Prostate surgery in which cases and how to do surgery on the prostate gland
Prostate surgery: in what cases and how is the operation done on the prostate gland
In what cases and how the prostate surgery is performed. What are the types of surgical interventions for diseases of the prostate gland and where they are best carried out.
How to do prostate surgery
Diseases of the prostate, previously considered age-related pathologies, are now diagnosed in 35-40-year-old men. Despite the efforts of specialists, it is not always possible to manage with conservative methods of treatment, 30% of patients need surgical intervention. And prostate surgery, according to statistics, firmly holds the 2nd place in urology. Consider what types of surgery are, and what are the indications for them.
The content of the article
- Indications for surgical treatment
- What are the types of operations?
- Open or traditional operation
- Useful video: perineal radical prostatectomy
- Endoscopic resection through the urethra
- Endoscopic Transrectal Method
- Useful video: transurethral resection of prostate adenoma
- Minimally invasive surgery
- Partial and complete resection of the prostate
- Recommendations during the rehabilitation period
- The choice of clinic is the patient’s prerogative
- Useful video: laser prostate adenoma removal
Indications for surgical treatment
Surgery on the prostate gland often becomes for men the only possible method to get rid of painful spasms when urinating, as well as to eliminate the growth of the tumor.
Surgery on the prostate do in the following cases:
- The proliferation of prostate tissue – prostate adenoma.
- Purulent prostatitis or abscesses in the body of the prostate gland.
- Constriction of the urethra (urethra).
- Delay or lack of urination.
- Tumors of the prostate are both benign and malignant.
- Urethral bleeding.
- The rapid growth of connective tissue – sclerosis or prostate fibrosis.
- Urinary incontinence.
Urologists or andrologists are the name given to specialists who should be referred to when anxiety symptoms appear. At the same time, urologists deal with pathologies of the urinary system as a whole, andrologists investigate disorders of the reproductive male sphere. But the doctor and the first and second specialization after all examinations can recommend prostate surgery.
Note! The operation of the prostate gland is performed strictly in-patient by surgeons under general anesthesia.
The operation on the prostate gland is performed in stationary conditions.
What are the types of operations?
Types of operations depend on the degree of prostate injury. With bulky tumors (more than 80 mm), the presence of multiple stones in the urinary system, developed diverticulosis of the bladder membranes, preference is given to a radical method – an operation to remove prostate gland enlargement or adenomectomy.
When the tumor size is less than 80 ml, a more benign prostate surgery is performed – adenoma excision. For mild inflammation, small-sized adenoma, surgeons tend to less traumatic endoscopic methods.
Regardless of the type of operation of the prostate gland, there are a number of contraindications to surgery:
- Severe forms of cardiac, renal and pulmonary insufficiency (there is a risk of intolerance to general anesthesia).
- Cystitis, pyelonephritis in the acute stage.
- Infectious diseases.
- Serious pathologies of the cardiovascular system and the brain.
According to the degree of intervention and penetration to the affected area, there are several ways to promptly remove a tumor.
Surgery are different in the form of intervention
Open or traditional operation
Surgery to remove prostate glandular growth, conducted in the traditional open way, 30 years ago was practically the only method of tumor removal. Other methods are widely practiced nowadays, but open adenomectomy has not lost its relevance as a way to cope with large-volume tumors and prevent the benign neoplasm from becoming malignant. The operation is also indicated with a significant accumulation of stones and a diverticulum proliferation in the urinary system.
The operation is classified as abdominal, as the intervention occurs through the opened bladder under general anesthesia.
To predict possible complications and terms of recovery before surgery, general and biochemical blood and urine tests, blood tests for AIDS and sexually transmitted diseases are mandatory. Also included in the list of preliminary training is ECG and ultrasound of the abdominal organs.
The course of the operation, which requires certain skills and qualifications of the surgeon, includes a number of steps:
- After the necessary hygienic procedures, a longitudinal or transverse section of the abdomen is made, penetrating the dermis and subcutaneous fatty tissue.
- Dissection of the anterior wall of the bladder allows you to analyze the contents of the latter for the presence of stones and diverticulum.
- The third most crucial moment of the operation is palpation of the detected tumor and its selection.
- Penetrating into the inner opening of the urethra, the surgeon with the index finger heals tissue growth that interferes with the normal functioning of the gland itself.
- After isolating the tumor, it is carefully removed through an open organ, trying not to damage the adjacent structures. The severed neoplasm is certainly sent for histological examination.
Like any type of surgical activity, open surgery has undeniable advantages, but has its drawbacks.
The main advantage of the traditional women viagra open method is radicalism, that is, the final and irrevocable excision of the tumor with all the aggravating symptoms.
The main negative consequence of the method is the probability of bleeding in the initial postoperative period. Blood loss is not as dangerous as the possible closure of the exit opening in the bladder with a blood thrombus. To prevent such a situation, the organ is washed with sterile saline through a catheter.
Disposal of the tumor also has its price – the consequences of anesthesia, a long recovery period (up to 3 months), the risks of complications (suppuration and bleeding of the wound, the formation of fistulas). Does not paint and postoperative suture.
Useful video: perineal radical prostatectomy
Endoscopic resection through the urethra
Transurethral resection of the prostate (TUR can you get high off sleeping pills) is used to remove an adenoma – a benign neoplasm. Currently, this type of surgical intervention is listed as the gold standard in the treatment of the disease, since the percentage of positive results is high, although the operation is complex and requires high professionalism from the performer.
TOUR is indicated in patients with a tumor size up to 80 ml. The operation lasts a maximum of 1.5 hours, the process itself consists of the following steps:
- After the introduction of epidural anesthesia, the surgeon penetrates the urethra with an endoscopic device (resectoscope) into the bladder.
- After groping for a local tumor with a special electric net, the affected tissue is cut off.
- A prerequisite for a successful operation is a good visualization of the process, which is achieved by continuous circulation of fluid through the resectoscope. The same purpose is served by the timely stopping of bleeding.
- Prostate adenoma is excised with fine chips, which are subsequently removed along with the fluid instrumentally.
- Bleeding vessels are coagulated by electric current, then the resectoscope is removed from the bladder, and its place is taken by the Foley catheter, which provides for washing the organ and outflow of urine in order to avoid irritation of the bladder.
The advantages of transurethral surgery are the aesthetic side – the absence of sutures, a short rehabilitation period and a fast positive dynamic.
The disadvantages include the limitation on the volume of the operated tumor and the presence of expensive equipment that requires competent, trained in the skills of owning the device, a specialist.