If the medicinal product does not give the desired result, you will forget what is life without pain, and there was a violation of potency, you need to seek the assistance of surgeons. In the case of adenoma, it is assumed partial, rarely complete removal of the prostate gland.
Modern medicine has in its Arsenal a large number of methods that will 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
In terms of modern methods disadvantages of this method are many:
- high risk of complications;
- long recovery after the intervention;
- the appearance of postoperative scars;
- significant blood loss (greater risk if a person has damaged a blood clot or shown receiving anticoagulants).
The effects of surgical intervention
This kind of manipulation may be accompanied by complications, especially:
- Infectious inflammatory diseases.
- Violation of the power, including retrograde ejaculation (50% men).
- Stricture the retail channel.
- Thrombosis of the veins of the legs.
In the recovery period
Usually takes a few weeks. In the early days, it is not allowed to rise, which increases the risk of thrombosis. To return to the normal urination, use a catheter that will be removed after 1-3 weeks.
Transurethral resection (TUR of the prostate
Today this method is the "gold standard" for the treatment of adenoma. Removal of the gland tissue is due to the influence of the electric current. The method does not involve incisions, the surgeon is a tool (resectoscope) is inserted through the urethra. In the course of the manipulation is carried out visual inspection of the surgical field, it is performed under local or regional anesthesia, takes about one hour.
The pros and cons
This method has more advantages in comparison with open surgery:
- good tolerability by the patient;
- a short recovery period;
- the risk of bleeding decreases;
- a smaller percentage of complications;
- no scars, stitches.
As disadvantages can be noted the existence of restrictions:
- removal of adenomas of small size;
- the possibility of postoperative bleeding in people taking anticoagulants (before the surgery you must stop taking).
What to expect after the procedure
This method of removal of the prostate has its own complications and side effects:
- The syndrome of water intoxication (TURP syndrome).
- Damage to the urinary tract.
- Infectious-inflammatory complications.
- Violation of potency.
Generally, the percentage of those who have after the surgery there were complications, a relatively small ‒ 15-30 %, while the efficiency reaches 90 %.
Features of the 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 the absence during this period, any complications, patient is discharged from the hospital for outpatient treatment.
Transurethral endoscopic laser surgery
Today for the removal of the prostate widely used method ROUND. However, it has been replaced with more modern methods, in particular the manipulation with the use of the laser.
Undeniable advantages of the surgery for removal of cancer by the laser in the case of adenoma today is obvious: the use of this technology allows to achieve higher precision and to avoid accidental damage to surrounding organs, tissues, nerves (important for preserving potency), to minimize the risk of bleeding through the connecting tissue laser
On the way
Laser hair removal is due to the influence of laser rays of different lengths. The beam penetrates the tissue, causing its destruction (evaporation, coagulation) effect of elevated temperature.
The most well studied and widely used methods of laser surgery is:
- transurethral photo selective vaporization of prostate (PVP) with the use of potassium-titanium-phosphate laser (KTF or green laser);
- transurethral enucleation of prostate using laser (HoLEP).
If we take the second method, the manipulation includes the introduction of the laser system through the urethra. The device is equipped with an optical system that allows manipulation of the laser under direct vision.
Laser energy focused on the tip of the fiber, allows to reduce the breast tissue to remove it without affecting the capsule of the prostate. After that, the 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 you to remove the adenoma of the large sizes (over 200 CC).
Advantages and disadvantages
The advantages of this method are:
- Excellent tolerability (surgery gentle).
- Unwanted complications and consequences, including bleeding, occur very rarely.
- Faster recovery and rehabilitation.
- Life without loss of power (the percentage of complications ‒ less than 1 %).
- The possibility for the use of patients taking anticoagulants are prone to bleeding.
- Removal can be performed on 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 don't talk what for any violations of potency. Urination returns to normal almost immediately after the surgery. The work is cold, and with it the risk of bleeding is very low.
The surgery lasts an hour or two, it depends on the size of the adenoma. After 2-3 days in the hospital, go to the 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 is individual. It depends on the age, about the importance of preservation of potency, adenoma size, and is determined by the treatment of the patient. But, the fact that modern technology allows many to find life, health and to remain a man in any situation, is undeniable!
In what degree of BPH surgery?
Almost 50% of men over the age of 50 years, are faced with an unpleasant illness which in medicine is called BPH or BPH. This is a pathological development of the tissue of the prostate. The reasons for this are not yet fully understood, but doctors tend to believe that the pathological changes occur due to violation of hormonal background.
Only there are three stages of the disease, which differ in the symptoms and methods of treatment. The second phase is characterized by a dysfunction of the bladder, kidneys, infections of the urinary tract. The first is not completely emptied during urination. The muscles of the body susceptible to degenerative change. Urine in the bladder does not move, the volume of the body begins to increase. For completely emptying of the body and removal of fluid, the patient has to work too hard, resulting in significantly increased blood pressure.
Treatment of BPH should be comprehensive. In the initial phase of the improvement of the patient's condition is possible by the application of a conservative method. It is the way of the nutrition, hormone therapy, folk remedies. If the 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, which is due to excessive growth of the prostate tissue. This leads to serious complications, such as compressed the adjacent organs (bladder, kidneys) and disturbed their work.
In this case, diet and medication does not help, you need to carry out the operation. The work is given in the following cases:
- persistent difficulties with emptying of the bladder;
- partial emptying of the bladder;
- bleeding in the urine;
- the stagnation in the bladder and the formation of deposits;
- infectious diseases;
- inflammation of the different reasons;
- 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 medication.
Today there are a few techniques that will help them to get rid of the disease and to return to a normal life.
Treatment of benign hyperplasia of the prostate can be performed with the 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 is reduced to a minimum;
- the patient remains in the hospital, just two days;
- almost no contraindications;
- a urine collection catheter is carried out only for 24 hours;
- minimises the risk of bleeding during or after surgery.
This is one of the two types of laser therapy, after which growth of the prostate tissue ends and all that is unnecessary, is removed by 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 advisable to men at a 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 big size. In result, restores the function of the urinary tract, normalizes urination, back potency.
By laser enucleation of tissue is sent to the laboratory for examination to exclude the possibility of development of cancer of the prostate.
This technique is the most popular among patients diagnosed with BPH. It is provided after a comprehensive review, if there are no contraindications and if conservative treatment is ineffective.
The surgery is performed using a special surgical device that allows you to access the prostate through the urethra. The surgeon widens the urethra or the removal of the adenoma. To carry out the work required epidural anesthesia.
Once the doctor has completed the surgery, all the instruments that are used are recycled, but the cloth is sent to the laboratory. The patient may not defecate, so he has a catheter to drain the urine and blood. Write it one week in the absence of any complications. During the rehabilitation it needs to follow a strict diet, with the exception of alcoholic beverages, greasy and spicy food, as well as all products that have even a mild diuretic effect.
This technique is in the direction of removal of the prostate gland. Before surgical intervention is required epidural or spinal anesthesia.
The advantage of this therapy is that the doctor gets access to the adenoma, and it can no obstacles to squeeze your finger. A small percentage of patients who are faced with the complications of urination after the procedure thanks to an accurate incision of the urethra. Treatment prostatic hyperplasia this method allows you to minimize the risk of injuries of the bladder.
After the operation, the patient is in need of care. He set a catheter to drain the blood and urine, monitoring of 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 prostatic hyperplasia lasts four to six weeks.
Adenectomy provided 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. Has surgery surgeon in the field of urology.
It is not always possible to carry out the operation for prostatic hyperplasia of the prostate, since 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 in the bladder;
- heart failure and other heart problems;
- the clotting of the blood;
- acute disease any organs;
- ankylosis of the hip joint.
If contraindications for surgical intervention without adenoma slow, but increases in size, should not be delayed. The faster you are going the treatment of hyperplasia of prostate by surgery, the faster the patient can return to normal life.