Prostate Surgery & Procedures (TURP, Rezūm, iTIND, Optilume, UroLift)

As many men age, the prostate (a small gland below the bladder) grows and squeezes the urethra—the tube urine passes through. This 'traffic jam' can cause a weak stream, urgency, frequent trips (especially at night), and the feeling you didn’t fully empty. It's a condition called benign prostatic hyperplasia (BPH). It's generally non-life threatening, but annoying and occasionally painful.

Before invasive procedures, many try medication (alpha‑blockers relax the channel; 5‑alpha‑reductase inhibitors shrink the prostate) and lifestyle changes (less evening fluids, caffeine moderation, timed voiding). These can reduce symptoms for many people and are often the first step.

There are several procedures for dealing with BPH

TURP (Transurethral Resection of the Prostate)

TURP is a hospital procedure where a surgeon passes a thin camera through the urethra and trims away extra prostate tissue from the inside to widen the channel. No outside cuts are needed. Using an electric loop, the surgeon shaves tissue to open flow and improve emptying. It’s considered the classic “gold standard” because it directly removes the blockage. The amount removed is tailored to the prostate’s size and shape, aiming for a clear path from bladder to urethra and stronger, more reliable urination.

Rezūm (water‑vapour therapy)

Rezūm uses controlled bursts of steam (heated water vapour) delivered through a small device inserted via the urethra. The vapour spreads into the enlarged prostate tissue, and the heat causes those cells to shrink over time. By reducing extra tissue volume, the urethral channel opens and urine can flow more easily. The treatment targets specific areas, including obstructing lobes, with brief injections of vapour. Because it doesn’t cut tissue, it focuses on making the prostate smaller from the inside to relieve pressure on the urinary pathway.

iTIND (temporary implanted nitinol device)

iTIND is a small, spring‑like metal device placed through the urethra into the prostate area for a few days. Its shape gently presses on the inside of the prostate and bladder neck, reshaping the channel to reduce blockage. After it’s been in place long enough to create these internal grooves, the device is removed through the urethra. The idea is mechanical remodeling from the inside to improve urine flow without permanently removing tissue, using the device’s expanding structure to “carve” a more open pathway.

Optilume (drug‑coated balloon dilation)

Optilume uses a catheter with a balloon, inserted through the urethra to the tight prostatic area. When the balloon is inflated, it stretches the narrowed zone to create a wider channel. The balloon’s surface is coated with medication that helps limit tissue overgrowth where the stretch happened. After a short time, the balloon is deflated and removed. The combination of mechanical widening and localized drug delivery aims to keep the pathway more open so urine can pass more freely from the bladder.

UroLift (prostatic urethral lift)

UroLift places tiny permanent implants via a scope through the urethra. These implants act like curtain tie‑backs, pulling the enlarged prostate lobes away from the urethral channel to create an open corridor. No prostate tissue is cut out; instead, the tissue is held back to remove the squeeze on the urethra. The number of implants depends on the anatomy. By physically widening the passage, UroLift helps improve stream strength and emptying with a minimally invasive, internal “lift.”

Consult your physician or surgeon to see which option is right for you.

Shorter wait times

• Consults and procedure dates are often scheduled in weeks—not months—so bothersome symptoms (weak stream, urgency, nighttime trips) are relieved sooner and you can get back to work, sleep, and daily life.

Choice and control

• Pick a surgeon/centre experienced with your preferred option (e.g., UroLift, Rezūm, HoLEP, TURP, Optilume, iTIND).
• Book dates that fit your calendar and travel needs; some centres offer virtual consults and rapid testing.

Certainty

• Private clinics usually provide a clear quote and confirmed date, helping you plan time off, rides, and support at home. Knowing the exact procedure and who will perform it can lower anxiety.

Tailored options and technology access

• Some newer/minimally invasive treatments may be available privately even if not widely offered locally in the public system, or not yet funded.

Overall quality-of-life impact

• Less time spent sleep-deprived, anxious about accidents, or tied to bathrooms; earlier relief can protect bladder function when medical therapy isn’t enough.

Public insurance coverage

• Generally covered:
  • TURP and HoLEP are widely available in the public system and are publicly insured when medically indicated (availability varies by province and wait times). This means you will likely need to travel out-of-province in order to get TURP done privately.
• Sometimes covered/variable access:
  • Laser vapourization (PVP/GreenLight) and other tissue-removing procedures may be available publicly depending on local resources.
• Often not publicly funded (check your province):
  • Some minimally invasive options like UroLift, Rezūm, Optilume, and iTIND are not consistently covered by provincial insurance plans and may require private payment or supplemental insurance. Access and policies change—confirm locally.
• Medications:
  • BPH medications are typically covered based on your provincial formulary and any private drug plan.

1. ‍Confirm your diagnosis. Most patients start with a family doctor or specialist who confirms BPH, and that surgery/treatment is advisable, but your surgeon can also confirm if needed.
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2. Research. Explore urologists who specialize in BPH procedures.
   • You can find surgeons in Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec on our app, and review qualifications, as well as pricing.
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3. Schedule an initial consultation. Most urologists offer in-clinic and online consults.
   
   • Consultations are usually booked within days or a few weeks.
   • Note: expect a consultation fee between $150 - $350.
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4. Consultation. The surgeon will review your condition, symptoms, and any previous treatments or diagnostics, such as x-rays or MRIs.
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5. ‍Post consultation. The surgeon will then review your case and provide surgical options based on your needs; review the risks and expected outcomes; and present pricing and scheduling options.
   
   • Because the procedure is not covered by your provincial health plan when done privately, you’ll need to review the quoted cost and consider payment options (out-of-pocket, private insurance, or financing).
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6. Schedule your surgery date. Once you confirm the procedure and payment, the clinic will schedule your surgery—generally within a few weeks.
   
   • For publicly covered procedures (i.e. TURP), plan for travel and accommodation, since the surgery will likely take place outside your home province.
   • Expect pre-surgery preparation, and possibly some pre-surgery tests.

Your surgery/procedure may look different. Confirm with your urologist.

TURP (Transurethral Resection of the Prostate)

Surgery takes 60–120 minutes.

Basic steps

• Check‑in and plan: Meet the team, review the plan.
• Anesthesia: Usually general or spinal (numb from the waist down).
• Scope in: A thin camera goes through the urethra to the prostate.
• Remove tissue: An electric loop shaves excess prostate tissue to open the channel.
• Rinse and check: Bladder is flushed; surgeon confirms a clear pathway.
• Catheter: A catheter is placed to drain urine while things settle.
• Wake‑up: Recover, get instructions, and plan catheter removal timing.

Rezūm (Water‑vapour therapy)

Procedure time ~10–20 minutes.

Basic steps

• Check‑in and plan.
• Anesthesia: Local numbing + light sedation (varies).
• Scope in: Small device goes into the urethra to the prostate.
• Steam injections: Short bursts of water vapour are delivered into targeted prostate spots.
• Done: Device out; brief observation.
• Wake‑up: Go home with instructions; swelling goes down over time as tissue shrinks.

iTIND (Temporary Implantable Nitinol Device)

Placement takes ~5–15 minutes; removal ~5–10 minutes a few days later.

Basic steps

• Check‑in and plan.
• Anesthesia: Local + light sedation (varies).
• Placement: A small, spring‑like device is placed via the urethra into the prostate/bladder neck area.
• Remodeling time: It stays in for several days, gently reshaping the channel.
• Removal: You return; the device is collapsed and removed through the urethra.
• Done: You go home the same day after each visit.

Optilume (Drug‑coated balloon dilation for BPH)

Procedures takes about 15–30 minutes.

Basic steps

• Check‑in and plan.
• Anesthesia: Local + light sedation (varies).
• Position and prep: Scope/catheter guided into the prostatic urethra.
• Balloon inflate: The balloon is positioned at the tight spot and inflated to stretch it open.
• Drug delivery: A medication on the balloon surface coats the area to limit re‑narrowing.
• Deflate and remove: Balloon out; quick check done.
• Wake‑up: Observation, then home with instructions.

UroLift (Prostatic urethral lift)

Takes about 15–45 minutes.

Basic steps

• Check‑in and plan.
• Anesthesia: Local + light sedation (sometimes general).
• Scope in: A special device goes through the urethra.
• Place implants: Tiny implants are deployed to pull the prostate lobes away from the channel, like curtain tie‑backs.
• Confirm opening: Surgeon checks the new corridor for good flow.
• Done: Device out; brief recovery and home the same day.

Everyone heals differently—follow your surgeon’s plan. Taking instructions seriously usually means smoother results. Many clinics offer virtual check-ins.

In general, what to expect

TURP (Transurethral Resection of the Prostate)

Week 1

• Burning when peeing, pink/red urine, urgency, frequent trips, bladder spasms; you’ll likely have a catheter for part of this period.
• Goals: stay hydrated, walk, manage bladder spasms, avoid straining.

Weeks 2–4

• Still annoying but improving: urine clears, fewer spasms, stronger stream.
• Activities: light duties, no heavy lifting; keep fluids up.

Weeks 5–8

• Flow continues to improve; frequency/urgency settle.
• Activities: gradually resume normal routines when cleared.

Rezūm (water‑vapour therapy)

Week 1

• Swelling in the prostate can make peeing harder at first; burning, urgency/frequency, possible catheter briefly.
• Goals: hydrate, take meds as directed, avoid bladder irritants (caffeine, alcohol).

Weeks 2–4

• Still annoying but improving: symptoms start easing as tissue shrinks.
• Activities: light activity; bathroom trips become less urgent.

Weeks 5–12

• Steady improvements in flow and control as shrinkage continues.

iTIND (temporary implant)

Week 1

• Device in for a few days; frequent urges, burning, pelvic pressure.
• Goals: hydrate, take medicines as directed; return for removal on schedule.

Weeks 2–4

• Improving: after removal, stream and control typically feel better.
• Activities: return to routine light activities as comfortable.

Optilume (drug‑coated balloon)

Week 1

• Reality check: burning with urination, urgency/frequency; mild blood in urine.
• Goals: hydrate well to flush; follow meds and activity guidance.

Weeks 2–4

• Improving: flow gets better as swelling settles; trips to the bathroom decrease.

Weeks 5–8

• Work phase: continue gradual return to normal routines.

UroLift (prostatic urethral lift)

Week 1

• Reality check: frequent urination, burning, pelvic pressure; tiny blood in urine.
• Goals: drink fluids, avoid heavy lifting/straining; take meds as prescribed.

Weeks 2–4

• Improving: stream strength rises, urgency/frequency settle.

Weeks 5–8

• Work phase: stable routine; most normal activities are fine when cleared.

Red flags—call your care team or seek urgent care

• Can’t pee or worsening retention
• Heavy bleeding with clots, fever/chills, severe pain not controlled by meds
• Dizziness/fainting, severe lower belly swelling, or signs of infection

Your team will tailor specifics to your prostate size/anatomy and the exact procedure—follow their instructions first.

Exact fees vary by province, clinic, device pricing, and complexity—always request a written, itemized quote.

In Canada, private clinics generally charge:

• TURP: $3,500–$7,000+
• Rezūm: $4,000–$9,000+
• UroLift: $4,000–$9,000+ (depends on number of implants)
• iTIND: $4,000–$9,000+
• Optilume BPH: $4,000–$9,500+ (device- and facility-dependent)

What’s usually included

• Surgeon/procedure fee
• Facility and nursing fees
• Standard anesthesia/sedation and monitoring (local + sedation for minimally invasive; spinal/general for TURP)
• Routine disposables/devices (e.g., a baseline number of UroLift implants or a single Optilume/iTIND device—confirm the exact allowance)
• Immediate post‑procedure recovery and a standard follow‑up visit
• Basic urinalysis or simple labs if part of the centre’s pathway

What’s sometimes extra (ask in advance)

• Additional UroLift implants beyond the base bundle
• Extra OR time beyond the standard block
• Anesthesiologist-administered deep sedation/propofol (if not bundled)
• Catheters or supplies sent home, bladder spasm meds, or antibiotics not on the standard list
• Pathology (if tissue is sent—more common with TURP)
• Unplanned imaging, ER transfer, or hospital admission
• Travel, accommodation, letters/forms, or extended follow-ups beyond the bundle

Choosing your urologist is a major benefit of going private—use it to your advantage.

What to look for

Experience and volume

• Ask how many BPH procedures they perform per year and their case mix:
  • Tissue-removing: TURP, HoLEP/laser vaporization
  • Minimally invasive: Rezūm, UroLift, iTIND, Optilume
• Request numbers specific to prostates like yours (size in cc, median lobe, prior retention/catheters).

Credentials and training

• Verify licensure with your provincial college (CPSO Ontario, CPSBC BC, CPSA Alberta, CMQ Québec, CPSM Manitoba, etc.).
• Look for FRCSC/FRCPC-certified urologists with endourology/BPH-focused training and active hospital privileges.

Outcomes and safety

• Ask for recent (last 12–24 months) data by procedure:
  • Symptom improvement (IPSS), flow rate (Qmax), and post‑void residual changes
  • Catheter‑free rate after retention
  • Unplanned return to OR, ER visits/readmissions, transfusion (for TURP), UTI rates
  • Re‑intervention rate at 1–2 years (especially for Rezūm, UroLift, iTIND, Optilume)
• Pain-control and catheter-management protocols; typical time to desk vs physical work.

Indications and alternatives

• Confirm why each option fits your anatomy and goals (size, shape, ejaculatory/sexual priorities, travel/time off).
• Ensure medications and non‑procedural options were considered (alpha‑blockers, 5‑ARI, PDE5 inhibitors, bladder training).

Procedure plan and techniques

• TURP: monopolar vs bipolar; strategy for median lobe; catheter and irrigation plan.
• Rezūm: number/location of vapor injections; plan for median lobe; catheter duration.
• UroLift: expected number of implants; suitability with/without median lobe.
• iTIND: dwell time, management while device is in, removal plan.
• Optilume: balloon size/positioning; how drug dosing is determined.
• How unexpected findings (strictures, stones) are handled and billed.

Imaging and planning

• Pre‑op assessment: prostate size (ultrasound/MRI), residual urine, uroflow, cystoscopy if needed.
• How these results change the plan or move you toward a different procedure.

Facility accreditation

• Confirm clinic accreditation (Accreditation Canada, CAAASF) and hospital transfer protocols.
• Anesthesia coverage (local + sedation vs spinal/general) and on‑site recovery standards.

Questions to ask during your BPH consult

Experience and outcomes

• How many TURP/Rezūm/UroLift/iTIND/Optilume cases do you perform yearly? What are your results for prostates like mine?
• Recent complication and re‑intervention rates? Catheter‑free rate after retention?

Personalized fit

• Which procedure do you recommend for my prostate size/anatomy and why? How does it align with my goals (ejaculatory function, speed of relief, downtime)?

Peri‑operative plan

• What anesthesia will be used? Will I need a catheter, and for how long?
• What is the timeline to desk work, driving, exercise, and full activity?

Logistics and costs

• What exactly is included in the quote (anesthesia type, device count for UroLift/Optilume/iTIND, follow‑ups)?
• How are add‑ons billed (extra implants, longer OR time, unexpected findings)?
• Do you provide an operative note and plan to my primary care provider?