TURP for prostate adenoma

As medical statistics show, today a huge number of middle-aged men are faced with such a terrible pathology as prostate adenoma. The essence of this pathology is an increase in the tissue muscles of the prostate gland, the process itself is absolutely painless, but it tends to cause negative consequences for the crane.

The prostate gland is located under the bladder region and is also surrounded by the urethra. Expanding in all directions, it can squeeze them, leading to problems with urination, respectively, to congestion in the bladder. Stagnant residual urine can provoke cystitis, pain, a burning sensation, as well as stone formation and sand.

The concept of prostate adenoma

The formation of adenoma of the prostate gland, or, as it is called today, the formation of benign prostatic hyperplasia, the abbreviation BPH, fortunately can be benign, does not spread metastases, because it is not a cancerous tumor.

At the same time, in order to avoid increased volumes, tumors, as well as the manifestation of further complications, if a doctor detects a prostate gland adenoma, a man is immediately prescribed a course of therapeutic intervention.

One of the methods of treatment of this urological disease is the widespread operation of transurethral resection of adenoma of the prostate gland today.

List of indications for surgery

Benign prostate tumors are very common. Today, many people of the stronger sex who are over 49 years old, as well as 74% of men who are over 69 years old, have faced such problems.

Adenomas of the prostate are the most common causes of surgery called TURP of benign prostate adenoma. It is performed when the volume of the prostate is no more than 78 cubic centimeters, also when the man is very young, but he really wants to preserve his prostate gland.

Surgery is performed when the following symptoms accompanying pathological progress are present:

• obstructive urinary tract disease - narrowing of the lumen in the ureter, the ureter neck decreases, therefore it is extremely difficult or painful to empty the urethra;
• frequent, painful urge to empty urine;
• the diverticulum of the walls of the urea (the tissues of the urea sag, due to which additional cavities are formed);
• the phenomenon of urinary incontinence in the bladder, urination at night, sometimes involuntary (enuresis);
• persistent infection associated with the urogenital tract;
• the volume of urine that is residual has exceeded 49 cubic centimeters.

Also, transurethral resection is performed when doctors have identified the threat of carcinoma - a malignant degeneration of tissue muscles. In this state of affairs, it is possible to save the prostate only with good general analyzes of the man, as well as if the stage of the pathology is initial.

What are the contraindications for TURP of the prostate?

Operative resection is not performed under the following conditions:

• benign tumors with terminal stages, or carcinomas affecting large volumes of the prostate gland, as well as tissues of adjacent organs;
• varicocele - varicose veins of the scrotum;
• pathology of ankylosis in the hip joint - immobility resulting from the fusion of tissue muscles;
• any inflammatory processes of active stages, even caries;
• Plasma clotting disorders;
• pathology of the cardiac, vascular systems.

How is TURP of the prostate performed?

Transurethral resection of the prostate is performed on average for an hour and a half. As an anesthesia, as usual, doctors use epidural anesthesia (injections into the spine). During the resection, the man is in a full state of consciousness, but half of the body into which the injection was made was not felt. If the patient wishes to use general anesthesia, doctors can use it as an anesthetic.

The patient is placed on the operating couch on his back, his lower limbs are divorced on both sides and fixed. The health worker treats all the external organs of the patient's small pelvis with antiseptics, in order to prevent infection, covers the man with a sterile sheet.

A special gel solution is applied to the urinary canal by injection. At this stage, the preparation comes to an end, the doctors begin the course of the operation.A resectoscope is inserted into the urinary canal - special equipment, which consists of a pair of tubes that allow the fluid to circulate in the desired direction, and also immerse all the necessary working elements.

During transurethral resection of the prostate gland, the working elements are made up of a special electrical loop. It is formed initially in a shape adjacent to the prostate gland. Due to the influence of electric currents, the loop produces a partial resection of the affected tissue muscle.

During a surgical operation, the loop damages the vascular circulatory system, this significantly impairs the visualization of the course of the intervention and does not allow the surgeon to fully control the process. This was the reason that during transturethral resection, an irrigation solution is used, which is supplied through the canal of a rectoscopic device, and removed by another canal. The irrigation solution helps to wash the gland, therefore, visualizes the area for resection.

Tissue cutting

The cut tissue muscle, which is called shavings, is sucked off using special pumps. After this procedure, the state of the vascular system is fully checked for integrity. If necessary, surgeons perform hemostasis (stop bleeding), then remove the resectoscope.

Special Faley catheters are inserted into the urethra, ending in balloons. Thanks to their work, fluid arrives at the former place of formation of a benign adenoma, that is, an independent cleaning of the focus where there was a tumor occurs. This procedure is necessary in order to stop the bleeding of a damaged small vessel.

After TURP of prostate adenoma, the urinary tract should be systematically flushed. This action is performed in order to prevent the wall of the swollen prostate from falling off and to prevent clogging of the urethra by the resulting blood clots.

However, even after hemostasis, uncontrolled blood flow can be observed up to four days after surgical procedures. This is due to the fact that the area in which coagulation takes place (the site of the former tumor) produces rejection, that is, small vessels are damaged again. While rehabilitation lasts, Faley catheters must remain in the urinary tract for the entire period of time.

Terms of stay in the clinic after transurethral resection of the prostate are from four days to one week. It is important to control the correct urination of a man, an examination for the volume of residual urine throughout the period for recovery after the tour. During a delay, difficulty, filling of urea may occur, and this factor is unfavorable, because it can create a condition for an infectious disease.

Recovery period after transurethral resection

During the entire period of a patient's stay in a medical facility, there are catheters in his urethra that allow him to monitor his condition. If there is no plasma flowing out of the catheter, it means that the recovery after TUR was successful, the man can be discharged, followed by a course of drug therapy at home.

It is common for a man not to feel any postoperative pain, but catheters tend to deliver uncomfortable sensations, and the man also feels the urea filling. In some cases, a small number of mild spasms may occur, which can be stopped with the help of special medications.

In addition to these symptoms, after resection, difficulty urinating may occur. Doctors of medical institutions can give the patient a course of special exercises that significantly facilitate urinary processes. Also, a man should remember that for seven weeks he must comply with all the prescriptions of doctors, which are recommended, depending on the complexity of the operation performed individually.