Prostate surgery

Prostate surgery - a group of interventions carried out at an adenoma, cancer or prostate abscess. The purpose of the operations may be the removal of pathologic outbreak and preventing its further progression, prevention of complications of the genitourinary system, or diagnosis clarification and definition of optimum tactics follow-up treatment.

Prostate surgery is performed using endoscopic equipment or through traditional open access. Type Access (vesical, crotch, retropubic, transrectal etc.) Selected according to the type, location and extent of the pathological process.

Typically, prostate surgery is performed routinely under general anesthesia.

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Typically, prostate surgery is performed routinely under general anesthesia.

Adenoma of the prostate is one of the most common diseases in men. Symptoms of prostate hyperplasia reveals one in seven patients aged over 50 years. Posthumously (during autopsy) adenoma is diagnosed in one in three men over 60 years.

A significant proportion of the pathological processes of the body make up the advanced forms of prostatitis, prostatic abscess, and prostate cancer. The risk of developing these diseases increases with aging.

With the increase in life expectancy prostate surgery is becoming increasingly popular direction Modern andrology, which allows to ensure the preservation of man's health and patients to improve the quality of life of elderly and senile age.

On the relationship between the state of the prostate and urinary function guess in the days of Hippocrates, but up until surgery prostate were not carried out, care in this organ pathology was reduced to elimination of urinary retention by catheterization.

First prostatectomy independently of each other in 1834 and completed Guthrie Amussat. Subsequent years were a period of rapid development operations on the prostate. a number of approaches have been developed, perfected technology interventions.

Basic principles and tactics of surgical treatment of prostate disease has not since undergone fundamental changes. In this classic technique prostate surgery have been improved.

In addition, new minimally invasive techniques, will reduce the number of complications and reduce the duration of the postoperative period.

types of operations

There are four main types of interventions on the prostate:

Prostate surgery involving the removal of the diseased part of the organ using the public access. This group includes all types of prostatectomy (vesical prostatectomy, retropubic prostatectomy, etc.). Indications for surgery on the prostate gland is benign prostatic hyperplasia. A variation of interference is selected considering the size and location of an adenoma. Scheduled prostatectomy operate under general anesthesia.
Prostate surgery involving the removal of a modified part of the organ using endoscopic equipment. This group includes trasuretralnaya resection of the prostate and laser vaporisation of the prostate. Both prostate surgery is performed through resectoscope introduced into the urethra channel, the difference is in the type of tool used for removal of abnormal tissues. When administered TOUR resectoscope through the loop, while vaporisation - laser. Sometimes both prostate surgery combined in a single surgical procedure. Indications are adenoma small and medium size. Intervention planning performed under general anesthesia.
Prostate surgery, involving removal of the entire organ. In this group include radical prostatectomy. Intervention can take place of the two open accesses (and perineal retropubic). In recent years, some medical centers this operation on the prostate gland began to perform with endoscopic equipment endoscopic technique but it can not be considered until embedded in the broader clinical practice. The indications for intervention are the local forms of prostate cancer. Radical prostatectomy is carried out in a planned manner under general anesthesia.
Minimally invasive medical diagnostic prostate surgery. This group is represented by a puncture prostate abscess. Performed on an emergency basis through the perineum under local anesthesia TRUS using special needles. The purpose of this prostate surgery is the removal of pus and susceptibility of pathogenic organisms. Subsequently operate opening and drainage of an abscess, antibiotic therapy is performed.

testimony

Surgery on the prostate are indicated for prostate cancer, a local prostate cancer, advanced forms of prostatitis and prostate abscesses.

The decision about prostate surgery should be individualized based on the severity and prevalence process of clinical symptoms and its effect on the state of the pathology of the genitourinary system.

The list of factors indicating the need for intervention, include a large amount of residual urine, bladder stones, re acute urinary retention, hematuria, renal insufficiency caused by pathology of the prostate, and suspected purulent process in tissues Prostate.

Contraindications

Enumeration contraindications to operations on the prostate gland from the prostate depend on the underlying disease.

Thus, prostatectomy, transurethral resection and laser vaporization is not carried out in malignant neoplasias body, and radical prostatectomy usually operates at common forms of malignancy neoplasms.

General contraindications for prostate surgery are recent myocardial infarction, acute respiratory diseases, blood coagulation disorders, asthma somatic disorders, severe diabetes and certain inflammatory processes.

postoperatively

After surgery on the prostate treatment is carried out in a hospital. Hospitalization duration determined by the severity pathologies view intervention and the patient's general condition.

In most cases (with the exception of endoscopic surgery on the prostate gland), the minimum period of stay is 9-10 days. Patients are advised to comply with bed rest and drink plenty of fluids, prescribe antibiotics and pain relievers.

In the early days of urine through the urinary catheter installed during surgery on the prostate gland. In some cases, using a system of continuous bladder irrigation.

The catheter is usually removed in 2-4 days (after endoscopic operations) or 7-10 days (after open surgery). Sutures are also removed after 7-10 days. After removal of the catheter in the urine for a while may be present blood impurities.

Within 6-8 weeks after prostate surgery the patient is advised to give up active exercise. Sex life can be resumed after 4-6 weeks.

A list of dates and restrictions may vary depending on the type of intervention.

complications

The early complication of operations on the prostate gland are bleeding, damage to neighboring organs, wound infection and transient incontinence. In some cases, seen the development of acute infections of the urogenital system (prostatitis, pyelonephritis, cystitis, urethritis, etc.).

In the late period after surgery on the prostate gland sometimes arise complications such as urethral stricture, education "predpuzyrya" retrograde ejaculation, impotence and permanent incontinence urine. Possible relapse.

The likelihood of recurrence and the development of complications depends on the type of the pathological process, the type of operation and other factors.

The cost of prostate surgery in Moscow

Surgical intervention in prostate are sufficiently broad band techniques, differing objectives, scope and level of complexity. Performed in specialized andrology and urology centers and large general hospitals.

Prices of prostate surgery are formed taking into account access in Moscow, scope and technical complexity of the intervention, the qualification of Operating andrologist, the need for endoscopic equipment, the type of anesthesia, the number and nature of diagnostic procedures in the preoperative period, length of hospital stay, amount of therapeutic measures before and after operations.

A source: http://www.krasotaimedicina.ru/treatment/prostate/

Operation of prostatitis in men: the main types and possible complications

Surgical intervention for prostate physician may be asked if treatment of a patient via traditional medication, physiotherapy and alternative therapies has not been reached result.

Operation of prostatitis in men - is usually a last resort for chronic bacterial or nonbacterial prostatitis is associated with complications such as:

Urinary retention (inability to urinate).
Failure to respond to conservative or minimally invasive therapies.
The constant presence of blood in urine.
The stones in the prostate, kidney or bladder, arising from the violation of urination prostatitis.
Frequent urinary tract infections.
prostate abscess.
Paraproctitis.

Contraindications for prostate surgery in men:

acute inflammation of the urogenital system;
age over 70 years;
diabetes;
acute respiratory viral infection;
running and difficult runs cardiovascular disease and bronchopulmonary systems;
hemophilia;
administration of drugs, blood thinners;
hypothyroidism.

See also:Luteinizing hormone (LH) in males, their importance and the normal level

Surgical procedures include:

Transurethral resection of the prostate (TURP). This operation removes the inner part of the prostate. This is the most commonly used prostate surgery in men, it is also considered the best endoscopic surgical treatment of benign prostatic hyperplasia, although there are other surgical alternatives.
- Before the operation, appointed by the standard of research: analysis of blood (the general, coagulation and biochemical) and urine. TURP is usually done under spinal anesthesia (anesthetic is injected into the space surrounding the spinal cord), but the anesthesiologist may use general anesthesia, depending on the patient's condition.
- On the day of surgery can not eat and drink, to avoid problems with anesthesia.
- After surgery, there will be no external scars, because all manipulations are performed inside the urethra.
- When TURP reduces the duration of post-operative period in comparison with the open prostatectomy, and there are fewer complications.
- Disadvantages include painful urination and a frequent urge to him in the first days after TURP.
open prostatectomy. This operation prostatitis in men is often done when the prostate is greatly increased when complications arise, or when the bladder has been damaged. The surgeon makes an incision in the lower abdomen (retropubic operation) or between the scrotum and anus (perineal operation) and removes part of the prostate or in its entirety.
- Before the operation, you need to do ultrasound, cystoscopy and magnetic resonance scan and pass several tests: urine, blood test for prostate specific antigen, it the PSA. There will also be scheduled for a consultation the anesthesiologist.
- On the day of surgery you can not eat and drink.
- Advantages of open prostatectomy: an effective treatment for prostatitis and its attendant problems.
- Disadvantages: a long stay in hospital (up to 7 days) and post-operative recovery (from a month or more). The risk of high blood loss. Because of damage to nerve fibers may have difficulty achieving an erection until constant erectile dysfunction.
Laser surgery (vaporization, laser cauterization). Using laser energy destroyed diseased prostatic tissue, and decreases its volume. In this case, the blood vessels, "sealed" and do not bleed.
- Before the operation, you need blood tests (general and biochemical), urine, do an ultrasound of the urinary tract and may have a prostate biopsy (on the advice of a urologist-oncologist). On the day of surgery you can not eat and drink.
- Advantages: It endourological operation of prostatitis in men, ie the tool is carried out through the urethra without incisions. Because of this there is no bleeding, and do not require a long hospital stay. The postoperative period is an average of three days. Laser treatments provide relief of symptoms associated with diuresis, and improve patients' quality of life. However, long-term studies are needed to determine whether the laser treatment as effective as TURP.
- Disadvantages: Laser surgery may not be effective with a large prostate volume.
Drainage of an abscess (closed abscess) Prostate. The surgeon exposes abscess through the rectum or perineum (the most common), by dissection of skin and subcutaneous tissue and the introduction into the cavity filled with pus rubber drainage.
- Before the operation is carried TRUS are assigned blood and urine, the consultation with proctologist (suspected development fistula).
- Advantages: short rehabilitation period, there is no risk of loss of sexual function.
- Disadvantages: may not be the complete removal of an abscess, bacterial toxins can spread throughout the body.
Transurethral incision of the prostate. This operation does not involve removal of the prostate tissues. Several small incisions using a resectoscope made in the prostate to reduce prostate pressure on the urethra. Thereby urination easier. A variety transurethral prostatic surgery is electrovaporization at which prostate tissue via electrode roller is heated and evaporated. In this case, there is an immediate blood clotting, which reduces blood loss to a minimum.
- Before the operation, you need blood tests (general and biochemical), urine, do an ultrasound of the urinary tract. On the day of surgery you can not eat and drink.
- Advantages: significantly reduced the risk of retrograde ejaculation, compared with TURP, while achieving the same relief of symptoms of prostatitis. It does not require a long recovery period and hospital stay (usually - 2-3 days).
- Disadvantages: requires continued treatment of prostatitis.

Its useful to note

There is no better treatment for prostate, suitable for all patients. I need to talk with your doctor about the risks and benefits of each procedure and together choose the best option transactions.

Common risks for prostate surgery in men include: a reaction to the anesthesia, bleeding, infection, and stricture (fusion of the lumen) of the urethra.

Bleeding - the most common risk of open prostatectomy.

The prostate is surrounded by a rich network of blood vessels and the patient usually becomes from 0.4 to 0.8 liters of blood during surgery.

In some cases, blood loss may be much greater, which will require a blood transfusion.

Signs of infection include: fever, chills, edema, drainage from incision.

note

Immediately after prostate surgery may experience involuntary leakage of urine, but they must be stopped with the passage of time. However, for some women, especially those older than 70 years, may develop urinary incontinence.

Removal of lymph nodes can lead to fluid accumulation (lymphedema) in the genital region or legs. This can cause pain and swelling, but lymphedema can be treated.

Once the catheter has been removed from the bladder, the patient should be able to help yourself. If this fails, or fails to empty the bowel, you should immediately inform your doctor.

Urethral stricture - formation of a single or multiple scar scarring due to lesions of the urethra and the penile spongy body.

Since the scar is a mechanical obstacle to the urine, may be various problems with urination.

With a view to the prevention of postoperative adhesions urethral lumen patients are encouraged to drink plenty of fluids to urinate more often.

Operation of prostatitis in men can not always cure bacterial infection or chronic prostatitis, this procedure may even worsen the symptoms.

It is possible that the surgeon will not be able to remove part of the prostate that causes symptoms. If we remove the entire prostate, it can lead to incontinence and (or) erectile dysfunction, which significantly affect the quality of life.

A source: http://prostatitoff.net/operacii/

Types of operations with prostate adenoma - a type of surgery to choose?

Kind of benign prostatic hyperplasia determines the choice of surgery in the treatment of diseases, along with the presence of complications and age associated diseases patient.

Types of prostate adenoma

Normal and inflamed prostate

Benign prostate hyperplasia begins to grow out of a kind of reference point - proliferative center. In the future it will provide clinical development speed and determine the method of surgery.

Depending on the location of the tumor proliferative Center are the following types of BPH:

middle lobe hyperplasia;
hyperplasia lateral lobes;
mixed.

BPH is divided by size:

small (20-25 g / cm³ 35-45);
medium (25-80 g / cm³ 45-60);
large (80-250 g / cm³ 60-150);
giant (250-300 g / 150 cc).

Prostate size was determined by ultrasonography.

Types of BPH according to the shape (as determined by ultrasound and MRI):

spherical (bladder outlet) Form: adenoma grows into the cavity of the bladder. This species occurs in 40% of cases;
pear (intratrigonalnaya): Growth in the direction of the rectum - (35%);
grozdevidnaya (retrotrigonalnaya) ravonomernoe proliferation nodes in all prostate lobes (20%);
subtrigonalnaya hyperplasia all share no pressure on the bladder (5%).

Clinical types of prostate adenoma:

Compensated (1 st). It lasts for many years due to the reserve capacity of the organism to resist the process. It is characterized by urination disorders in the form of the increased frequency, it is impossible to hold back the urge, night toilet visits, urinary incontinence, and the weakening of the jet pressure. Bright clinic is characteristic only for the bladder outlet and retrotrigonalnogo tissue overgrowth.

1st stage of prostatic adenoma most suitable for thermal minimally invasive interventions.

Subcompensated (2 tablespoons). Symptoms of urinary disorders worse. The bladder loses the ability to push the urine begins to expand, and after emptying it remains in the urine. May develop acute urinary retention. Gradually there is a retrograde throw urine in the upper urinary tract with the development of the expansion of the ureters and renal pelvis, kidney failure begins.

The most effective methods of surgical treatment of BPH in the second stage are TUR and laser technology.

Asthma (item 3). urinary tract tissues lose their functional capacity to contract. bladder size is very large. Expressed the phenomenon of chronic renal failure. To urinate, the patient has to be installed catheter.

In step 3 BPH carried abdominal or laparoscopic surgery, while contra thereto - palliative TUR. When well-equipped clinic is considered to be an effective method of Endovascular occlusion of arteries adenoma.

Manifestation of BPH - schedule

The figure shows that the "deceit" prostatic adenoma is to maximize the manifestation of disease symptoms in The moment when present complications of the upper urinary tract, and the operation is necessary for health.

Varieties of operations for prostate adenoma

The main goal of surgical treatment for BPH is to remove the patient from the intravesical obstruction.

Absolute indications for removal of prostate adenoma:

Chronic infectious processes in the urinary tract.
Acute urinary retention after catheterization.
Persistent hematuria.
The formation of stones in the bladder.
Bilateral expansion of pelvis and ureter.
Renal insufficiency.
The amount of residual urine over 200 ml.
Diverticulosis.

See also:The clinical picture and treatment of HPV in men

Relative indications for removal of prostate adenoma:

Lack of effect of drug therapy.
The growth of the middle lobe.
The patient's age less than 45 years.

Contraindications:

chronic pulmonary heart;
infectious diseases in the acute stage;
aortic aneurysm;
cerebral atherosclerosis.

Minimally invasive techniques:

transrectal microwave hyperthermia.

8-10 sessions conducted through 48 hours. Temperature effect above 45 degrees adenoma leads to increased microcirculation, activate the immunity, suppress inflammation and cell growth. Eliminates irritative symptoms;

Transurethral microwave thermotherapy.

The treatment results in the formation of necrosis zones in the prostate while preserving the integrity of the urethra.

The methods used and applied in an outpatient 1 step BPH. The effectiveness of the treatment of 80%, the duration of effect up to a year.

Complications: hematuria, bladder spasm, going without treatment.

Prostatic stents are widely used for the expansion of the urethral lumen.

transurethral resection

TOUR - popular and is considered the standard method of surgical treatment of BPH.

The intervention is performed using epidural or general anesthesia. Through the urethra using the resectoscope removed hyperplastic tissue. On resectoscope loop electric current is supplied, thus excised tissue and coagulating the blood vessels.

Work carried out in a medium of irrigation liquid supplied under pressure to the urethra. Incrementally remove the prostate part of the urethra, cervix of the bladder and prostate tissue.

At the slightest trespass excision of damaged ureters, the bladder is punctured and the urethra.

After surgery, the urethra is set hemostatic balloon catheter for a period of 1-3 days, followed by a separate set of urination.

Types of BPH, in which applied TOUR: mean size, retrotrigonalnaya, Step 2, the mixed BPH.

Modern bipolar plasma TOUR allows to stop urination disorders in almost 90% of the operated patients.

TOUR easily tolerated by the patient, requires a short period of hospitalization (2-3 days), but it is traumatic and unpredictable aspect in the method of postoperative complications.

Indications for removal of prostate adenoma:

tumor volume less than 60 cc - mostly, but some surgeons are able to remove large tumors with the help of modern equipment;
diseases of the cardiovascular system decompensated;
a history of prostate operations, urinary bladder, intestines;
weak efficiency of minimally invasive procedures and long-term drug therapy;
chronic prostatitis.

Contraindications:

vesicoureteral reflux, ureteropieloektaziya;
diverticula;
urinary tract tumors;
varicose veins of the pelvis.

Some features of transurethral resection:

time of the procedure using a monopolar electrode should not exceed 60 minutes;
We need a lot of experience and skill of the surgeon;
when the "hiding" the true volume of tissue excision;
resectoscope tube often has a diameter greater than the urethra, forcing its buzhirovat preoperatively. Damage to the mucous membrane of the urethra difficult amenable to recovery;
devastated bed turns to predpuzyr formation process which lasts from half a year to eighteen months. In predpuzyre created ideal conditions for stone formation and inflammation.

Complications in the early postoperative period:

Water intoxication or TUR syndrome is now very rarely (1% of cases). It is the result of the use of large quantities of irrigation fluid that is absorbed into the bloodstream and causes electrolyte disturbances.
Bleeding - the most common complication TOUR (up 80%).
Inflammation of the seminal vesicles, bladder, testicular, prostate tissue residues: occurs in 16% of cases.

Consequences of transurethral resection:

retrograde ejaculation (from 70 to 90% of patients);
stricture (narrowing) of the bladder neck and urethra (15%);
incontinence (10%)

Abdominal surgery and laparoscopy

Cavitary removal of the prostate adenoma

Open prostatectomy is performed in three ways:

Transvesical prostatectomy with access through the bladder hyperplasia middle lobe. Tumor recovered by extracting its finger through the urethra into the bladder.
Retropubic - Pumping at the side of the prostate lobes. This preserves the integrity of the bladder and urethra.
Transvesical ekstrauretralnaya operation that maintains the integrity of the urethra - modern way of recessed access.

The operation is performed under general anesthesia. In modern urology increasingly used as a method of emergency surgery. After the operation in the urethra a balloon catheter haemostatic (5-8 days of standing time), with favorable postoperative period the duration of stay in hospital - one to two weeks.

Types of BPH, in which use open access: intratrigonalnaya, bladder outlet, a large and medium size 3 clinical stage.

Indications for removal of prostate adenoma:

any tumor size;
pathologies of the locomotor apparatus (inability patient location on gynecological chair);
periodic hematuria;
inability to urinate on their own;
Recurrence of infections;
renal failure;
lack of effect of TUR and prolonged drug treatment;
the appearance of stones in the bladder;
diverticulosis.

Early complications of open prostatectomy postoperative occur in approximately 6% of patients:

bleeding. repeated emergency surgery may be needed to stop the bleeding in some cases;
pulmonary embolism. In order to prevent pulmonary embolism taking anticoagulants and practiced early ambulation bed;
nonhealing wound postoperative inflammation due to infection of joining: pyelonephritis, urethritis, cystitis, epididymitis, orchitis. After surgery always prescribe antibiotics;

The consequences of abdominal surgery:

urinary incontinence;
stricture of the urethra and bladder;
chronic fistula (if conducted drainage of the bladder through the surgical wound).

Open prostatectomy poorly tolerated by patients, but this method is less traumatic to the urethra, compared with tour, so in the future, the risks are minimal urinary disorders.

Laparoscopy is applied at step 2-3 diseases in prostate size from 100 cc. Laparoscopy is performed only in BPH planned.

After a few small incisions in the abdominal wall is held installation trocars, are introduced through endoscopic visual equipment, and carry out removal of the tumor.

Access is behind the pubis and extraperitoneal thus not touching the abdominal cavity. Prolonged standing of the catheter and the length of stay is 2-4 days.

Forms of BPH for laparoscopy: intra- and retrotrigonalnaya, medium and large sizes, mixed, sub- and decompensation stage.

Indications:

the large size of the tumor;
hematuria;
inability to urinate on their own;
recurrent infection in the urinary tract;
diverticulosis;
renal failure;
ineffectiveness of minimally invasive techniques and drug therapy.

Laparoscopy in BPH occurs with minimum risk of bleeding and lack of urination disorders in the future.

The average cost of the most popular in our operations and foreign clinics

A country	analyzes	ultrasound	Consultation urologist specialist	ROUND (hospitalization)	Laser surgery (hospitalization
Israel	250$	210$	650$	10600$	10000$
Germany	200€	370€	400€	8000€	12000€
Russia	5000 rubles.	2000 rubles.	1000 rubles.	50,000 rubles.	60000 rubles.
Belarus	200 rubles.	100 rubles.	50 rubles.	300 rubles.	—
Ukraine	3000 UAH.	2800 UAH.	1500 UAH.	11000 UAH.	16000 UAH.

The elderly and old age, in the presence of diseases of the cardiovascular system decompensated, abdominal and laparoscopic approach is not possible, in this case, a palliative TOUR to make life easier patient.

Endovascular occlusion of the prostatic arteries by

This modern method is used for large size of the tumor and the patient's inability to move TOUR, abdominal surgery and general anesthesia.

The effect occurs within 2 months: significantly reduced the volumes of the prostate, and is reduced urination.

In patients with very large tumors, artery occlusion can be used as a method of preparing a radical removal of adenomas. Embolization does not apply with thrombophlebitis and coagulopathies.

Hospitalization is short: 2-3 days.

Holmium laser technology (HOLEP)

Enucleation, vaporization, resection of the prostate adenoma. Online access is carried out through the urethra. Operation is efficient and low-traumatic, allows to remove the large amount of tissue (more than 100 cm³). Used Spinal type of anesthesia. Hospitalization up to 3 days.

Complications (found in 8% of patients):

damage the bladder mucosa;
perforation of the bladder wall;
bleeding;
infectious and inflammatory processes;
spasm of the urethra and bladder neck.

Modern laser technology urologists recognize the new standard for the surgical treatment of BPH.

The postoperative period: treatment

When the prescribed treatment is carried bleeding with medication, by tensioning and fixing of the urinary catheter, or proceed to the emergency open surgery.
Infectious complications are being treated a course of antibiotics.
For the treatment of urinary incontinence and stricture conduct operations:

Optical urethrotomy;
laser treatment (incision and ablation);
recanalization urethra;
Installation of urethral stents.

After the tour and open prostatectomy examination by a doctor is held once in three months, after minimally invasive procedures - a month later, three and six months, and then annually.

The duration of the operation depends on the size of the tumor and varies from 1 hour to one and a half. During the operation of the remote tissue is sent for histological examination.

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In clinics and abroad applies robotics (robot da Vinci).

A source: https://prourologia.ru/opuholi-mochepolovoj-sistemy/opuholi-pochek/adenoma-prostaty/vybor-operatsii.html

removal of the prostate

Most of urological abnormalities accounted for prostate disease in men. Increasingly, they are fixed not only in the mature, but in the age of the young.

Vague clinical picture and the later appearance of acute symptoms leads to the fact that care is not provided in time.

In the early stages it is effective medication, but in severe cases can not do without surgery. We will understand when they do surgery on the prostate and some modern methods exist.

Indications and contraindications for surgery

Diseases of the prostate gland in men occur mainly after the age of 45. During this period, hormonal changes, there is wear and tear of the body, accumulate negative environmental factors.

One of the first to suffer from urogenital system, there is a chronic prostatitis or BPH.

Last diagnosis is a benign formation in the breast tissue, which in most cases requires surgery.

A benign tumor (adenoma) or prostatic hyperplasia (BPH) is a common urological disorder

Direct indications for its implementation are the following pathological manifestations:

frequent desires in a toilet with an incomplete emptying of the bladder;
pain in the pubes and perineum;
violations of the outflow of urine, its sharp delay;
large size tumors in the gland;
chronic urinary incontinence;
the presence of stones in the prostate gland;
renal insufficiency on the background of decompensated adenoma;
occurrence of bleeding from the urethra;
recurrent urinary tract infections.

The operation in this case is the recovery of functions of the genitourinary system, and prevention of complications of other pelvic organs. Afraid and refuse surgery should not be. If the doctor has chosen this method of treatment, then once it is able to effectively relieve man of trouble.

Do not forget that under certain conditions of removal of the prostate is contraindicated. This fact must be considered when choosing the appropriate therapy.

In chronic inflammation, the urologist can send a man to the operation

By the absolute prohibition applies:

acute intestinal diseases;
heart failure;
problems with blood clotting;
inflammation in the body;
cystitis and pyelonephritis at acute stage;
severe renal impairment;
cerebral atherosclerosis.

Preparing to remove the prostate gland

The operation's success depends largely on the preparatory phase. First of all, to conduct a full examination of the patient. This may include blood, urine, rectal prostate study and rectum, pelvic ultrasound, urodynamic diagnosis. If you suspect a malignant adenoma prostate biopsy tissue.

Treatment takes place in a hospital. Duration of stay in the clinic depends on the surgical method may be from several days to 3 weeks. Constant medical supervision is very important for a speedy recovery and to prevent complications.

One day before the surgery to remove the prostate gland requires a enema and shave below your navel

Special preparations are required. Immediately before the operation necessary to carry out a number of recommendations:

for 8-10 hours before the scheduled time can not eat and drink water;
the day of the should not take drugs, especially anticoagulants;
pre-test for tolerance to anesthesia, to select a suitable type of anesthesia (general or spinal);
conduct hygiene perineum (cleaning the hair removal).

Surgical treatment options for prostate

Operation in prostate adenoma assigned every third clinical case. This is the only radical method of curing the disease if a significant growth of the prostate, and conservative treatment (medication, catheterization) does not help.

TOUR - one of the most popular ways to solve the problems of the prostate, which accepts most men

Modern urology has a number of ways, some of which are minimally invasive and nearly painless:

Transurethral resection (TUR).

It relates to innovative technologies in medicine, so each year the number of operations increases in comparison with traditional surgery. The method consists in the removal of adenomas using high-frequency electrical pulses.

Is introduced through the urethra special resector that scrape the affected tissue and cauterize the wound formed. Almost bloodless procedure does not require cutting band, it takes about an hour.

Effective when the tumor size is not more than 80 cm3, and using the latest bipolar technology - to 120 cm3. Positive dynamics coming fast enough.

Transurethral incision.

The operation is performed by dissection of the urethra which runs through the prostate. Pinch weakened urination improving. When this tissue is not excised gland that prevents severe blood loss and trauma. It carried out in mild cases, with little benign prostatic hyperplasia.

Technique is the same as in the Tour. But the incision does not mean resection

Prostatectomy (prostektomiya).

Prostate removed opencast suggestive abdominal incisions.

Depending on the tumor distinguish suprapubic (vesical), a crotch, retropubic, extracystic prostatectomy. Outdated but a proven and effective method for large size tumors or complicated cases of the disease.

It involves general anesthesia and a long rehabilitation period. Pretty radical method with the risk of complications.

The endoscopic method of treatment that does not require surgical intervention. It involves the introduction of laser into the urethra and evaporation of the affected prostate tissue powerful beam. The procedure is safe due to the possibility of coagulation, ie, prevent blood.

Is performed under epidural (spinal) anesthesia, the patient remains conscious. Effectiveness is not inferior to the previous embodiments, the superior quality recovery period (2-3 days on average). A good option for patients with clotting problems, diabetes, cardiovascular disease.

This type of operation is assigned, provided that the diameter of the tumor does not exceed 1.5 cm.

Laser Prostatectomy is performed using a laser with a different wavelength

Minimally invasive method used to remove a small-sized tumors, in the absence of complications.

On the abdomen of the patient makes a small hole through which is inserted the ultrasonic knife. He excised diseased glandular tissue without damaging healthy area.

The entire process is displayed on the screen, allowing manipulation tidy and absolutely accurate.

In each case, the choice is made on the basis of the physician survey results.

Features of the rehabilitation period

Result of treatment depends not only on the successful progress of the operation, but also from the recovery period. Regardless of whether it was a laser or prostektomiya if it is properly and competent rehabilitation. General recommendations apply to all patients who underwent surgical treatment of BPH.

Spend on drink a course of antibiotics (they are prescribed by a doctor)

The following rules must be strictly implement:

regularly go through all cleaning procedures (washing bladder, dressings, catheterization);
taking antibiotics (antibiotics) if there is a risk of inflammation;
first time, bed rest, while in hospital (duration depending on the type of surgery);
gradually return to motor activity from small hiking (to resolve the doctor);
the first day did not eat, so that was not a chair, and then to follow a diet - eat more fiber, protein and fluid, is not greasy, salty, spicy;
eliminate the strong physical exertion for at least 1,5-2 months;
to give up smoking and alcohol;
abstain from sexual activity until the full restoration of the functioning of the prostate;
perform special exercises at home;
undergo regular inspection at the urologist.

Actively improve immunity (with the help of vitamins, natural foods, herbal medicine)

The duration of the rehabilitation period depends on the complexity of the operation, and may range from several days to 2 months. All this time, you need to follow all the doctor's instructions to avoid serious complications.

Possible consequences of the removal of the prostate gland

The most common effects include:

bleeding during major surgery;
mechanical tissue damage due to breach of the art procedures;
retrograde ejaculation (reverse ejaculation in mochevik);
decreased libido, libido, orgasm, impotence;
progressive growth of prostate hyperplasia;
infectious process in the prostate and the urinary tract;
urinary incontinence;

abnormal narrowing of the urethra;
stagnation in the pelvic, lung organs;
TUR syndrome (ingress of washing liquid into the bloodstream during transurethral resection);
thrombosis, and thrombosis of the veins and arteries.

These complications, unfortunately, occur in urological practice. Most of them can be avoided by performing a doctor's recommendation. In some cases, can not do without reoperation.

The risk of adverse effects is reduced in proportion to the stage of disease.

No need to expose their health test, it is better to consult a doctor at the first problems with the prostate gland - then surgery may be avoided.

A source: https://mensup.ru/zdorove/prostatit/kogda-delayut-operaciyu-na-prostate

Prostate surgery