.

In my opinion, nothing currently available is superior to the TURP procedure when done by a properly skilled and experienced surgeon.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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