Tour of large prostate adenoma

TURP of the prostate (transurethral resection of the prostate)

TUR of the prostate (transurethral resection of the prostate) is an endoscopic surgical removal of the entire prostate or its part without incisions and sutures, which is performed using a special apparatus - a resectoscope, consisting of optics, a resecting element and a light source.

Indication for TURP is a benign tumor of the prostate gland, which disrupts urination and significantly reduces the quality of a full-fledged male life.

Prostate surgeries: what are they?

Today, in world medicine, three main methods are used for prostate surgery:

• Posterior pubic adenomectomyThe operation is performed through an incision in the peritoneum in the pubic area. Effective for men with large prostate volume (more than 100 cc). May be accompanied by large blood loss, Urinary incontinence in the postoperative period and a fairly long rehabilitation.
• Laparoscopic method The surgeon removes the prostate gland or part of it through small punctures under the control of endoscopic equipment. Effective for men with a large volume of adenoma with a total prostate volume of more than 100 cc. see Differs in low trauma. Patients return to normal life much faster.
• Vaporization of Prostate adenoma with a laserPerformed through the urethra. The main advantage is minimal blood loss. Effective for small volumes of adenoma (up to 25 cc). A good alternative to drugs when they cannot be taken for one reason or another.
• TUR of the prostate TUR of the prostate today is one of the most effective methods of surgical treatment of prostate adenoma, which quickly removes the symptoms of the disease and helps to restore normal urination in the vast majority of cases within just a few days.

Please note: which method to choose, our specialists will determine based on the results of a thorough diagnosis, taking into account a number of factors, including the disease itself and its severity, the size and shape of your prostate at the time of the examination, the presence or absence of concomitant diseases, general condition organism and others.

TUR of the prostate: indications

Prostate adenoma, or benign prostatic hyperplasia (BPH) is the main reason for the use of TURP. Here are the main symptoms of this disease:

Frequent urge to urinate, including at night Difficulty starting to urinate Slow and long urination Intermittent urination Feeling that the bladder is not completely emptied Blood in the urine

Note: prostate adenoma is not the only pathology in which TURP is performed. Your doctor may prescribe this surgery for you to treat or prevent complications due to blocked urine flow, which is usually provoked by:

• Recurring urinary tract infections
• Narrowing of the urethra with a length of no more than 1 cm
• Various treatments for prostate cancer

TURP is preferred over other surgical options if:

Please note: Unlike many other treatments for an enlarged prostate, TURP helps to quickly achieve long-term results and fully restore urination and men's health, even in severe cases.

If you have any of the symptoms described above, this is already a good reason to see a urologist. Remember: many diseases of the male genitourinary system can be eliminated without surgical intervention if the problem is identified and eliminated in time. Therefore, if something is wrong with your men's health, do not self-medicate - sign up for an appointment with a urologist right now.

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TUR of the prostate: preparation for surgery

Once again, before prescribing you for TURP or any other treatment, whether conservative or surgical, your doctor will prescribe a number of diagnostic procedures to help you make an accurate diagnosis.

What does direct preparation before TURP include:

• 1 1.5 weeks before surgery, stop taking medicines that can thin the blood (Aspirin, Ibuprofen, Naproxen, vitamin E, Clopidogrel, Warfarin and others)
• The night before surgery, shave your pubic area and take a cleansing enema
• On the night before surgery, do not eat or drink anything after midnight
• On the day of surgery, take only the medicines that our specialists have prescribed for you

TUR of the prostate: how is the operation performed?

Turn of the prostate is performed under general anesthesia or spinal anesthesia.Our anesthesiologists will select anesthetic drugs individually - based on the results of preliminary diagnostics and contraindications to certain anesthetic substances.

The duration of the operation depends on the complexity of your case and ranges from 1 to 2.5 hours.

After a TURP, you will stay in our hospital until our specialists consider that the operation was successful and nothing threatens your health.

TURP: rehabilitation

A soft catheter remains in the urethra for 1-3 days after surgery. After it is removed, you may experience discomfort when urinating. Don't worry, these feelings are normal. After a week at most, they will completely disappear.

Complete healing lasts about 2 months. The most important thing is to strictly follow all the recommendations of our specialists and follow a few simple rules that will help you avoid complications and recover quickly:

• During recovery, avoid driving, heavy machinery, lifting heavy objects, making sudden movements, and trying not to force the muscles of the abdominal wall and perineum (for example, when defecation)
• To avoid constipation, which can lead to complications due to strong muscle tension during bowel movements, follow the diet that our specialists will prescribe for you
• Drink 8-10 glasses of water a day - this will help to flush the bladder well and speed up recovery
• Strengthen your pelvic floor muscles with specific exercises to help prevent urinary incontinence
• Do not resume sexual activity until our specialists allow you

TURP: possible complications

TURP of the prostate is one of the safest methods of surgical treatment of the prostate gland. But, like any operation, TURP can cause complications - both early and late.

Early complications

Bleeding. If you notice blood in your urine, don't worry - it's completely normal after a TURP. But if the blood persists for several days, please notify our specialists immediately.

Infection. Urinary tract infections can occur if a catheter is used to remove urine for a long time.

Problems of urination. urinary incontinence is common after TURP. As a rule, it passes within a month. Short-term urinary retention can be in the first few days after surgery - that is why a catheter is most often installed.

TUR syndrome. This is a syndrome of water intoxication of the body, which is extremely rare and requires the mandatory intake of diuretics.

Late complications

Retrograde ejaculation. Retrograde ejaculation, or dry orgasm, is common: sperm is not thrown out through the urethra, but into the bladder. This does not affect sexual sensations, but nullifies the possibility of having children. If you develop this complication, do not worry and immediately inform our specialists who will help you.

Erectile dysfunction. Weak erection after TURP is an extremely rare complication that occurs in a few.

Urine incontinence. Temporary urinary incontinence is common after TURP, but sometimes it can develop into a chronic pathology later in some men. To avoid this, let our specialists know in time as soon as you notice that urinary incontinence happens to you more often.

Repeated surgery. Approximately 10% of men who have undergone a TURP need reoperation within 7 years. You can only get rid of them surgically.

Turn of the prostate in the network of clinics "Capital": why should you contact us?

High-tech

Professional

Over the years of successful practice, our specialists have performed a huge number of surgical operations on the prostate gland of varying degrees of complexity and returned hundreds of men to full-fledged male health.

That's why, turning to us, you can be sure that our specialists will help you: they will thoroughly understand your situation, make an accurate diagnosis and safely perform TURP.

Please note: our cozy rooms for single and double occupancy have everything you need for a comfortable stay: a nurse call button at any time of the day, a private bathroom, air conditioning, a refrigerator, a TV, a microwave and Wi-Fi. Good nutrition and rehabilitation procedures will help you quickly recover from surgery and return to a full life.

Do not delay your visit to the urologist if you feel that something is wrong with your male health. Sign up for prim right now.

Indications for TURP and postoperative period

If a prostate adenoma develops in the male body, the patient needs TURP (transurethral resection).This operation involves the excision of the affected tumor tissue. Such an endoscopic intervention is prescribed if the characteristic neoplasm of the bladder and prostate pathologically increases in size, disrupts the outflow of urine, and provokes other health complications. Transurethral resection of the prostate gland is performed only by a surgeon, it requires a preliminary examination of the tumor for malignancy.

What is TURP

If the prostate is pathologically enlarged, and conservative methods of treatment have proven ineffective in practice, the doctor resorts to surgical intervention. Such a radical solution is appropriate mainly for older patients. Medically recommended TURP is a complex operation during which the surgeon removes the prostate in full or in part. Surgery is prescribed for benign prostatic hyperplasia (BPH), when the tumor size is in the range of 60-80 cm3.

If prolonged inflammation prevails, which is accompanied by acute pain and other unpleasant symptoms, doctors recommend TUR of prostate adenoma. The operation is performed by a surgeon in a specialized clinic; it is equally prescribed for benign and malignant tumors after a series of clinical examinations and a mandatory biopsy. Transurethral resection of prostate adenoma has the following medical indications:

• bladder obstruction with impaired urination;
• bladder stones;
• chronic hematuria;
• false urge to go to the toilet;
• pain syndrome of the perineum;
• renal failure due to urology.

Contraindications

An operation to remove a prostate tumor is not recommended if the patient has impaired blood clotting - the risk of bleeding increases. Absolute contraindications are chronic diseases of the cardiovascular and genitourinary system of the stage of relapse, severe conditions of the clinical patient. In addition, it is important before starting surgical interventions to determine the patient's response to local anesthesia or general anesthesia, to exclude side effects.

Other medical contraindications are listed below:

• varicocele;
• carcinoma;
• adenoma in the terminal stage;
• ankylosis of the hip joint;
• retirement age;
• inconvenience of using the technique on the focus of pathology;
• any inflammation.

Operation progress

If a presumptive diagnosis is made, the tumor continues to compress the urinary tract, exert increased pressure on neighboring structures, the doctor prescribes the day and time of the operation. Pre-recommends the patient to be examined, to pass the necessary tests. After clarifying the disease and clinical examination, the stage of preparation for surgical intervention begins, which provides for a complete rejection of medications for a week, from food - the day before the operation.

On the eve of the operation, it is allowed to take sedatives to calm the nervous system, while it is important to refrain from sexual activity before and after surgery. For 3-7 days hospitalization of a clinical patient is required. The sequence of actions on the operating table is as follows:

Complications

After surgical procedures, the consequences for the patient may not be the most favorable, while complicating the course of the disease itself. Potential pathologies are as follows:

• retrograde ejaculation;
• intra-abdominal infection;
• urethral strictures;
• urinary incontinence;
• diagnosed impotence.

Postoperative period

After surgical manipulations, the patient is under strict medical supervision in a hospital for several more days. The main task during the rehabilitation period is to normalize the outflow of urine, prevent pain, and restore the previous sexual activity. At first, physical activity is completely excluded, the patient should lie more. Other restoration measures are presented below:

• drink plenty of water to normalize the outflow of urine;
• infusion therapy to avoid inflammation;
• taking antibiotics and uroantiseptics to prevent secondary infection.

Price for TURP

The cost of the operation depends on the rating of the clinic, the reputation of the specialist, the city of the surgical intervention. At the same time, it is important not to forget about the quality of the services provided, not to save on your own health.

Transurethral resection (TUR) of the prostate: what is it and how is it performed?

Modern men often suffer from an increase in the size of an unpaired androgen-dependent organ called the prostate gland.

Pathological changes are considered benign. Constantly growing glandular tissues disrupt the normal excretion of physiological fluid from the bladder.

After detecting a deviation from the norm, drug therapy is prescribed and nutrition is adjusted. The lack of a positive effect on the background of taking medications and using a diet requires an operation.

A popular method of therapy is the laparotomy method of removing overgrown tissues, which has proven itself in endourology. TUR of the prostate is considered the most effective surgical intervention that can instantly reduce the pronounced manifestations of the disease and restore normal urination.

TUR operation in urology: what is it?

Transurethral resection is considered a fairly popular type of surgery, which involves the removal of all or part of the gland.

Prostatectomy is performed to eliminate lesions of the urinary system of varying severity, provoked by the growth of prostate tissue. A minimally invasive operation is characterized by a minimal risk of complications.

Transurethral resection of the prostate

Unlike the traditional method of removing formations, during low-traumatic surgery, the tumor is excised in layers, while the surrounding tissues and organs are preserved.

Carrying out an innovative medical intervention excludes a surgical incision and the loss of a large volume of blood. The prostate gland and the prostatic part of the urinary system are removed through the perineal access.

Indications for transurethral resection of the prostate

Even a significant increase in the size of a neoplasm cannot in itself be an indication for surgical intervention.

Only after a general examination and receipt of laboratory results, the urologist confirms the appropriateness of TUR.

Most often, the reason for the operation is a benign or malignant tumor of the gland.

Prostate adenoma

Transurethral bipolar resection provides a chance to quickly reduce the symptoms of a benign disease. The procedure is suitable for the category of patients with a very large prostate.

Normal and enlarged prostate

The method guarantees long-term benefits. Medicines and other approaches to treatment do not give such significant results.

Prostate cancer

TUR is performed under the following factors:

• inability to empty the bladder, provoked by a tumor of the gland;
• progressive increase in the volume of residual urine on the background of conservative treatment;
• presence of a catheter;
• Specific digital examination findings and negative biopsy results.

Contraindications for surgical treatment

TOUR is not indicated in every case. A number of pathologies and disorders prevent its implementation.

An operation on the prostate is not indicated against the background of the following conditions:

• acute chronic heart disease;
• other inflammatory processes,
• hyperthermia;
• prostate cancer;
• immobility of the hip joints;
• kidney dysfunction;
• Willebrand disease;
• hemophilia;
• postoperative complications.

How it is done: operation technique

The operation is performed under general anesthesia or spinal anesthesia, and lasts just over an hour.

It includes a light source, a mechanical device for rinsing fluid, an electrical loop for tissue evaporation and coagulation of blood vessels. Skin dissection is not done, sutures are not applied.

Techniques for performing TUR differ in the type of tissue removal and the type of loop used. With monopolar resection, the part of the gland that injures the urethra is eliminated. Bipolar cutting involves the removal of tissue around the ureter.

After the operation, a catheter is placed for the patient to urinate for a short time. The device can cause painful contractions of the bladder.

Recovery after surgery

The TUR increases the flow of fluid excreted by the kidneys. After removal of the catheter, pain or discomfort is felt during emptying. Discomfort lasts a week, then disappears.

Within 5-7 days, the wound heals, damaged cells are rejected and excreted from the body. Full tissue repair occurs after 2 months.

The following measures will help speed up recovery:

• exclude driving or heavy machinery, lifting, jerky movements, muscle tension during bowel movements;
• drink 8 glasses of water daily to flush the bladder;
• follow a fruit and vegetable diet.For constipation, laxatives are used;
• avoid alcohol for at least two weeks after surgery;
• sexual life is resumed only on the recommendation of a doctor;
• inform the urologist about all medications and herbs taken to avoid bleeding;
• Continue antibiotic treatment even in the absence of any symptoms of inflammation.

Consequences and possible complications

Reviews about TUR, posted on the sites of clinics and on medical forums, demonstrate the high efficiency of manipulation.

Patients note a quick recovery, restoration of the reproductive and urinary systems, elimination of pathological symptoms, the return of a full life, the absence of problems and pain. The TUR operation is safe, but there are risks of pathological processes in the postoperative period.

Short-term aggravating conditions:

• Bleeding. After TURP, a small amount of blood in the urine is considered acceptable, but persistent severe hemorrhages are a sign of serious complications. Sometimes a large blood loss requires a blood transfusion;
• infectious processes. With prolonged use of the catheter, the introduction of pathogenic microorganisms into the urinary tract is possible;
• Impaired urination. Involuntary excretion of urine is expected after surgery and resolves after a month. Short-term inability to urinate occurs several days after medical manipulation. A catheter is used to help drain the accumulated fluid;
• water intoxication syndrome. Occurs very rarely, is a serious complication. Excess fluid is excreted with diuretics.

Long-term postoperative complications:

• violation of ejaculation. Seminal plasma can be thrown into the bladder. Incorrect ejaculate passage does not reduce sexual pleasure, but affects the ability to procreate;
• Erectile dysfunction. Sometimes impotence happens;
• urinary incontinence. Temporary incontinence is possible, in exceptional cases, in some patients, the ability to restrain the fluid secreted by the kidneys is lost;
• repeat operation. In 10% of cases, men who have undergone TURP require another surgical intervention. Large formations of connective tissue contribute to urinary tract obstruction and require additional manipulation. Most often, urethral stricture occurs.

When can men avoid complete removal of the prostate?

For a man, the very reality of prostate loss is a huge stress. Considering that such drastic measures are taken only in emergency cases, it is not always possible to avoid surgical intervention.

The procedure is carried out in the following situations:

• large volume of accumulated urine, provoked by prostate adenoma;
• genitourinary infections;
• the presence of acute urinary retention;
• kidney dysfunction syndrome;
• urolithiasis;
• blood in the urine, exceeding the allowable rate;
• presence of complications;
• active growth of a malignant tumor.

Today, there is another popular way to remove an adenoma - destruction with a long-wave laser. A device inserted through the urethra through an endoscope acts on overgrown tissues, vaporizes and removes them. The obvious advantage of the laser method is the fact that the next day the patient is discharged home.

The price of the operation depends on a large number of factors. The country and the clinic matter.

The cost of prostatectomy consists of the following components:

• specialist consultation;
• full examination;
• conducting laboratory diagnostics, taking a puncture;
• diagnosis and confirmation;
• Patient state parameters;
• type of anesthesia;
• presence of cancer, other pathologies;
• presence of contraindications;
• length of stay in the clinic.

Related video

How a TURP is performed:

It should be remembered that, despite the use of modern equipment, prostatectomy is a rather serious medical manipulation, and after it, the patient must spend several days in the hospital under the supervision of specialists.