Surgical treatment for an enlarged prostate involves the removal of the enlarged part of the prostate that restricts the urethra. The most common surgery to achieve this end is transurethral resection of the prostate (TURP). The surgeon inserts an instrument called a resectoscope into the penis through the urethra. The resectoscope is about 12 inches long and 3/8 of an inch in diameter. It contains a light, valves for controlling irrigating fluid, and an electrical loop to remove the obstructing tissue and seal blood vessels. The surgeon removes the obstructing tissue and the irrigating fluids carry the tissue to the bladder. This debris is removed by irrigation and any remaining debris is eliminated in the urine over time. The entire operation is completed within 90 minutes. Patients will remain in hospital for 2-3 days following surgery. During this period a catheter is used to drain urine.

Holmium laser enucleation of the prostate (HoLEP) is another surgical procedure to remove part of an enlarged prostate. In this procedure, a holmium laser is used to remove obstructive prostatic tissue and seal blood vessels. HoLEP is usually performed as a day procedure in the hospital.

A fourth procedure is a prostatectomy. In this case an incision is made in either the lower abdomen or the perineum (the area between the rectum and the scrotum). The prostate is then removed. After surgery a urinary catheter is inserted to ensure bladder emptying.