BPH is in some cases need surgery

If the drug does not give the desired result, you forget what is life without pain, and it was a violation of the power to seek the assistance of surgeons. In the case of adenoma, it is assumed, partial, rarely complete removal of the prostate.

Modern medicine has in its Arsenal a large number of methods that enable you to quickly and effectively solve literally painful problems. Below are some of the most commonly used methods, as well as the latest techniques for the future.

BPH

Open prostatectomy (traditional version)

This is one of the first ways that has been adopted by medicine.

The advantages and disadvantages of

According to the modern methods of the disadvantages of this method are numerous:

  • high risk of complications;
  • long recovery after;
  • pain;
  • the appearance of postoperative scars;
  • significant blood loss (greater risk if a person has a weakened blood-thinning drugs or have shown that receiving anticoagulants).

The effects of surgical intervention

This manipulation may be accompanied by complications, in particular:

  1. Infectious inflammatory diseases.
  2. Bleeding.
  3. Violation of potency, including retrograde ejaculation (50% men).
  4. Incontinence.
  5. Stricture of the urethra channel.
  6. Thrombosis in the veins of the legs.

Recovery

Usually takes several weeks. In the early days is not allowed to rise, which increases the risk for thrombosis. If you want to restore the normal urination, which uses a catheter, which is removed after 1-3 weeks.

Transurethral resection (TURKEY) prostate

BPH resection

Today this method is the "gold standard" treatment of adenoma. Removal of the gland tissue is due to the influence of electric current. The method does not involve incisions, the surgeon's tool (resectoscope) is inserted through the urethra. Through the manipulation is carried out visual inspection of the surgical field, is carried out under local or regional anesthesia, takes about one hour.

The advantages and disadvantages of

This method has several advantages in comparison with open surgery:

  • the good tolerability by the patient;
  • a short recovery period;
  • the risk of bleeding is reduced;
  • a smaller percentage of complications;
  • no scars, stitches.

As the shortcomings can be noted the existence of restrictions:

  • the removal of adenomas size small;
  • the possibility of postoperative bleeding in people taking anticoagulants (before the surgery you should stop taking).

What you can expect after the treatment

This method of removal of the prostate has its own complications and unintended consequences:

  1. Bleeding.
  2. Syndrome of water intoxication (TURP syndrome).
  3. Damage to the urinary tract.
  4. Infectious-inflammatory complications.
  5. Incontinence.
  6. Violation of potency.

In general, the percentage of those who are after the surgery there were complications, a relatively small ‒ 15-30 %, while the efficiency reaches 90 %.

The characteristics of the recovery

After the manipulation, the bladder is drained with a catheter. The catheter is removed 3-4 days, and 5-7 days in case of absence in this period, any complications, the patient is discharged from the hospital for outpatient treatment.

Transurethral endoscopic laser surgery

Today for the removal of the prostate often used method ROUND. However, it is replaced with more modern methods, in particular the manipulation with the use of a laser.

The undisputed advantages of the surgical removal of the prostate with the laser in the case of adenoma today is obvious: the application of this technology allows greater precision and to avoid accidental damage to nearby organs, tissues, nerves (important for the conservation of power), to minimize the risk for bleeding through the connecting tissue laser

On the method of

Laser removal is due to the impact of the laser beams of different lengths. The beam penetrates into the tissue, which causes the destruction (vaporization, coagulation) the effect of elevated temperature.

The most well-studied and is a commonly used method, the laser surgery is:

  • transurethral photo selective vaporization of the prostate (PVP) using potassium-titanium-phosphate laser (KTF or green laser);
  • transurethral enucleation of the prostate with laser (HoLEP).
BPH enucleation

If we consider the second method, manipulation includes the introduction of a laser through the urethra. The device is equipped with optical system that allows the manipulation of the laser under direct vision.

Laser energy focused on the tip of the fibre, allows it to cut into the breast tissue to remove it, without affecting the capsule of the prostate. After this, tissues were moved into the bladder and removed. Coagulation of bleeding vessels is generated by converting the fibres to the tip 3-4 mm from the capillary. This procedure allows you to remove the adenoma of large size (more than 200 CC).

The advantages and disadvantages of

The advantages of this method are:

  1. Excellent carrying (surgery gently).
  2. Unwanted complications and consequences, including bleeding, which occur very rarely.
  3. Faster recovery and rehabilitation.
  4. Life without power loss (percentage of complications ‒ less than 1 %).
  5. The possibility of use for patients taking anticoagulants are prone to bleeding.
  6. The removal can be carried out on any volume of the adenoma.

And what after the surgery?

The effectiveness of the method is close to 100% with minimal risk of complications and recurrences. Also we are not even talking about all the violations of potency. Urination is back to normal, almost immediately after the surgery. The operation is bloodless, so is the risk of bleeding is very low.

The operation takes an hour or two, it depends on the size of the adenoma. After 2-3 days in the hospital, it goes to a catheter, and the patient was discharged for ambulatory treatment.

As you can see, the methods for the removal of the prostate a lot, but is a method that is individual. This depends on the age, the importance of maintaining strength, adenoma size, and determined by the treating physician. But the fact is that modern technology allows many to find life, health and stay man in any situation, it is undeniable!

At what rate of BPH surgery?

Almost 50% of men older than 50 years, are facing uncomfortable disease, which in medicine is called BPH, or BPH. This is a pathological growth of the prostate tissue. Its causes are not completely understood, but doctors tend to believe that the pathological changes that occur due to violation of hormonal background.

Only there are three stages of disease, which differ in the symptoms and methods of treatment. In the second stage is characterized by dysfunction of the bladder, kidney, urinary tract. The first is not completely emptied during urination. The muscles of the body susceptible to degenerative change. Urine in the bladder is not moving, the volume of the body begins to rise. For complete emptying of the organs and removal of fluids, the patient has to work too hard, which greatly increased blood pressure.

Treatment of BPH is the need to be comprehensive. In the initial phase to improve the patient's condition is possible by means of conservative methods. This is a diet, hormone therapy, folk remedies. If drug treatment is not effective, it is necessary to perform a surgical procedure in which the doctor removes excess tissue with a special tool.

benign prostatic hyperplasia operation

Indications for surgery

BPH can be progressive increase in size due to overgrowth of tissue of the prostate. This leads to serious complications, such as compressed adjacent organs (bladder, kidneys) and disrupted its work.

In this case, diet and medications do not help, you need to perform the surgery. The operation is assigned in the following cases:

  • persistent problems with emptying the bladder;
  • partial emptying of the bladder;
  • bleeding in the urine;
  • the stagnation in the bladder and the design of the application;
  • infectious diseases;
  • inflammation of various etiology;
  • the penetration of the urine into the blood, poisoning the organism;
  • kidney failure.

According to statistics, in 70% of cases the effective problem can be solved with diet and medications.

Today, there are several techniques that help to get rid of the disease and return to normal life.

Laser therapy

Treat benign prostatic hyperplasia can be performed with a laser. This is the most gentle method, which is suitable for men regardless of the age of the patient and his disease. After the laser therapy was for the reconstruction of the functions of the organs of the urogenital system appears normal urination, the rehabilitation period is short.
The main advantages of the treatment of prostatic hyperplasia laser:

  • the method, which helps achieve positive results;
  • risk to the health of the patient is reduced to a minimum;
  • the patient remains in the hospital for only two days;
  • there are almost no contra-indications;
  • a urine collection catheter is carried out only for 24 hours;
  • reduces the risk of bleeding during or after surgery.

Laser ablation

This is one of the two types of laser therapy, after which growth of the prostate tissue terminates and all that is unnecessary, is removed by the evaporation or burning sensation. This technique is effective if the adenoma has not yet had time to grow and its size does not exceed 140 cm3. It is recommended that people in young age. A positive result in 98%.

Laser enucleation

This technique involves the removal of the laser beams of all benign tumors of the prostate. It is prescribed to patients with a diagnosis of BPH the second and third level. The procedure allows you to safely remove the formation of large sizes. In result, restores the functioning of the urinary tract, normalizes urination, returns potency.

By laser enucleation of tissue is sent to a laboratory for examination to exclude the possibility for the development of prostate cancer.

BPH laser

Transuretralna resection

This technique is the most popular among patients with the diagnosis of BPH. It is prescribed after a comprehensive examination, if no contraindications and if conservative treatment is ineffective.

The surgery is performed using a special surgical device that allows access to the prostate through the urethra. The surgeon dilates the urethra or to remove the adenoma. For the execution of the operation requested epidural anesthesia.

When is the doctor who conducted the operation, all instruments that are used are recycled, but the cloth, which is sent to the laboratory. The patient is not able to defecate, so he has a catheter to drain the urine and blood. Write a week, in the absence of any complications. During rehabilitation should follow a strict diet with the exception of alcoholic beverages, fatty and spicy foods, as well as all products that have even a slight diuretic effect.

Adenectomy

This technique is intended for the removal of the prostate. Before surgical intervention is required epidural or spinal anesthesia.

The advantages of this therapy is that the doctor gets access to the adenoma, and it can be free of barriers to squeeze your finger. A small percentage of patients who experience complications of urination after the procedure thank you for a precise incision of the urethra. The treatment of prostatic hyperplasia this method allows you to minimize the risk of damage to the bladder.

After the surgery the patient needs care. Put a catheter to drain the blood and urine, monitoring of hemodynamic parameters. If you want to reduce the intensity of pain, prescribed pain pills.

The first two days after surgery, the patient must follow a liquid diet. Rehabilitation after the removal of prostatic hyperplasia takes four to six weeks.

Adenectomy prescribed to patients with a diagnosis of BPH in which the adenoma has reached the size of 75 grams and conservative treatment does not improve the patient's condition. Has surgery surgeon, specializing in urology.

Contraindications

This is not always possible to perform surgery for prostatic hyperplasia, as there are many contra-indications. It is impossible to solve the problem with the use of surgical intervention in patients who have:

adenoma of the prostate in men
  • varices, where dilated veins of the bladder;
  • heart failure and other heart problems;
  • of blood clotting;
  • acute diseases of any organs;
  • ankylosis of the hip.

If contraindications for surgical intervention there is no adenoma slow, but increases in size, would not be postponed. Sooner will be done the treatment of hyperplasia of prostate by surgery, the quicker the patient can return to normal life.

27.05.2019