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Diseases of the urogenital area are considered one of the most common among all pathologies in men. This is a whole group of diseases with similar symptoms. One of them may be Residual urine - ischuria, when the bladder is not completely emptied.
Normally, men may have an insignificant accumulation of urine (up to 50 ml). In the presence of pathological processes in the body, the volume of non-excreted fluid can be up to 1 liter. This phenomenon can lead to serious complications (hydronephrosis, pyelonephritis). The first signs of impaired urination require early diagnosis and adequate treatment.
In men, this syndrome can be a signal for the development of a number of diseases that cause difficulty in the outflow of urine through the urethra:
Additional causes of innervation can be:
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In a healthy man, the emptying of the bladder should be complete. The allowable residue rate is about 10% of urine, that is, for an adult it is no more than 50 ml. If its volume is higher than the permissible norm, it can be argued about the development of urological pathologies. To confirm or refute the diagnosis, you need to accurately determine the amount of urine remaining.
There is complete or incomplete urinary retention. With a full delay, even with strong straining, a man cannot pass urine at all. Partial delay is the incomplete emptying of the bladder.
Additional signs indicating an increase in the amount of residual urine:
With a gradual increase in residual urine and prolonged obstruction of its outflow, chronic ischuria develops. With incomplete emptying, the disease can be asymptomatic for a long time. The patient can identify the problem only after the occurrence of complications due to stagnation of urine and impaired renal function.
Prolonged retention of urine leads to stretching of the muscles of the bladder and sphincters. From a crowded organ, urine begins to involuntarily stand out. Paradoxical ischuria develops. Constant urination in incomplete portions leads to the fact that an acute delay can not be recognized in time. The second stage of the disease develops, in which degenerative-dystrophic changes in the nerve receptors of the bladder occur.
With chronic residual urine, kidney function is almost always impaired. A man may be disturbed by:
If a man has impaired urine outflow and does not take any measures to eliminate the problem, this will eventually lead to the development of dangerous pathologies:
It is impossible to independently determine the volume of residual urine. To do this, they resort to such research methods as bladder catheterization and abdominal ultrasound.
Quite often, diagnostics give false positive results. The fact is that normally it is carried out within 5 minutes after urination. But, as a rule, more time passes between going to the toilet and the examination, and a new portion of urine has time to accumulate in the bladder.
Diuretics can distort the diagnostic results, as well as the use of a large volume of liquid the day before. Some patients find it difficult to go to the toilet in a polyclinic due to a certain psychological discomfort.To get more reliable results, the analysis must be carried out at least 3 times.
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To find out the causes that cause urinary stagnation, a more thorough diagnosis using laboratory and instrumental methods may be required:
To get rid of residual urine, you need to restore the patency of the urethra.
Since the pathological condition is a symptom, and not a separate disease, it is possible to restore normal urination only after eliminating its root cause:
Its main task is to cure the disease that led to the residual urine. With atony of the bladder, drugs are prescribed that restore the ability to contract. With spasms, muscle relaxants are recommended. If they do not have the desired effect, a selective dorsal rhizotomy is performed. This is a dissection in the bundle of nerves of the spinal cord of those that provoke spastic contraction of the organ.
If incomplete emptying in men is caused by cystitis, treatment should include taking antibacterial drugs, which the doctor selects based on the type of pathogen. Antibiotics of the group of macrolides and fluoroquinolones are effective. Additionally, antispasmodics, diuretics, vitamins, immunomodulators, as well as dietary nutrition are prescribed.
In case of urolithiasis, treatment consists in the elimination of calculi. Depending on the types, sizes, and shape of the stones, the doctor may prescribe conservative therapy with the use of stone-dissolving drugs. But in most cases, surgical intervention is used, since drug therapy is ineffective in the presence of large formations and those that cannot be dissolved. An effective surgical method of treatment is lithotripsy (crushing stones using ultrasound or a laser). The operation is low-traumatic, does not violate the integrity of the patient's skin. Recovery after crushing takes place quickly enough, without serious consequences.
For the treatment of narrowing of the urethra, bougienage is often used - the introduction of special instruments into the urethra that expand it. This method does not eliminate the main cause of the narrowing and gives only a temporary effect.
When a large amount of fluid accumulates in the bladder and it is impossible to empty it naturally, one has to resort to the catheterization method - the introduction of a rubber catheter into the urethra. The procedure is performed by a doctor in a hospital. Self-insertion of the catheter at home is prohibited - the risk of infection of the bladder is high.
First, the urethral opening is treated with a disinfectant. The catheter is moistened with glycerol and inserted into the urethra with tweezers. Movements must be done progressively, gradually moving forward by 2 cm. You can not forcibly move the catheter forward. For some diseases (for example, urolithiasis), such a procedure can lead to serious consequences.
Sometimes it may be necessary to place an indwelling catheter. It must be in the urethra for several days. To prevent infection, the bladder should be washed with antiseptic agents (Furadonin, Nitroxoline). An oral antibiotic may be prescribed. If catheterization is not possible, the patient is referred to a urologist, where the issue of the possibility of surgical intervention to eliminate the cause of urinary retention will be resolved.
Video - expert recommendations on the treatment of residual urine in the bladder in men:
After the act of urination, a man may have urine in his bladder. Normally, this should not be, but if less than 10% of urine remains, this condition can also be considered normal. If the volume of residual urine exceeds 10% of the total, then this is a symptom of the disease (more than 40 ml of urine). This cause is more common in children or older men. This is due to a reduced tone of the muscles that are responsible for emptying the bladder or hypertonicity of the urethral sphincters.If the problem of residual urine is left unattended and untreated, there is a risk of diseases such as:
The development of complications is associated with reflux of urine into the ureter and kidney or prolonged retention in the bladder and, as a result, prolonged exposure of the bladder wall to harmful substances contained in the urine.
Diagnosis of residual urine is a difficult research method. Therefore, for its compliance with certain measures:
After a man has performed an act of urination, the volume of urine that remains in the bladder is determined. This can be done in two ways: bladder catheterization or ultrasound. Ultrasound is a non-invasive research method. The volume of residual urine is normally impossible to determine by ultrasound or its small amount is determined. This method is used in clinics because of its simplicity and availability. However, the accuracy of the result is low due to the indirect determination of urine volume (with ultrasound, residual urine is calculated using formulas). Bladder catheterization is a reliable method for determining the volume of residual urine in the bladder in men. The disadvantage is the need to use a catheter, which can injure the urethra or bladder. Due to the fact that it is a difficult procedure to determine the volume of residual urine, the norm may be a false positive result. This is due to the errors that were made during the diagnostics:
Due to the high probability of errors occurring during manipulation, the test must be carried out at least three times. Diagnostic procedures are also prescribed to identify the disease that caused the residual urine. It is mandatory to prescribe a general blood and urine test, as well as sowing discharge from the urethra and determining the sensitivity of the microflora.
Residual urine is a sign of urinary tract disease and is never the only symptom. Associated symptoms may include:
Residual urine may be suspected if the urge to urinate has become less pronounced and over time the man feels the desire to go to the toilet less often and less strongly.
If these symptoms are detected, you should consult a doctor to find out the cause and prescribe the appropriate treatment.
The causes of residual urine can be nervous diseases, infectious-inflammatory or malignant processes in the male genitourinary system. Neurogenic bladder is the main cause of residual urine. With this pathology, the muscles of the bladder become weak, do not contract, as a result, there is no urge to urinate and, as a result, urine accumulates. Due to the weakness of the muscles, the bladder is not able to completely empty. Neurogenic urinary tract occurs when there is a violation of the part of the nervous system responsible for urination. At the same time, the pressure remains high and urine is thrown into the ureters and kidneys. The disease can be combined with a lack of urge, excessive tension of the pelvic muscles during urination, or painful sensations during trips to the toilet. The outcome of this disease is the development of severe kidney pathologies. In addition to a neurogenic bladder, the causes of residual urine are:
If residual urine has been detected in a man, treatment should be given immediately. Therapy should be aimed at eliminating the cause that caused the appearance of residual urine. In addition, there are basic principles of treatment:
One of the first symptoms of bladder cancer is the presence of residual urine. Several methods are used to treat a malignant neoplasm of this localization:
These methods will help eliminate the accumulation of residual urine in the bladder
For the treatment of prostate adenoma, it is advisable to use hormonal preparations that reduce its size, as well as herbal preparations.In case of ineffectiveness, surgical treatment is performed:
In addition, cryodestruction, the use of high temperatures or exposure to the prostate with laser radiation has a positive result. To reduce the volume of residual urine, balloon dilatation of the urethra is also used so that urine can flow freely.
Given that cystitis is an infectious pathology, treatment should be aimed at eliminating the pathogen. For this apply:
It is also necessary to strengthen the immune system with the help of immunomodulators, vitamins and hardening of the body.
Stones in the bladder irritate its wall. As a result, the contractile function is impaired, and the bladder is emptied with the formation of residual urine. For the treatment of this disease, there are conservative and surgical methods. With small sizes of stones, a diet is prescribed depending on the composition of the stone, as well as medications. However, their effectiveness is low and they act only on stones consisting of urates. To reduce pain and spasms caused by damage to the bladder wall with a stone, analgin and no-shpu are used.
The stones are promptly removed using a cystoscope, which crushes the stones. This type of surgery helps to avoid injury to the bladder. If this method does not work, the operation is performed with open access and opening of the bladder.
In addition to surgery, there are non-invasive methods of treatment. Remote lithotripsy helps break up stones using electromagnetic waves. However, this method is not effective in all cases and is not prescribed for large stones.
The amount of urine that remains in the human body after urination is called residual urine. Regardless of age, this is considered a deviation. Urine retention may be complete or incomplete. In the first case, the patient feels the urge to go to the toilet, but cannot do it. Sometimes for several years emptying occurs only with the help of a catheter. With incomplete retention, urination occurs, but not completely. Residual urine in the bladder often provokes the formation of stones and the development of inflammation. Lack of treatment is unacceptable. After all, each time the disease progresses, the level of residual urine is constantly growing, the bladder begins to stretch, pain appears, and at the end - urinary incontinence.
The norm of residual urine for men and women is 3040 ml. The critical figure is 50 ml. This means that the normal outflow of urine is disturbed in a person, and diseases develop. As for the norms of residual urine for a child, they are as follows:
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Residual urine can occur for a variety of reasons. In general, they are divided into three groups:
Uterine fibroids and ovarian cysts in women can prevent urine from leaving the body.
Obstructive disease is considered to be a health problem that prevents urine from leaving the body. For example, stones, tumors, polyps, Prostate adenoma in men, uterine fibroids and ovarian cysts in women, as well as narrowing and soldering of the urinary canals. Swelling of the urethra and contraction of the muscles of the bladder, which occur due to inflammatory infectious diseases, also lead to urinary retention. So, the prostate, cystitis, urethritis provoke the occurrence of residual urine.
The last group of causes include the loss of central nervous system control over urination. In such cases, the bubble itself is healthy, and the problem lies in the muscles of the organ or sphincter, which stop contracting at the right time. The causes of this state of the body are often sclerosis, injuries of the spinal cord and brain, congenital pathologies of the central nervous system, and diseases of the spine. The fact is that antidepressants, antiarrhythmics, diuretics, hormonal drugs, drugs for Parkinson's disease, as well as some painkillers negatively affect the tone of the organ.
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When you leave the toilet, but you have the feeling that there is still urine left inside - the first wake-up call and a symptom of bladder disease. Also, symptoms include unstable or intermittent flow of urine, or when it comes out in drops. In addition, the presence of such a symptom as the continuous process of urination after tension in the muscles of the abdominal wall also determines health problems.
Doctors associate other symptoms with diseases that provoke the appearance of final urine.So urolithiasis is characterized by frequent urination, pain in the area of the bladder, the appearance of blood in the urine. And also when urinating, patients experience itching and burning. Usually the pain gets worse after exercise or hard work.
With prostate, men suffer from pain in the groin and disorders of sexual function. And pyelonephritis leads to pain in the lower back, a sharp increase in body temperature to 37.538 degrees, and there is also a feeling of general fatigue. Cystitis also causes frequent urination, sharp pains in the lower abdomen. During urination, itching and burning occurs. And also for a long period of time, the temperature rises to 37.138 degrees.
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This deviation is dangerous because at the first stage of development it does not have pronounced symptoms. This contributes to the progression of the disease and it goes into a more severe stage. At the second stage, the manifestations are already more pronounced. But even now they can be confused with the common cold, as it is chills, fever, back pain. Therefore, it is very important to carry out the determination of the residual volume of urine. If it exceeds the norm, then this is the first symptom of illness.
Urine analysis in combination with other diagnostic methods will help determine the pathology.
Determination of residual urine is a rather complicated process and consists of a set of measures:
So, first of all, in order to determine the volume of residual urine (RUR), it is necessary to conduct clinical blood tests, urine tests and an analysis for bacteriological urine culture. The next step is an ultrasound of the bladder, prostate, uterus and ovaries. In addition, if necessary, the patient has to undergo a cystoscopy and urodynamic study. Cystoscopy is considered the most effective, but it is also known for its harm. Therefore, doctors prescribe this procedure only in extreme cases.
Also, the definition of OOM is carried out using ultrasound. It is carried out twice. The first time with a full bladder, and then 510 minutes after urination. The amount of liquid is determined by a special formula. The height, width and length of the bubble are taken into account. In order for the OOM result to be accurate, the procedure is carried out 3 times.
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Unfortunately, there is a great risk that the results of urine residual volume tests may be erroneous. Therefore, if you have a positive diagnosis, do not worry and repeat all the procedures. So, before undergoing an ultrasound scan, you need to refrain from diuretic drinks, drugs, as well as those products that irritate the bladder. Indeed, 10 minutes after their use, the amount of urine increases by 100 ml, and, of course, the result will be distorted. In addition, all tests should be carried out immediately after the patient went to the toilet. Only under such conditions will the POM be measured correctly. Of course, in most cases it is impossible to undergo an ultrasound immediately after emptying.
And also, in order to completely empty your bladder of urine, urination must be done in the usual conditions, and in a hospital this is simply impossible. Also, the patient should go out of need in connection with the natural urge, and not because it is necessary. The posture also matters, it should be familiar. If you do not follow these rules, then, of course, the diagnosis will reveal the rest of the urine.
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If you suspect that you have excess urine in your body, seek qualified help immediately. After all, the consequences of your delay can cause you many problems. Very often, doctors have to operate on patients, because treatment with drugs is not able to help. And all this is only because of the belated determination of the final urine. Therefore, among the complications, the most common are:
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Residual urine in the body is not a disease, it only indicates its presence. That is why, first of all, it is necessary to determine the causes of the appearance of excess urine. Also, you need:
Basic principles of treatment:
Neurological abnormalities are considered much more complex. In this case, unfortunately, one cannot do without surgical and medical intervention. If the patient has atony, the doctor prescribes medications that will help the bladder restore contraction function. With his spasms, muscle relaxants are often prescribed.If all attempts were in vain, then an operation has to be performed, during which the doctor cuts in the spinal cord those nerves that form spastic contractions of the bladder.
Residual urine is an important criterion for determining the presence of pathological changes in the lower urinary tract. In a healthy body in the cavity of the bladder after the act of urination, the residual urine should not exceed 10% of the total volume of urine. Determining the amount of residual urine in the bladder is of great diagnostic value in a number of pathologies, usually requiring immediate treatment.
The act of urination (innervation) is a combination of the work of the muscular layer (detrusor) of the bladder, which, by contracting, ensures the removal of fluid, and the sphincters of the urethra, which regulate the retention of urine in the process of its accumulation until the desire to perform the act of urination arises.
Depending on the development of pathological changes in any of the structural elements of the urinary tract responsible for the removal of urine, various disorders occur, leading to damage to the detrusor of the bladder, followed by the development of atrophy and, accordingly, the inability to contract sufficiently.
Important! Although urine volumes greater than 50 ml are of clinical significance, the maximum residual quantity may exceed 1 litre.
Table: Permissible residual urine volume by age
Effective methods of treatment of benign neoplasms of the prostate gland In some diseases of the urinary tract, the emptying of the bladder in a man may be incomplete, as a result of which a small amount of urine remains in it, which is called residual. In a normally functioning, healthy body, this should not happen at all, but if no more than 10% of urine remains in a man’s bladder, this condition is also considered normal. In the same case, when the amount of residual urine formed is higher than the permissible norm, and 40-50 ml of urine remains in the man’s bladder (or more than 10% of the total capacity of the bladder), such a violation of the functional state of this organ can be considered one of the symptoms of the pathology.< /p>
The rate of residual urine most often increases in older men or children, due to a decrease in the tone of the muscular apparatus responsible for the outflow of urine from the urinary tract during the act of urination, as well as an increase in the tone of the urethral sphincters. Such a problem should not be ignored, since in advanced cases, residual urine can provoke the development of such serious diseases of the genitourinary system as hydronephrosis, pyelonephritis, diverticulitis, cause the appearance of chronic inflammatory processes and malignant tumors in the bladder.
The main reason for the progressive increase in the volume of residual urine in the bladder in males is the weakness of the detrusor muscle, which is located in the apex and body of the bladder and is directly responsible for the act of urination. Straining, the detrusor relaxes the muscular sphincter, which leads to the beginning of the act of urination. An increase in the volume of residual urine in the bladder is often facilitated by various functional disorders of the urethra (including complications of previous diseases). The amount of residual urine accumulated in the patient's bladder most often increases as a result of the development of the following urinary tract diseases:
As mentioned earlier, the rate of residual urine in men should not exceed 40-50 ml. If a much larger amount of urine remains in the patient's bladder, then such a symptom gives the doctor the opportunity to judge whether the patient has any urological disease. Diagnosing such a violation is quite simple - if, when a man goes to the hospital, a significant increase in the volume of the abdomen in the suprapubic region is determined, the doctor examines the patient by percussion and palpation of this area. Sometimes, the excess of the allowable rate of residual urine is very slight - in such a situation, an ultrasound scan of the urethra is performed. It is carried out by a qualified doctor immediately after emptying the bladder.
Residual urine is a violation of the functional state of the urinary tract, which is a constant symptom indicating the development of more serious pathologies of the patient's urethra.The lack of timely and adequate elimination of this problem often leads to the following consequences:
The appearance of residual urine in the bladder, its incontinence or retention is often the main cause of prostate adenoma and other pathologies of the urinary system in men. These symptoms cause a violation of the functional state of the urinary tract and reduce the contractility of the bladder.
Prostate adenoma is characterized by the presence of such complaints from the patient: difficulty in the outflow of urine during urination, incontinence, a feeling of insufficient emptying of the bladder (due to infravesical obstruction - squeezing the urination canal). Often, to eliminate such a problem, the doctor needs to perform a catheterization procedure with a mandatory examination of the patient for hidden diseases of the urinary system.
Since the rate of residual urine in a patient should not be higher than 40-50 ml, after a diagnostic examination, ultrasound and confirmation of the diagnosis of prostate adenoma, you should immediately start treating this pathology. Otherwise, the patient cannot avoid such severe complications of BPH as acute urinary retention, incontinence and hematuria (the presence of blood in the urine).
There are two main therapeutic tactics for managing patients suffering from prostate adenoma - this is the use of medications and surgical methods for removing the neoplasm. The decision to choose one or another method of therapy is made by the doctor together with the patient, depending on the size of the benign tumor, the stage of the disease, its clinical symptoms and the presence of concomitant pathologies. The optimal treatment tactics is carefully selected for each patient on an individual basis.
In this case, medicines based on aspen bark, pumpkin seeds, fan palm fruits, nettles, etc. are used.
As a result of many scientific studies, scientists have determined that some plants are able to eliminate infravesical obstruction of the urethra, relieve the unpleasant symptoms of prostate adenoma, as effectively as 5-alpha-reductase inhibitors. It is for this reason that herbal preparations are widely used in the treatment of various pathologies of the prostate. Medicines, which include plant components, not only reduce the size of the affected gland, eliminate inflammation and swelling of this organ, but also prevent further growth of the neoplasm.
The advantage of using such drugs is a mild and safe effect on prostate adenoma. But these herbal preparations are effective only at an early stage of the disease; at later stages of BPH, they are preferred to be used only as part of a combined treatment, together with alpha-blockers.
The following drugs are used - Tamsulozosin, Alfuzosin, Terazosin and Doxazosin. Preparations from this list quickly and effectively relieve irritation of the urethra and obstruction of the urination canal, eliminate urinary retention. The result of using these funds appears already in the 1-4th day of treatment.
In this case, the disadvantage of the pharmacological action of these drugs is that they do not affect the size of the prostate and the growth of BPH, as a result of which the disease continues to progress. Also, these drugs cause a fairly large number of side effects: hypotension, dizziness, retrograde ejaculation, migraine.
For the treatment of prostate adenoma, Dutasteride or Finasteride is most often used. The use of these medications is very effective if the size of the prostate does not exceed 40 cm3. They are especially helpful in preparing the patient for transurethral resection and any other prostate surgery. And all because taking these drugs significantly reduces blood loss in the patient, both during and after surgery.
The disadvantages of this method of treatment include a rather slow appearance of the effect of the use of these medications (4-6 months), as well as the manifestation of some undesirable side effects - an increase in the mammary glands in men, a decrease in erection and libido, the occurrence of azoospermia (a decrease in the number or the complete absence of spermatozoa in seminal fluid).
In this disease, suppositories with antiseptic, analgesic, anti-inflammatory and antibacterial effects are most often used. The choice of one or another type of suppositories depends primarily on the stage of BPH.
If this pathology is accompanied by an inflammatory process caused by infectious agents entering the prostate or urethra, then the doctor may recommend to the patient the use of antibiotic-based suppositories. Vitaprost is best suited for such purposes, which will not only eliminate a bacterial infection, but also reduce inflammation and swelling of the prostate.
Suppositories with an antispasmodic mechanism of action can also be used for the symptomatic treatment of prostate neoplasms. This should include rectal suppositories Buscopan and Papaverine. These medicines help relieve tension in the prostate, relax the vessels and small capillaries of the gland, eliminate muscle tension in the bladder, and improve blood access to the problem organ.
Anti-inflammatory suppositories include Dicloburn, Voltaren and Diclofenac. Also, these medicines have a pronounced analgesic effect. The action of these suppositories is aimed at improving the blood supply to the diseased organ and adjacent organs.
The use of suppositories perfectly eliminates the violation of outflow and urinary retention in prostate adenoma, which helps to normalize kidney function and reduce the risk of stones in them.
Beaver musk or beaver stream is a medicine of animal origin, which has a unique composition and has a peculiar smell. Considering this product from a scientific point of view, we can conclude that beaver musk is a fairly strong immunomodulator. Also, this tool tones the entire human body, eliminates nervousness, improves the functioning of the hormonal system and blood circulation, relieves inflammation, increases testosterone levels in the blood of a man.
Treatment of BPH using beaver jet takes quite a long time from 1 to 2-3 years. Take musk in the amount of 1 tsp. no more than 2 times a day with breaks of 6-7 days before each new month of admission. After 6 months from the moment of application of the remedy, various herbs with a regenerating effect are included in the therapy. Neoplasms of the male and female reproductive system are successfully treated with a beaver jet. Before using this medicine, be sure to discuss this issue with your doctor.
This surgery is performed without incisions (unlike abdominal operations) directly through the patient's urethra. For transurethral resection, it is necessary that the weight of the tumor does not exceed 60 g, and the volume of residual urine is 150 ml.
In most cases, during such a surgical intervention, not the entire gland is removed, but only a certain part of it. Therefore, after performing this kind of operation, the patient is recommended to take medications that inhibit the progression of the disease and the growth of the neoplasm. Although transurethral resection is not as painful and dangerous as abdominal surgery, this method of treatment still has certain disadvantages. This is mainly a large number of complications, among which it is worth highlighting retrograde ejaculation, bleeding, narrowing of the urethral canal, sclerosis of the cervical region of the bladder, incontinence or urinary retention. The consequence of a violation of the outflow of urine can also be a severe impairment of the patient's kidney function and the appearance of stones in them.
Laser contact vaporization - it is used in the treatment of BPH only when the volume of the affected organ does not exceed 30 cm3. In this case, the neoplasm is removed with a laser using the contact evaporation method. The operation is minimally invasive and is performed under direct visual control, which is provided by modern endoscopic equipment.
Contact laser resection - this operation to remove an adenoma is one of the most complex interventions that require great experience and skill of the surgeon. This treatment for BPH is similar to a transurethral resection but is performed using a laser. In this case, the affected gland tissues are removed by a controlled laser pulse.
Interstitial laser coagulation - is also carried out using a special laser, which is injected into the patient's urinary tract through a puncture of tissues and mucous membranes. Laser energy causes atrophy of the tissues of the affected prostate - and this, in turn, inhibits the growth of the tumor, and normalizes the process of urination. The disadvantage of this technique is that in the postoperative period, dysuria often occurs here, as a result of which it becomes necessary to install a special drainage for a long time.