If the medication does not give the desired result, that you forget that a life without pain, and there was violation of power, he must seek the help 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 the medicine.
Advantages and disadvantages
In comparison with modern methods disadvantages of this method are many:
- high risk of complications;
- recovery time after surgery;
- the appearance of postoperative scars;
- major blood loss (greater risk if a person has the impairment of the coagulation of the blood or exhibits to receive anticoagulants).
The effects of the surgical intervention
This type of manipulation that may be accompanied by complications, in particular:
- Infectious inflammatory diseases.
- The bleeding.
- Violation of potency, including retrograde ejaculation (50% men).
- Stenosis urethral channel.
- Thrombosis of the veins of the legs.
The recovery period
Usually lasts 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" of treatment of the adenoma. The removal of the gland tissue is due to the influence of the electric current. The method does not involve incisions, the surgeon of the tool (resectoscope) is inserted through the urethra. Along the manipulation is carried out visual inspection of the field surgical, that is performed local or regional anesthesia, lasts about an hour.
The pros and cons
This method has many advantages in comparison with surgery open:
- good tolerability by the patient;
- a short recovery period;
- the risk of bleeding is reduced;
- a small percentage of complications;
- there are 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 should stop taking).
What to expect after the procedure
This method of extraction of the prostate has its own complications and unintended consequences:
- The bleeding.
- The syndrome of water intoxication (TURP syndrome).
- Damage to the urinary tract.
- Infectious-inflammatory complications.
- Violation of potency.
In general, the percentage of those who have after the surgery there were complications, a relatively small ‒ 15% and 30%, while the efficiency reaches 90 %.
The characteristics of the recovery
After the manipulation, the bladder is drained with a catheter. The catheter is removed 3-4 days, and 5-7 days in case of absence during this period, any complications the patient is discharged from the hospital for outpatient treatment.
Transurethral endoscopic surgery laser
Today for the removal of the prostate widely used method of ROUND. However, it is replaced with more modern methods, in particular, the manipulation with the use of a laser.
Advantages of surgery to remove the prostate by means of the laser in the case of the adenoma today is obvious: the use of this technology allows to obtain a greater degree of precision and to avoid accidental damage to nearby organs, tissues, nerves (important for the preservation of power), to minimize the risk of bleeding through the connection of the tissue laser
About the method
Laser removal is due to the impact on the laser beams of various lengths. The beam penetrates into the tissue causing its destruction (vaporization, coagulation) effect of high 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 take into account that the second method, the manipulation that involves the introduction of the system of laser through the urethra. The device is equipped with an optical system that allows the manipulation of the laser under direct vision.
The laser energy focused at the tip of the fiber, allows to cut the breast tissue to remove it without damage to the capsule of the prostate. After this, the tissue was moved into the bladder and removed. The coagulation of bleeding blood vessels are produced by converting the fiber tip 3-4 mm of the capillary. This procedure allows you to remove the adenoma of large size (over 200 CC).
Advantages and disadvantages
The advantages of this method are:
- Excellent tolerance (surgery soft).
- Unwanted complications and consequences, including bleeding, occur very rarely.
- Faster recovery and rehabilitation.
- Life without loss of potency (percentage of complications ‒ less than 1 %).
- Possibility of use for patients who take blood thinners are prone to bleeding.
- The removal can be carried out on any volume of the adenoma.
And that after the surgery?
The effectiveness of the method is close to 100% with a minimal risk of complications and recurrences. Including we are not talking of any kind about the violations of power. Urination returns to normal almost immediately after the surgery. The operation is bloodless, and therefore, the risk of bleeding is very low.
The operation takes an hour or two, depends on the size of the adenoma. After 2-3 days in the hospital, he goes to a catheter, and the patient is discharged to outpatient treatment.
As you can see, ways to remove the prostate a lot, but the choice of method individual. Depends on the age, the importance of the preservation of potency, adenoma size, and is determined by the treating physician. But the fact that today's technology allows many to find a life, health and to remain a man in any situation, it is undeniable!
In what degree of BPH surgery?
Almost 50% of men over the age of 50 years, was faced with an unpleasant illness which in medicine is known as BPH or BPH. This is a pathological growth of the prostate tissue. Its causes are still not fully understood, but doctors tend to believe that the pathological changes occur due to violations of hormonal background.
There are only 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, kidney, urinary tract. The first is not completely emptied during urination. The muscles of the body are susceptible to the diseases change. The urine in the bladder does not move, the volume of the body begins to increase. For a complete emptying of the organ, and the elimination of liquid, the patient has to work very hard, resulting in great increase of the blood pressure.
Treatment of BPH must be comprehensive. In the initial phase to improve the condition of the patient 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 perform a surgical procedure in which the doctor removes the excess tissue with a special tool.
Indications for surgery
BPH may gradually increase in size due to overgrowth of prostate tissue. This leads to serious complications, such as will compress the organs adjacent (bladder, kidney) and has interrupted his work.
In this case, the food and the medicines do not help, you need to perform the surgery. Operation assigned in the following cases:
- persistent difficulties with the emptying of the bladder;
- partial emptying of the bladder;
- bleeding in the urine;
- the stagnation of the bladder and the formation of deposits;
- infectious diseases;
- inflammation of different etiology;
- the penetration of urine in the blood, the intoxication of the organism;
- the renal failure.
According to statistics, in 70% of cases in an efficient way the problem can be solved through diet and drugs.
Today there are various 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 suited for men, regardless of the age of the patient and their condition. After the therapy laser is observed the restoration of the functionality of the organs of the system, urogenital seems normal urination, the rehabilitation period is short.
The main advantages of the treatment of hyperplasia prostatic with laser:
- the method helps to achieve positive results;
- the risk to the health of the patient is reduced to a minimum;
- the patient remains in the hospital only two days;
- there are almost no contraindications;
- a urine collection catheter is carried out only for 24 hours;
- minimizes the risk of bleeding during or after surgery.
Ablation with laser
This is one of the two types of laser therapy, after which the growth of the prostate tissue ends and all that is unnecessary, is removed by the evaporation or burning. This technique is effective if the adenoma has not yet had time to grow, and its size does not exceed 140 cm3. It is recommended for men of young age. A positive result in 98%.
This technique involves the 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 you to safely remove the formation of large dimensions. Consequently, restores the function of the urinary tract, normalizes urination, back power.
After the laser enucleation tissue is sent to a laboratory for examination to exclude the possibility of developing cancer of prostate.
This technique is the most popular among the patients diagnosed with BPH. It is prescribed after a comprehensive examination, if there are no contraindications and if the conservative treatment is not effective.
The surgery is performed by a device surgical that allows access to the gland of the prostate through the urethra. The surgeon widens the urethra or to remove the adenoma. To carry out the operation requires anesthesia epidural.
Once the doctor has completed the surgery, all the instruments used are recycled, but the cloth is sent to the laboratory. The patient can not defecate, so he has a catheter to drain the urine and the blood. Write a week in the absence of complications. During the rehabilitation must follow a strict diet with the exception of alcoholic beverages, fatty and spicy foods, as well as all of the products that have even a slight diuretic effect.
This technique is aimed at the removal of the prostate. Before the surgical intervention is necessary, epidural or spinal anaesthesia.
The advantage of this therapy is that the doctor gets access to the adenoma, and perhaps without obstacles to strengthen your finger. A small percentage of patients who suffer complications of urination after the procedure, thanks to a careful incision of the urethra. Treatment of hyperplasia prostatic this method allows you to minimize the risk of injuries of the bladder.
After the 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 the removal of the hyperplasia prostatic lasts four to six weeks.
Adenectomy prescribed to patients diagnosed with BPH in which the adenoma has reached the size of 75 grams and the conservative treatment does not improve the condition of the patient. Have the surgery a surgeon specializing in urology.
It is not always possible to carry out the operation for the hyperplasia prostatic, because there are a number of contraindications. It is impossible to solve the problem through the use of surgical intervention for patients:
- varicose veins, where dilation of the veins of the bladder;
- heart failure and other heart problems;
- of the coagulation of the blood;
- acute disease any organs;
- ankylosis of the hip joint.
If contraindications for surgical intervention no adenoma slow, but increases in size, it should not be delayed. As soon as you carry out the treatment of hyperplasia of prostate by surgery, the faster the patient can return to normal life.