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Types of surgery for prostate adenoma
Types of surgery for prostate adenoma
Adenomas (oncological neoplasms) or diseases of prostatic hyperplasia, that is, BPH is a very common prostaturological disorder in males today. 9.5% of males in the age categories from 35 to 50 years old and 33% of men of advanced age 55-72 years old may have this disease. The disease of prostate hyperplasia is not as dangerous as cancer, but this factor does not exclude the threat of problems with sexual activity and the perception of various areas of life in males. Doctors distinguish three stages of prostatic hyperplasia. The first and second stages are subject to drug therapy, while the third involves only surgical intervention.
At the beginning of the twentieth century, medicine discovered one of the most effective surgical methods for treating oncology and prostate adenoma. When diagnosed with prostate adenoma, an operation is prescribed. This type of surgery is called "open prostatectomy". At the moment, such an operation is actively replaced by transurethral resections of the prostate glands, in other words - TUR, which are characterized by large-scale efficiency of the prostatic scale, and provide a chance for very short rehabilitation periods.
The characteristics of the prostate in transurethral resections of the prostate are as follows:
- Transurethral resection of the prostate is performed only when the volume of the prostate has reached 73-78 ml, no more;
- Disclosed options for intervention "prostatectomy" or "adenectomy" - if the volume of the prostate has exceeded 76 ml.
Minimally traumatic options for surgical operations on prostate adenomas:
- Green laser surgery for adenoma;
- transurethral ablative techniques with needles;
- vaporization transurethral;
- prostatic stent;
- robot-assisted prostatectomy (a manipulation that does not use the hands of the surgeon, but a specially designed artificial intelligence).
Symptoms of the disease
Adenoma of the prostate is an operation performed in the prostate on neoplasms that resemble nodes of various shapes and sizes. Their occurrence is explained primarily by age-related changes. With age, the endocrine system malfunctions, in which the male gland located next to the bladder can begin to enlarge and many men experience discomfort, manifested by such factors:
- when the urethra is empty, a painful sensation is formed, despite the fact that the urge is disturbing quite often (most often at night);
- urinary streams are absolutely sluggish, often urinary processes are interrupted. If you do not visit the doctor on time, for some time the stream becomes minimal, possibly even drip urination due to the prostate in men;
- due to the distorted work of the prostate glands, urine begins to leak (possible violations of the channels in the ureter);
- in the process of urination, the canals and the body are subject to tension, therefore, hernias form from such overvoltage, the rectum is often disrupted, over time the latter may even fall out;
- erectile function slows down its work, the ejaculation process is disrupted, pains during erection are formed;
- pain is found in the groin area, which systematically radiates to the lower back.
Preliminary Investigation Procedure
How are complete diagnoses made? In order to determine one of the multiple therapies for sick patients, they are carefully researched.
Therefore, the following procedures are carried out:
- the patient needs to undergo urine and plasma tests. This is necessary in order to specifically determine the overall picture of the health of the prostate and the likelihood of disease in other parts of the body not associated with the pelvic organs;
- uroflowmetric research method, in which the doctor can identify complex degrees of distortion of the urinary flow rate;
- rectal forms of monitoring the state of the prostate gland;
- the method of transrectal ultrasound observation of the prostate glands is the main way to obtain a sufficient amount of information about the size of adenomas and other structural features of pathogenesis;
- Receive Prostate Specific Antigen (PSA) Sheets to clarify the possibility of cancers affecting the prostate.
Surgical treatment options
In the context of the progression of medical research, a large number of surgical solutions are used to remove prostate hyperplasia.
Of these, the main ones can be distinguished:
- Open surgery (adenomectomy) is a traditional method;
- transurethral incisions;
- laser treatments for precancerous cells;
- transurethral operable tissue incisions;
- arterial embolization method;
- laparoscopic incision techniques;
- enucleation of prostate adenoma.
Popular prostate adenoma surgeries
Surgery to remove prostate adenoma in medicine is called the gold standard for a quality cure for the disease of prostatic hyperplasia. Such a resection consists of a complete or partial excision of the prostate gland using instrumental support, which is carried out through the urethra.
The operation to safely remove the prostate gland is performed as follows:
- current at high frequency, which is propelled by the wire loop. This operation removes damaged areas of the prostate glands and restore the circulatory system;
- cystoscopy. It is used to visually guide and control the resection of prostatic hyperplasia. This was the reason to call these types of interventions endoscopic operations of prostate adenomas;
- The patient is obliged to use the catheter in the urine discharge channel for two days while in the hospital under the supervision of doctors.
A global proportion of men (81% -92%) show an absolute improvement in their physical condition after this surgery.
There is a term "open prostatectomy". It involves the removal of prostate adenoma, used for men with a prostate over eighty grams. In this case, only the prostate gland is removed, leaving the testicles.
This procedure performs the following actions:
Laparoscopy of adenoma of the prostate is a method that does not require severe surgical intervention, which involves only small holes in the abdomen of patients. Micro-cameras and the necessary surgical device are inserted into these incisions.
The advantages of this operation are as follows:
- the time of the operation can be visually inspected on the monitor screens (microcameras have the maximum resolution);
- there is a special ultrasonic knife that cuts out the affected part of the prostate tissue that is least affected;
- After surgery, catheters are left in the urethral canal for six days.
The method of laser prostatectomy is performed with the involvement of laser pulses with waves of different duration. With such an operation to remove a prostate adenoma, the risk of complications is extremely minimal, or absent altogether. The risk for the patient to remain impotent, to receive intraoperative blood loss, retrograde ejaculation, problems in the reproductive system and enuresis is reduced.
Transurethral needle ablation surgery involves a high frequency of radio waves, while causing thermal (thermal) disruption in the tissues of the prostate gland, damaging it. The needle delivers energy to the area of the prostate gland, which is localized. This is one of the fastest procedures performed under local anesthesia. Its implementation does not require the subsequent installation of catheters. The only problem is that doctors have not yet determined the duration of effective exposure.
A prostatic stent is a flexible, self-expanding device that is placed in the urethral canal for prostate adenoma to subsequently maintain patency in the urethra. The degree of optimization of the symptoms of this operation is compared with TUR, although additional optimized studies should be used.
Best sides of a prostatic stent:
- short duration of surgery under local anesthetics;
- a small amount of plasma flows out;
- there is no need to constantly wear a catheter in the postoperative period;
- the operation is performed as an outpatient therapy;
- transurethral vaporization implies simultaneous evaporation and clotting of prostate tissue, therefore, hemorrhage is minimized as such;
- Patients wear postoperative drains for only one day; they spend the same amount of time in the hospital.
The cost of laparoscopic prostatectomy is about 140 thousand. TUR costs 49 thousand. In the case when the patient wishes to resort to the method of radical (cavity) prostatectomy, this operation will cost him 56 thousand.
In Belarus, such operations are carried out only in medical institutions in Minsk
It is worth remembering that during the initial recovery periods, that is, two weeks, everything must be done to avoid stress and sudden movements. A man should drink plenty of water in order to flush his bladder and prevent constipation. In case of constipation, it is necessary to consult a urologist for medical assistance.
