The tumor of the prostate benign nature than the diagnosis of adenoma. This masculine pathology is one of the first places among urological diseases. The normal volume of prostate is related to the chestnut. This increases proliferation of fibro-muscular. One reason for this is the likelihood that the adenoma in the older age of the patient. In connection with the enlarged prostate reduces the lumen of the ureter. This leads to problems with urination. If the cells are malignant, then we talk about the prostate cancer.
Indications for surgery in BPH
The feasibility of partial or total removal of the prostate adenoma is determined by each patients case individually. The indications for surgery are:
- The efficiency of drug therapy. Benign prostatic hyperplasia (BPH), i.e. the increase in the volume of the prostate, may develop, regardless of whether it is still appropriate treatment. If within six months the effects of the drug are not revealed, it is assigned to the excision of the adenoma, the surgical intervention.
- The sudden growth of the prostate tissue. This means that the tumor is developing very quickly, so to stop the process only with the complete removal of hyperplasia.
- Pain. To eliminate the pain in the initial stages of the disease the use of preparations and analgesics, and injections of novocaine. If pathology is running, the unpleasant symptom continues after the medication.
- The age of the patient. Surgical intervention is indicated only in the age of 65-70 years. In all cases, the patient's condition is considered separately.
Ways to remove the prostate
If indications assigned to the removal of the prostate adenoma methods of surgical intervention. Today, there are several ways to this procedure. It can be open or minimally invasive. In the first case, manipulations are performed through an incision in the abdominal Department. Due to the large number of contraindications, and the effects of deleting this operation is rarely performed, but is considered to be a classic treatment of the transurethral resection. Special cases required open prostatectomy is surgery to remove the prostate.
Previously, the only way for the surgical treatment of cancer of the prostate was open Adenomectomy. The general anaesthesia. The doctor removes the tumor, thus:
- the area of operation is treated with an antiseptic solution, removing the hair;
- the surgeon makes an incision in the skin, subcutaneous tissue;
- the following your incision in the anterior wall, the bladder, the doctor carefully inspects the body, the stones presence;
- then the surgeon removes the tumor itself due to the fact that the index finger enters the urethra and makes a small tear in the mucous membrane;
- keep the bladder to insert the catheter to allow rinsing of the wound with saline.
Open surgery, the guarantee, the irrevocable removal of the tumor, but the rehabilitation of the patient after a very long time, up to 3 months. In addition, there is a risk of complications, such as pus and bleeding. Another serious problem that the postponement of the general anesthesia. Also, judging by the reviews, after the surgery left scars.
Transurethral resection (TUR)
The so-called elimination of tumors without incisions. Through the urethra removed tumor cells. In this case, you can still use a local anesthesia. The technique is complex, therefore, requires the high qualification of the surgeon. The procedure is as follows:
- through the urethra resectoscope introduction;
- a special loop tool scraping ingrown epithelium to its removal;
- and then there's the watering, the bladder, the other examination of the operated area;
- the next, introduced a special catheter with a balloon, which is filled with liquid;
- a few days in the absence of postoperative complications, the catheter is removed.
After this surgery, the prostate is renovated in 2 months. After the first day of may, spasms when urinating, but sooner or later I'm gone. The operation lasts less than an hour, the advantage. Benefits can be considered, but the lack of scars after tumor removal. In addition, the procedure is practically pain-free.
Removal of the prostate using minimally invasive techniques
The traditional methods of treatment of adenoma of a large number of possible negative consequences. To reduce the risk of complications, minimally invasive techniques to help. This is mainly the laser resection. In modern surgery, these advanced techniques:
- embolization arteries prostate;
- laser ablation;
- laser enucleation of the adenoma;
- interstitial laser treatment;
- needle ablation;
- endoscopic resection.
Embolization arteries prostate
The essence of this method lies in the fact that the blockage of the blood vessels that supply blood to the prostate is increased. The procedure under local anesthesia. The surgeon controls the actions of using a special apparatus. The task of the doctor to find the end of the blood circulation in the prostate. They introduced a micro-catheter and, through the substrate intravascular embolus. The advantage of this method is that the patient is being discharged after 6 hours after the procedure.
All treatment methods the laser ablation of the adenoma characterized by fewer complications. Furthermore, it allowed patients with bleeding disorders. Equipment is inserted through the ureter. The laser beam cut areas of benign prostate, blood vessels "unit". This operation, when the tumor is in the 60 to 80 CC Benefits in the short postoperative period with minimal complications, but laser removal lasts two times longer than the TOUR.
Enucleation of the adenoma
Removal of the prostate so that a "husking" of the prostate tissue by exposure to laser. After the surgery to check the presence of the malignant cells. Benefits include:
- the option to remove the tumor, even when the growth of the gland 200 g;
- short dormancy period;
- the surgery is possible in patients with a pacemaker, metal tools, bones, or bleeding disorders.
After endoscopic enucleation of the tumor tissue through the bladder, crushed with a laser removal, via catheter drainage. The presence of inflammatory processes, or the inability to introduce the catheter into the ureter a contraindication to the operation. The same applies to the severe general condition of the patient.
Interstitial laser therapy
The point is, this is the procedure to remove the tumor during the flat, the mucous membrane of the bladder or of the prostate a focused laser beam. Such introductions a few. The radiation gland treatment on all sides, which is necrosis. The disadvantage of this method is that for a time the symptoms can worsen. The reason for this is that the wound is deep, the prostate.
Atrophy of the glandular tissue of this operation by heating high-frequency radio waves. Fall into the prostate via needles that enter the gland. The disadvantage of the procedure, the efficiency of the large-sized tumors. The advantage of this method is that it's an outpatient procedure i.e. the patient immediately after removal, to go home.
Laparoscopic removal of the prostate
This technique is indicated when the prostate volume of greater than 100 CC is carried out through special tubes, which penetrate through small incisions in the skin. The camera showing the progress of the procedure on the monitor. Removal of the prostate lasts around 2 hours with general anesthesia. At the end of the urethra to insert a catheter. The benefit of a small rehabilitation period. In the hospital the patients are discharged in 2-4 days. The disadvantages can be noted the small scars of the incision.
This technique also does not require the abdominal opening. This significantly reduces the blood loss. Iron is cut with the surgical instruments which are inserted through a tube the thickness of 1-1,5 cm the advantage of the procedure is that it does not affect the erectile function as it relates to the preservation techniques. In the absence of stones, inflammation and small adenomas, this operation is still preferable. Advantage of the short dormancy period.
The effects of the surgery removal of prostate adenoma
Rehabilitation after removal of adenoma of the prostate can be so smooth. Health problems appear more often as the treatment, of prostate. A few days there is blood in the urine, incontinence, or pain when urinating. Last side effects long. If late, ask a specialist. Every patient reacts differently to the surgery, so depending on the type of operation may have different effects or relapse. In this case, you will need a second surgery.
Remove all of the prostate is potentially dangerous. All patients at risk of blood loss and infection. Anesthesia is a serious burden on the cardiovascular system. After the surgery, there are complications of this nature:
- the lack of sperm during intercourse;
- the inflammation of the pelvic organs;
- erectile dysfunction;
Potency after surgery
Recovery of erectile function occurs after a certain time after the surgery, but to live a sexual life is not recommended before the full tissue regeneration. The average duration of such a period, approximately a month. This period can be increased, depending on the state and age of the patient. The full restoration of potency in a man, the consummation of the sexual act ceases to be allocated to sperm. Because partial damage to the semen. The reproductive function is preserved, but the extraction of the sperm is necessary for stab.
Rehabilitation after surgery of the prostate
After the surgery, it is important to follow the recommendations of the urologist for faster recovery. Concerning the nutrition, physical activity and maintaining the patient's sexual life. These recommendations are important to prevent possible complications after the surgery. In the early rehabilitation period for the first 5-7 days. At this time the patient can return to normal urine. In general, the healing period can be 3 months or more.
Adjustments to lifestyle
Directly after the surgery, it is necessary to exclude acts of negligence, because that can lead to deterioration and cause inflammation. I don't do the following:
- for a long time to sit in a chair;
- a hot shower or bath;
- own car;
- to lift the weight more than 3 kg.
Within six months after the surgery, it is necessary to refrain from sexual activity. It is true that the work is not recommended, it is better to the first few weeks of sick leave. After removal of the prostate suggested a walk, and then some time after that, the morning light exercises, swimming. After recovery I don't smoke. The nicotine in them will negatively affect your blood circulation, which can lead to the inflammation.
No less important factor in the recovery, the correct nutrition. From the diet to exclude the food. This includes, baked, salted, smoked, sweet. You have to deny the alcohol content of beverages. The diet should consist of:
- low fat soups;
Therapeutic physical training yoga
After the surgery to remove the prostate is not useful to any physical activity. It is necessary to exclude Cycling, the training, the heavy weights. Better go to the swimming and to the gym soft stretching. Doctors recommend to pay attention to the yoga. Judging by the reviews, it is useful for the following exercises:
- On the ground, extend hands along the body. Compress decompress dam muscles for 2-3 seconds to 1 minute.
- Without changing position, bend the arc body, replacing his hand under the bottom of the pool tore the sex. Freeze for a few seconds to its original position. Repeat another 4-5 times.
The treatment does not end after the surgery. To exclude complications, the patient needs to be more drug, the list, which includes the following:
- The use of antibiotics. Used to eliminate the infection developed after surgery. The course of treatment duration of no more than 7-10 days.
- The pharmaceutical schedule the purpose of the pain 2-3 days after the procedure. First, the patient is taking strong painkillers, and goes on easier.