Method of treatment of prostatic adenoma

A surgical technique for treating bladder outflow obstruction is disclosed in which access is gained to the treatment site via the bladder itself through one or more suprapubic conduits. The disclosed technique includes inserting at least a first conduit suprapubically into the bladder, inserting at least a surgical instrument along the first conduit, distending the bladder with an isotonic fluid, viewing the position of the instrument using remote visualisation means, direct visualisation means, or a combination of the two, and using the surgical instrument to create at least one hole in the prostate gland, thereby to debulk the adenoma. Preferably the procedure is performed using electrosurgery, which offers significant advantages in terms of minimally invasive surgery and patient recovery times in comparison to more conventional forms of surgery.