Pain after prostate tour surgery

How to treat complications during rehabilitation after TUR of prostate adenoma

TUR (transurethral resection) of prostate adenoma is a minimally invasive operation during which the overgrown glandular tissue in the region of the prostatic part of the urethra is removed. This type of surgical intervention refers to endoscopic. Access to the adenoma is carried out through the male urethra, which provokes a number of negative consequences from the genitourinary system. Recovery after TUR includes rehabilitation measures aimed at preventing and eliminating complications.

What complications are associated with rehabilitation

Rehabilitation after resection of an adenoma lasts an average of 2-3 weeks. The fewer concomitant diseases, the faster this period ends. Previously, patients spent 7-10 days in the hospital. Modern technologies allow to reduce the length of stay in the hospital to 1-3 days. After the same time interval, the urinary catheter is removed. The very next day after the operation, it is recommended to get out of bed to prevent stagnation of blood in the pelvic area. Good blood supply to tissues will allow the body to complete tissue regeneration processes faster.

Physical activity in the postoperative period is completely excluded - you can not lift more than 1.5 kg. Violation of the rules can provoke bleeding and discomfort.

The cause of pain in the early recovery period is sometimes the material of the catheter, soft silicone, which is tolerated by patients much better than rubber.

The list of complications after TUR includes urination disorders, pain, and infection. In some cases, erectile dysfunction occurs.

Urination

Urine leakage may occur after catheter removal. Episodes occur mainly during coughing, sneezing, laughing. Occasionally there is drip incontinence or frequent urge. This complication is provoked by irritation of the receptors caused by surgery. Urination returns to normal in 1-2 weeks. It is usually not necessary to treat such symptoms.

Sometimes Urinary incontinence is severe. The cause is damage to the sphincter of the urethra. The use of bipolar or plasma resectoscopes eliminates such consequences.

Conservative restoration of sphincter function is possible with the help of Kegel exercises. They can be performed only from the 2-3rd week with the consent of the doctor.

Internal bleeding

In most cases, in the first days of recovery after TURP, urine with blood passes through the catheter - the bladder and urethra are cleared of tissue debris, and damaged vessels become empty. Bleeding may appear later - after 2-3 weeks (maximum after a month). This is due to the healing of the wound surface of the prostate and the discharge of the scab ("crust"). This state of affairs does not last long. If the bleeding is heavy, you need to call a doctor.

Infectious inflammation

In modern clinics, plasma instrument sterilizers are used, which minimizes the likelihood of patient infection. However, infection is also possible during a hospital stay. In 30% of cases, infection occurs with the so-called hospital microflora, which is resistant to most drugs.

As a prophylaxis, 5-7 days before the operation, antibiotic therapy is carried out (appointed according to the results of a urine test). In the first week of recovery after TUR, the course is repeated. If a complication nevertheless develops, then a bacterioscopic analysis of urine is performed and appropriate antibiotics are prescribed.

To reduce the risk of infection after excision of a prostate adenoma, the patient should drink 2-3 liters of fluid daily (before 8 pm). This measure prevents the reproduction of pathogens in the bladder and urethra.

Erectile dysfunction

Sexual life should be started no earlier than one month after prostate surgery and only if the recovery is uneventful. erectile function after TUR is usually not disturbed. On the contrary, the normalization of arterial blood flow to the penis helps to strengthen potency. If necessary, PDE-5 inhibitors (Sildenafil, Vardenafil) are prescribed to improve erectile function.

The expansion of the lumen of the prostatic part of the urethra can cause retrograde ejaculation (sperm enters the bladder). This does not harm health, but causes psychological discomfort and causes male infertility. To combat the pathology, medical and surgical treatment is used.

Diet after TOUR

Recovery at home includes taking antibiotics, drinking enough fluids, following a diet, and following doctor's recommendations. The patient is usually given a detailed list of medications and prescriptions.In the first weeks, all irritating foods and drinks are excluded from the diet:

• strong tea (including green), coffee, cola, alcohol;
• salty and spicy dishes;
• fatty and fried foods;
• spices and marinades.

The diet should include a sufficient amount of fiber (cereals, vegetables, fruits). This will ensure timely emptying of the intestines, eliminate the injection of excessive pressure in the pelvic region. To enhance the antiseptic effect and speedy recovery of urinary tract tissues, the following drinks are useful:

• lingonberry and cranberry fruit drinks;
• herbal decoction: bear ears, bearberry, lingonberry leaves;
• infusions on rose hips, mountain ash.

Recovery after TUR in most cases proceeds without complications and does not require additional treatment. Many patients return to work after 1-2 weeks of rehabilitation at home. After 1-2 months there is a complete recovery of the body. During this time, you must follow a diet and take precautions.

Consequences of TUR of adenoma

Complications after prostate adenoma surgery is an extremely important topic for men who are going to have TUR or open surgery. This article presents all the possible complications and consequences after the removal of prostate adenoma, the postoperative period and rehabilitation after TUR of the adenoma.

Removal of prostate adenoma: consequences

In my practice, I adhere to a simple rule: if a patient is indicated for one or another planned surgical intervention, I tell about all possible risks and complications and insist that he make a decision not at the time of the conversation with me, but at the earliest - the next day . Simply because the patient must make a conscious and informed decision, know and clearly assess all the risks. This leads to better interaction between the doctor and the patient, respectively - the result of the treatment is much better.

With regard specifically to the consequences of the removal of prostate adenoma, we will certainly discuss both mild and transient postoperative negative aspects, as well as serious complications and ways to overcome them. Pain and urinary incontinence after TURP, inflammation and fever, bleeding and just an admixture of blood in the urine after, Frequent urination and cloudy urine, rehabilitation and diet after the intervention - all these issues require detailed discussion.

Postoperative period after TUR of adenoma

TUR syndrome

The most common operation to remove adenoma is transurethral resection - TUR of prostate adenoma. The most formidable complication after it is TUR syndrome - water intoxication of the body. The fact is that the washer fluid used during the intervention can be absorbed into the bloodstream and cause "water poisoning". This is a dangerous, sometimes resuscitative complication. An isotonic solution of a liquid in which monopolar energy works causes the destruction of red blood cells and a violation of the electrolyte state of the blood. This can be deadly, especially for patients with heart disease. Despite the fact that the incidence of TUR syndrome does not exceed 0.3%, this complication of TUR of the prostate is the reason for the rejection of monopolar TUR.

Hospitalization after TURP

If earlier, when using monopolar transurethral resection of prostate adenoma, the patient lay 7-10 days, then modern technologies can reduce hospitalization to 1-3 days. The same applies to the presence of a urinary catheter in the postoperative period after TURB: now we leave the catheter for only 24-48 hours. In the postoperative period, there may be an admixture of blood in the urine for some time, in rare cases - drip incontinence and frequent urination. All these phenomena disappear after 2-4 weeks and do not recur in the future.

Pain after TUR of prostate adenoma

The occurrence of pain after TUR of prostate adenoma is associated with several reasons: the use of a rubber catheter, inflammation, bladder overflow and untimely anesthesia.

Bleeding after TUR of prostate adenoma

In transurethral resection of the prostate gland, tissues are cut off with a special loop. Naturally, this leads to damage to the capillaries and blood loss. However, bipolar and plasmokinetic types of interventions simultaneously with cutting allow coagulation of blood vessels. This allows us to do without any significant bleeding, while calmly completely removing all adenomatous tissue.

Temperature after prostate adenoma removal

With any surgical intervention, inflammation and, as a result, an increase in body temperature are possible. That is why we conduct urine and blood tests before the operation, excluding the presence of inflammatory changes.Before surgery, we prescribe broad-spectrum antibiotics and continue their use for 5-7 days after surgery.

Complications after surgery (TUR) for prostate adenoma

Urinary incontinence after TUR of prostate adenoma

Urinary incontinence after TURP is associated with damage to the urethral sphincter. Most often, urinary incontinence after removal of prostate adenoma occurs when using a monopolar resectoscope, while bipolar or "plasma", being devoid of many disadvantages, can avoid this complication. Treatment of urinary incontinence after TUR of adenoma is to perform Kegel exercises for men, however, these exercises can be performed no earlier than 2-3 weeks after TUR of prostate adenoma.

Frequent urination after removal of prostate adenoma

This situation is associated with two factors: irritation of the receptors after TURP and the "habit" of the bladder to strong contractions. Frequent urination develops in 20-30 patients who underwent surgery, usually disappears 1-2 weeks after TURP.

Turbid urine after TUR of prostate adenoma

This is not a complication, but a standard situation. A maximum of 1 month after TUR of adenoma, the urine becomes cloudy. There is nothing to worry about, but this must be reported to the doctor. Cloudy urine or blood in the urine after TURP is associated with the discharge of a scab from the surface of the removed prostate. As an analogy, one can cite the discharge of a wound scab, for example, after a knee injury. After 1-2 weeks, a dry scab leaves. The same thing happens with the scab after the operation of TUR of prostate adenoma. Unlike the knee, an eschar in the prostate bed is constantly bathed in urine, so cloudy urine is noted.

Urethral stricture after TUR of prostate adenoma

Most often, this complication occurs in inexperienced urologists or when using outdated equipment, the cause is electrosurgical damage to the urethra. The occurrence of urethral stricture requires a second operation.

Rehabilitation after TUR of prostate adenoma

As a rule, special rehabilitation after TUR of prostate adenoma is not required. In most cases, patients start going to work a week after the operation. Many patients ask the question: "Will the erection suffer after TURB surgery"? No. With correctly performed bipolar or plasma resection, in almost all cases, the erection improves significantly, which is associated with the normalization of arterial blood flow to the penis.

Professional approach: modern diagnostics and minimally invasive interventions.

Team: Endourology Specialist Group.

Concil of specialists to ensure safety even in elderly patients.

Equipment: Karl Storz and Olympus bipolar and plasmakinetic resectoscopes.

Comfort: no queues at admission to a premium class hospital.

Safety: using the methods recommended by the professional associations EAU and AAU.

Result: getting rid of prostate adenoma and its complications.

As well as GCP certification, confirming the highest standards of diagnosis and treatment.

We will arrange hospitalization on the day of arrival, conduct the necessary examinations, and establish an accurate diagnosis. We will organize your treatment as soon as possible.

Good afternoon. I turned to Hovhannes Eduardovich a few years ago with a very unpleasant male problem (I can’t remember the exact name, but the young wife began to doubt the correctness of choosing a life partner in the evenings and at nights). Unlike other doctors, Hovhannes Eduardovich gave me an exact diagnosis and solved my problem extremely quickly (although his phrase, on the second day after the examination, we will operate, at first scared me with determination). Now I am happy to watch my daughter grow up, and I understand that if it were not for Hovhannes Eduardovich, everything could not be so rosy. To top it off, I can say that Hovhannes Eduardovich helped my father, a man who is distrustful of medicine, to cope with the problem of kidney stones, and to become, probably, the only doctor whom my dad believes and trusts.

Review from www.doctors.am

It so happened that quite serious problems arose in the urological part, which extremely interfered with a normal lifestyle. After a long search and visits to various hospitals, which, by the way, was mostly useless, my son introduced me to Hovhannes Eduardovich. And if not for him, everything would have ended very badly. Hovhannes Eduardovich gave me the necessary diagnosis in his own clinic. The diagnosis was not simple: urointestinal fistula and prostate adenoma. The fistula was intervened promptly, I was discharged, and after a while we again met with the doctor for further treatment. The operation was performed on the day of hospitalization, and on the fourth day I was already at home.A few days later, a completely new stage began in my life, which was distinguished by its quality. I am extremely grateful to Hovhannes Eduardovich. I can probably add only that I am amazed at the humanity: powerful charisma, magic hands, self-confidence, a wonderful sense of humor.

My father had very unpleasant symptoms in the urological and proctological parts, he turned to Dr. Dilanyan, who insisted on an urgent diagnosis. After several diagnostics of rectoscopy, colonoscopy, cystoscopy, the diagnosis of vesico-intestinal fistula, formations in the intestine and prostate adenoma was made. The colonoproctological part of the operations was not carried out by Hovhannes Eduardovich, but he provided us with all the information at a high level. We knew everything we needed and in the format we needed. Dr. Dilanyan himself took part in the operation to remove the fistula from the side of the bladder, and also performed the subsequent (3 weeks after the first) operation to remove prostate adenoma. The operations were as successful as possible, the father began to live a different life, the physiology worked as usual. My whole family is incredibly grateful to Hovhannes Eduardovich. Since then, I advise everyone to contact the doctor.

Review from the site doctors.amI want to express my gratitude to the doctor from God, this is Hovhannes Eduardovich Dilanyan! But first things first. I am a doctor myself, but we also get sick. I was diagnosed with adenocarcinoma in the prostate gland in a fairly advanced stage. I will not talk about what I experienced during this period, people who have gone through this will understand. They advised me to go to Germany, Israel. But a friend, a urologist surgeon, offered to contact Hovhannes Eduardovich, who at that time was in Yerevan. Perhaps it was fate. Hovhannes Eduardovich brilliantly performed an operation to remove a tumor (launched) using the laparoscopic method. A year and three months have passed - I feel great, I live a full life, all functions were restored somewhere within a year. Thank you very much DOCTOR JAN!

Moscow Center for Innovative Urology

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Urgent message about consequences after TURP

Occurrence, diagnosis and treatment of benign prostatic hyperplasia

Prostatitis is one of the most common diseases among the stronger sex. Most men who are faced with this problem prefer to ignore the painful symptoms, believing that the immune system will cope with them on its own. The consequences of neglecting your health can be deplorable. So, if prostatitis is disturbed by pain in the groin area and is provoked by various external factors or promiscuity, then it is much more difficult to diagnose and predict the development of prostate adenoma. The same symptoms of both ailments can mislead even a specialist.

Prostatitis occurs as a result of sexually transmitted infections, bacterial lesions of the genitourinary system or hypothermia. The reliable reason explaining the formation of an adenoma, represented by a benign tumor, remains still unknown. Medical luminaries continue to put forward various hypotheses, the most likely of which is the "hormonal theory".

Who is at risk

Statistics show that the age of men in whom specialists diagnose prostate adenoma ranges from 45-55 years. However, the formation of a tumor is likely in 40 years in 10-15%, and by the age of 80 the number increases to 55-75%, that is, almost every second man of advanced age suffers from benign prostatic hyperplasia. Every year, the tumor grows by 1 cm3, reducing the speed and abundance of urination.

The well-established expression "mid-life crisis" by which women justify infidelity, aggressive behavior, apathy, depression, and nervous breakdowns is quite appropriate in medicine as well. This is a real test not only for physical health, but also for the mental state.In addition, the representatives of the stronger sex are more susceptible to external stimuli and, unlike women, do not have high stress resistance.

Symptomatics and diagnosis of a benign tumor

The instability of the hormonal background provokes dysuric disorders, guided by which one can suspect prostate adenoma:

In connection with the increase in the size of the prostate, the structure of the urethra, the structure of the bladder and the sphincter muscles that regulate the process of urination are deformed. Having diagnosed the disease, the doctor prescribes a TURP (transurethral resection of the prostate) to the patient. In case of untimely medical intervention, the patient is at risk of pyelonephritis, against which kidney failure develops and bleeding or the formation of kidney stones are possible.

Consequences of adenoma resection for the patient

TUR of the prostate is considered a more gentle way to eliminate the disease compared to open prostectomy. The patient feels discomfort only for the first 10 days. During the procedure, the doctor inserts a urological resectoscope equipped with an electric loop through the urethra. With its help, pathological tissue is removed and bleeding vessels are cauterized with a low-electrolyte saline or isotonic solution, which is appropriate in case of cardiovascular diseases in a patient.

The rehabilitation period after TUR is within 2-3 weeks, depending on the age of the patient and the state of health before the procedure. In the first few days after the TUR operation, the patient experiences frequent urge to go to the toilet, and urination is accompanied by a burning sensation. In 0.5-2.0% of patients, drops of urine may be released during sudden movements, physical activity, coughing or sneezing, when muscles contract. The first 24 hours after removal of prostate adenoma, bleeding may periodically resume. If it lasts more than a day, you should re-visit the urologist. As for the patient's sexual activity and sexual desire, the reaction of the body can be twofold and largely depend on the age of the patient.

According to statistics, at the end of the TUR operation, every second man reported an improvement in libido. However, a positive trend is observed in patients aged 40 to 55 years. 30% of the respondents did not feel any changes after the TUR operation. In 12%, erections noticeably worsened. However, urologists say that most complaints about the lack of sexual desire and erectile dysfunction after adenoma surgery came from patients over 60 years of age and, as practice shows, in older men this is not an exception, but rather a pattern. Therefore, it is not the doctors who perform the operations that should be blamed, but Mother Nature and the natural aging process of the body.

Treatment of patients during the rehabilitation period

During rehabilitation at the end of the operation, the doctor prescribes drug treatment to the patient with antibiotics, anti-inflammatory drugs, painkillers and alpha-blockers. In some cases, the temperature may rise, so it is necessary to have antipyretic pharmacological preparations on hand. The most popular are levofloxacin, metformin, aspirin and Coumadin.

For a month, retrograde ejaculation is possible, causing fear in men. At the end of sexual intercourse, the sperm is not thrown out, but enters the urinary canal, so the absence of visible traces of ejaculation is not an indicator of reproductive dysfunction. Over time, the ability to fertilize will be restored, and therefore it is necessary to protect yourself during sexual intercourse in order to prevent unwanted pregnancy.

Particular attention should be paid to nutrition after the TUR operation. Food should be rich in fiber, vitamins and minerals. The daily menu should be diversified with fruits and vegetables containing a huge amount of liquid. These included tomatoes, apricots, peaches, watermelons and exotic citrus fruits, especially oranges and tangerines. To improve potency, a patient who has had a TURP needs to consume greens and nuts. A balanced diet and a strict eating regimen contribute to a quick recovery.

Fatty and meat products should be avoided for a week. Food should be low-calorie and easily digestible. Diet helps to normalize the process of defecation. Drinks and foods containing alcohol should be excluded from the diet. Alcohol, soda (especially caffeinated water), salty or spicy foods irritate the urethra and cause sharp pain in the groin.

After TUR surgery, the patient should drink at least 2.5 liters of water per day, despite frequent urination, to restore the prostate. This precaution helps to prevent possible dehydration and speed up the natural metabolism.

A positive trend is observed in men leading an active lifestyle even after surgery.The first few days you need to walk a little, overcoming pain, and gradually develop the muscle mass of the small pelvis. Bed rest is the main cause of constipation and malfunctioning of the gastrointestinal tract. In addition, doctors do not recommend sitting on hard surfaces for more than 30 minutes. A prerequisite after TURP is movement.

Long water procedures and baths are strictly prohibited! A man after prostate surgery can rinse under running warm water for no more than 3-5 minutes only after 2 days.

Speedy recovery is facilitated by the removal of the catheter and Kegel exercise, which strengthens the muscles of the pelvis. To perform it, you must try to interrupt the process of urination for a couple of seconds, and after the expiration, continue to relieve yourself. Thus, a man re-learns to regulate the natural processes in the body. Over time, it is necessary to increase the duration of the interval and compress the desired muscle for 30-40 seconds.