If medication does not give the desired result, you forget about what a life without pain, and there was violation of potency, have to seek the assistance of surgeons. In the case of the adenoma, it is assumed partial, rarely complete removal of the prostate.
Modern medicine has in its Arsenal a large number of methods that allow you to quickly and effectively solve literally painful problem. Below are some of the most widely used methods, as well as the latest techniques for the future.
Open prostatectomy (traditional version)
This is one of the first ways that has been adopted by medicine.
Advantages and disadvantages
Compared to modern methods disadvantages of this method are many:
- high risk of the complications;
- a long recovery after the intervention;
- the appearance of postoperative scars;
- significant blood loss (greater risk if a person has impaired blood clotting or shown receiving anticoagulants).
The effects of surgical intervention
This kind of manipulation may be accompanied by complications, in particular:
- Infectious inflammatory diseases.
- Violation of potency, including retrograde ejaculation (50% men).
- Stricture urethral channel.
- Thrombosis of the veins of the legs.
The recovery period
Usually takes several weeks. In the early days not allowed to rise, which increases the risk of thrombosis. To restore the normal urination is used the catheter which will be removed after 1-3 weeks.
Transurethral resection (TUR) of the prostate
Today this method is the "gold standard" treatment of the adenoma. Removal of the gland tissue is due to the influence of electric current. The method does not involve incisions, the surgeon's tool (resectoscope) is inserted through the urethra. Throughout the manipulation is carried out visual inspection of the surgical field, it is performed under local or regional anesthesia, lasts about an hour.
The pros and cons
This method has much more advantages compared to open surgery:
- good tolerability by the patient;
- a short recovery period;
- the risk of bleeding is reduced;
- a smaller percentage of complications;
- no scars, stitches.
As the shortcomings can be noted the existence of restrictions:
- removal of adenomas of small size;
- the possibility of postoperative bleeding in people who take anticoagulants (before surgery you must stop taking).
What to expect after the procedure
This method of removal of the prostate has its own complications and unintended consequences:
- The syndrome of water intoxication (TURP syndrome).
- Damage to the urinary tract.
- Infectious-inflammatory complications.
- Violation of potency.
Overall, the percentage of those who have after the surgery there were complications, a relatively small ‒ 15-30 %, whereas the efficiency reaches 90 %.
The features of recovery
After the manipulation, the bladder is drained with a catheter. The catheter is removed 3-4 day, and 5-7 days in case of absence during this period, any complications patient is discharged from hospital for outpatient treatment.
Transurethral endoscopic laser surgery
Today for the removal of the prostate widely used method ROUND. However, it is substituted with more modern methods, in particular the manipulation with the use of a laser.
Undeniable advantages of surgery to remove prostate by laser in case of the adenoma today is obvious: the use of this technology allows to achieve high accuracy and avoid accidental damage to nearby organs, tissues, nerves (important for preserving potency), to minimize the risk of bleeding through the connecting tissue laser
About the method
Laser removal is due to the impact on the laser beams of various lengths. The beam penetrates the tissue, causing its destruction (vaporization, coagulation) effect of elevated temperature.
The most well-studied and widely used methods of laser surgery is:
- transurethral photo selective vaporization of the prostate (PVP) with the use of potassium-titanium-phosphate laser (KTF or green laser);
- transurethral enucleation of prostate using laser (HoLEP).
If we consider the second method, the manipulation involves the introduction of the laser system through the urethra. The device is equipped with an optical system that enables the manipulation of the laser under direct vision.
Laser energy focused on the tip of the fiber, allows to cut the breast tissue to remove it without affecting the capsule of the prostate. After that, tissues are moved into the bladder and removed. Coagulation of bleeding vessels is produced by converting the fiber tip 3-4 mm from the capillary. This procedure allows to get rid of the adenoma of large sizes (over 200 CC).
Advantages and disadvantages
The advantages of this method are:
- Excellent tolerability (sparing surgery).
- Unwanted complications and consequences, including bleeding that are very rare.
- Faster recovery and rehabilitation.
- Life without loss of potency (percentage of complications ‒ less than 1 %).
- The possibility of application for patients who are taking anticoagulants are prone to bleeding.
- The removal can be carried out at any volume of the adenoma.
And what after the surgery?
The effectiveness of the method is close to 100% with minimal risk of complications and recurrences. Including we are not talking whatsoever about any violations of potency. Urination returns to normal almost immediately after surgery. Bloodless operation, and hence the risk of blood loss is very low.
The operation takes an hour or two, it depends on the size of the adenoma. After 2-3 days in the hospital, goes to a catheter, and the patient is discharged to outpatient treatment.
As you can see, ways to remove prostate a lot, but the choice of method is individual. It depends on age, the importance of preserving potency, adenoma size, and determined by the treating physician. But the fact that modern technology allows many to find a life, health and to remain a man in any situation, is undeniable!
At what degree of BPH surgery?
Almost 50% of men over the age of 50 years, faced with an unpleasant disease that in medicine is referred to as BPH or BPH. This is a pathological growth of the prostate tissue. Its causes are not yet fully understood, but doctors tend to believe that the pathological changes occur due to violations of hormonal background.
Only there are three stages of the disease, which differ in the symptoms and methods of treatment. The second stage is characterized by a dysfunction of the bladder, kidneys, urinary tract. The first is not completely emptied during urination. The muscles of the body susceptible to degenerative change. Urine in the bladder is not moving, the volume of the body begins to increase. For a complete emptying of the organ and removal of fluid, the patient has to work too hard, resulting in greatly increased blood pressure.
Treatment of BPH should be comprehensive. At the initial stage to improve the patient's condition is possible by means of conservative methods. It is a diet, hormone therapy, folk remedies. If drug treatment is not effective, it is necessary to conduct a surgical procedure in which the doctor removes excess tissue with a special tool.
Indications for surgery
BPH can gradually increase in size due to overgrowth of prostate tissue. This leads to serious complications such as compressed adjacent organs (bladder, kidneys) and disturbed their job.
In this case, the diet and medicines do not help, you need to carry out surgery. Operation is assigned in the following cases:
- persistent difficulties with emptying of the bladder;
- partial emptying of the bladder;
- bleeding in the urine;
- stagnation in the bladder and formation of deposits;
- infectious diseases;
- inflammation of various etiologies;
- the penetration of urine in the blood, intoxication of the organism;
- renal failure.
According to statistics, in 70% of cases efficiently the problem can be solved through diet and medications.
Today there are several techniques that help to get rid of the disease and return to a normal lifestyle.
The treatment of benign prostate hyperplasia can be performed with a laser. It is the most gentle method, suitable for men regardless of the age of the patient and his condition. After laser therapy was observed restoration of functionality of organs of the urogenital system appears normal urination, the rehabilitation period is short.
The main advantages of the treatment of prostatic hyperplasia laser:
- the method helps to achieve positive results;
- the risk to the health of the patient are reduced to a minimum;
- the patient is in the hospital for only two days;
- almost no contraindications;
- a urine collection catheter is carried out only for 24 hours;
- minimizes the risk of bleeding during or after surgery.
This is one of two types of laser therapy, after which growth of the prostate tissue terminates and all that is unnecessary, is removed by the evaporation or burning. This technique is effective when the adenoma has not yet had time to grow and its size does not exceed 140 cm3. It is recommended to men of young age. A positive result in 98%.
This technique involves removal of the laser beams of all benign tumors of the prostate. It is prescribed to patients diagnosed with BPH, second and third degree. The procedure allows to remove safely the formation of a large size. In result, restores the function of the urinary tract, normalizes urination, return potency.
After the laser enucleation tissue is sent to a laboratory for examination to exclude the possibility of developing cancer of the prostate.
This technique is the most popular among patients diagnosed with BPH. It is prescribed after a comprehensive examination, if no contraindications and when conservative treatment is ineffective.
Surgery is performed using a special surgical device that allows you to access the prostate gland through the urethra. The surgeon widens the urethra or remove the adenoma. To carry out the operation required epidural anesthesia.
Once the doctor has completed the surgery, all the instruments used are recycled, but the cloth is sent to the laboratory. The patient cannot defecate, so he has a catheter to drain urine and blood. Write it a week in the absence of any complications. During rehabilitation it needs to follow a strict diet with the exception of alcoholic beverages, fatty and spicy foods, as well as all products that have even a slight diuretic effect.
This technique is aimed at the removal of the prostate. Before surgical intervention is required epidural or spinal anaesthesia.
The advantage of this therapy is that the doctor gets access to the adenoma, and it may without interference to squeeze your finger. A tiny percentage of patients who experience complications of urination after the procedure thanks to an accurate cross-section of the urethra. Treatment prostatic hyperplasia this method allows you to minimize the risk of injuries of the bladder.
After surgery the patient needs care. He set a catheter to drain the blood and urine, monitor the hemodynamic parameters. To reduce the intensity of pain, prescribed pain pills.
The first two days after surgery, the patient must follow a liquid diet. Rehabilitation after removal of prostatic hyperplasia lasts four to six weeks.
Adenectomy prescribed to patients diagnosed with BPH in whom the adenoma has reached the size of 75 grams and conservative treatment does not improve the patient's condition. To pursue surgery a surgeon who specializiruetsya on urology.
It is not always possible to carry out the operation for BPH, as there are a number of contraindications. It is impossible to solve the problem by using surgical intervention for patients who have:
- varices, where dilated veins of the bladder;
- heart failure and other heart problems;
- of blood clotting;
- acute disease any organs;
- ankylosis of the hip joint.
If contraindications to surgical intervention no adenoma slow, but increases in size, should not be delayed. The sooner will be carried out the treatment of hyperplasia of the prostate by surgery, the faster the patient can return to normal life.