The tumor in the prostate benign nature stands as the diagnosis of adenoma. This masculine pathology is one of the first places among urological diseases. At normal volume prostate gland it is related to the chestnut. It can increase by proliferation of fibro-muscular tissue. One of the reasons for the occurrence of the adenoma is 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 are talking about prostate cancer.
Indications for surgery for BPH
The feasibility of complete or partial removal of the adenoma of the prostate is determined for each patient individually. The indications for surgery are:
- The inefficiency of drug therapy. Benign prostatic hyperplasia (BPH), i.e. the increase in the volume of the prostate, may develop regardless even adequate treatment. If within six months of the effects of the drugs are not revealed, it is assigned to excision of the adenoma with surgical intervention.
- The accelerated growth of the prostate tissue. This means that the tumor is developing very quickly, so to stop the process will only complete removal of hyperplasia.
- Pain. To eliminate the pain in the initial stages of the disease use of antispasmodics and analgesics, and even injections of novocaine. If pathology is running, the unpleasant symptom remains even after taking medications.
- The age of the patient. Surgical intervention is indicated only in the age of 65-70 years. In each case, the patient's condition is considered individually.
Ways to remove 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 down to the abdominal Department. Due to the large number of contraindications and the effects of deleting this operation is rarely performed, but it is considered a classic treatment along with the transurethral resection. In advanced cases require open prostatectomy is surgery to remove the prostate.
Previously the only method of surgical treatment of tumors of the prostate was open Adenomectomy. It is performed under General anesthesia. The doctor removes the tumor so:
- the area of surgery is treated with an antiseptic solution, the hair is removed;
- the surgeon makes an incision of skin and subcutaneous tissue;
- next is the incision of the anterior wall of the bladder, the doctor carefully inspects the body for the presence of stones;
- then the surgeon removes the tumor itself due to the fact that the index finger enters the urethra and makes a small tear on his mucosa;
- further into the bladder to insert a catheter to allow rinsing of the wound with saline.
Open surgery is the guarantee for the irrevocable removal of the tumor, but the rehabilitation of the patient after it lasts a very long time, up to 3 months. In addition, there is a risk of complications such as pus and bleeding. Another serious issue is the postponement of 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 are removed tumor cells. In this case, you can even use a local anesthesia. The technique is complex, and therefore requires high qualification of the surgeon. The procedure is performed as follows:
- through the urethra resectoscope is introduced;
- with a special loop on the tool is scraping overgrown epithelium to its removal;
- then there is the irrigation of the bladder and another inspection of the operated area;
- next, there is 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 restored in about 2 months. In the first days after her may experience cramps when urinating, but eventually they pass. The operation lasts less than an hour, it is an advantage. Advantage can be considered and the absence of scars after tumor removal. In addition, the procedure itself is virtually painless.
Removal of the prostate gland using minimally invasive techniques
Traditional methods of treatment of adenoma have a large number of possible negative consequences. To reduce the risk of complications, minimally invasive techniques help. It is mostly laser resection. In modern surgery, such advanced techniques are:
- embolization arteries prostate;
- laser vaporization;
- laser enucleation of the adenoma;
- interstitial laser therapy;
- needle ablation;
- endoscopic resection.
Embolization arteries prostate
The essence of this method lies in the blockage of the blood vessels that supply blood to the prostate which increased. The procedure is performed under local anesthesia. The surgeon controls their actions by using a special apparatus. The task of the doctor is to find the end of the blood circulation in the prostate. They introduced a microcatheter and, through it, the substrate intravascular embolus. The advantage is that the patient is being discharged after 6 hours after the procedure.
Of all methods of treatment is laser vaporization of the adenoma is characterized by fewer complications. In addition, it allowed patients with bleeding disorders. Equipment is inserted through the ureter. The laser beam cut areas of benign prostate, blood vessels "brew". This operation is performed when the size of the tumor in 60-80 CC Advantages are short postoperative period and minimal complications, but is laser removal lasts two times longer than the TOUR.
Enucleation of the adenoma
Removal of the prostate in this way is a "husking" of prostate tissue by exposure to laser. After the surgery they can check for the presence of malignant cells. Its advantages are:
- the option to remove the tumor, even when the growth of the gland 200 g;
- short recovery period;
- the surgery is possible in patients with a pacemaker, metal devices in the bones or bleeding disorders.
After endoscopic enucleation of tumor tissue is transferred into the bladder, crushed with a laser and removed through catheter, with drainage. The presence of inflammatory processes or the inability to introduce the catheter into the ureter is a contraindication to the operation. The same applies to the serious General condition of the patient.
Interstitial laser therapy
The essence of this procedure is removal of the tumor – carrying through the punctures in the mucous membrane of the bladder or of the prostate a focused laser beam. Such introductions take a few. With the beam gland is treated from all sides, resulting in necrosis. The disadvantage of this method is that for some time the symptoms can even worsen. The reason for the wounds are deep in the prostate.
Atrophy of glandular tissue this surgery is by heating through high-frequency radio waves. They fall to the prostate via needles that enter into the gland. The downside of the procedure is its inefficiency for large size tumors. The advantage is that it is an outpatient procedure i.e. the patient can immediately after the removal to go home.
Laparoscopic removal of the prostate
This technique is indicated when the prostate volume greater than 100 CC It is carried out through special tubes, which penetrate through small incisions on the skin. Inside is the camera, showing the progress of the procedure on the monitor. Removal of the prostate lasts about 2 hours under General anesthesia. At the end of the urethra to insert a catheter. The advantage is a small rehabilitation period. From the hospital the patient will be discharged in 2-4 days. Of the minuses can be noted the small scars from the incisions.
This technique also does not require the abdominal opening. This significantly reduces blood loss. Iron is cut by surgical instruments which are inserted through a tube in the thickness of 1-1,5 cm the Advantage of the procedure is that it does not affect erectile function, as relates to the preserving techniques. In the absence of stones, inflammation and small adenomas, this operation is more preferable. Advantage is the short recovery period.
The effects of surgery for removal of prostate adenoma
Rehabilitation after removal of prostate adenoma can be so smooth. Health problems appear even more often compared to treatment of prostatitis. A few days there are blood in the urine, incontinence or pain when urinating. Last side effects long. If they were delayed, you should consult a specialist. Every patient responds differently to surgery, so depending on the type of operation may have different effects up to relapse. In this case you will need a second surgery.
Any removal of the prostate is potentially dangerous. Every patient is at risk of blood loss and infection. Anesthesia is a serious burden on the cardiovascular system. After surgery there are complications of this nature:
- the lack of sperm during intercourse;
- inflammation of the pelvic organs;
- urinary incontinence;
- erectile dysfunction;
Potency after surgery
Recovery of erectile function occurs after a certain period after the operation, but to begin to live a sexual life not recommended before full tissue regeneration. The average duration of such a period is approximately one month. This period may be increased depending on state and age of the patient. With full restoration of potency in some men, the consummation of the sexual act ceases to be allocated sperm. Cause partial damage to the spermatic. Reproductive function is preserved, but extraction of sperm required puncture.
Rehabilitation after surgery of the prostate
After the surgery, it is important to follow all the recommendations of the urologist for faster recovery. They relate to nutrition, physical activity and maintaining a patient's sex life. These recommendations are important to prevent possible complications after surgery. The early rehabilitation period is the first 5-7 days. At this time the patient can return to normal urine. In General, the recovery period can be 3 months or more.
Adjustments to lifestyle
Immediately after surgery, it is necessary to exclude acts of negligence, because they can lead to deterioration and cause inflammation. You cannot do the following:
- long to sit on a chair;
- take a hot shower or bath;
- to drink alcohol;
- self-drive car;
- to lift a weight more than 3 kg.
Within six months after the operation it is necessary to refrain from sexual activity. Right to work is not recommended, it is better to take the first few weeks of sick leave. After removal of the prostate is recommended to walk, and some time after to do with the morning light exercises and swimming. After recovery should not smoke cigarettes. Nicotine in them negatively affects circulation, which can lead to inflammation.
Not less important factor of recovery is proper nutrition. From the diet to exclude junk food. This includes fried, salted, smoked and sweet. You need to refuse from alcoholic beverages. The diet should consist of:
- low fat soups;
Therapeutic physical training and yoga
After surgery to remove the prostate is not useful to all physical activity. It is necessary to exclude Cycling and training with heavy weights. Better go swimming and gymnastics with soft stretching. Doctors recommend to pay attention to yoga. Judging by the reviews, useful are the following exercises:
- Lie on the floor, extend hands along the body. Compress decompress perineal muscles for 2-3 seconds for 1 minute.
- Without changing position, bend the arc body, substituting the hands under the lower back and the pelvis tearing from sex. Freeze for a few seconds, to take original position. Repeat another 4-5 times.
The treatment does not end after your surgery. To exclude complications the patient needs to take several drugs, the list of which includes:
- Antibiotics. Used to eliminate infection developed after surgery. The course of treatment lasts no more than 7-10 days.
- Painkillers are schedule purpose the relief of pain for 2-3 days after the procedure. First, the patient is taking strong analgesics and then goes on lighter.