Transurethral resection of the prostate ( prostate )
Urology / / August 12, 2017
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Transurethral resection of the prostate (TURP) is a type of prostate surgery to remove all or part of the prostate gland, in order to facilitate ongoing moderate or severe symptoms of the urinary system caused by an enlarged prostate.
prostate, or prostate is a male sex unpaired organ that surrounds the urethra.It secretes a fluid that mixes with sperm, providing the vital activity of sperm in the semen.Enlarged prostate gland squeezes the urethra, causing problems with urination.
increase is due to prostate overgrowth of the prostate (benign prostatic hypertrophy or BPH) or in some cases of prostate cancer.
There are three main surgical technique used to remove the prostate gland:
The oldest method is called "open" or "suprapubic" method.During such an operation an incision is performed in the perineum, the area between the base of the scrotum and the anus.This approach has largely been replaced by new minimally invasive operations.
Laparoscopic surgery allows t
suprapubic and laparoscopic approaches allow you to remove the lymph nodes, however, may interfere with normal erectile dysfunction after surgery.
Transurethral resection of the prostate, to date, is the most effective surgical procedure that quickly reduces symptoms of benign prostatic hyperplasia, and in a few days in most men restored normal urination.
To determine whether or method of treatment, your doctor will consider how serious your symptoms, what other health problems you have, and the size and shape of your prostate.
TOUR preferable to open surgery when:
- prostate volume of less than 60 -80 cm 3;
- a relatively young age of the patient, which is necessary to maintain sexual function;
- suspected prostate cancer;
- obesity, severe concomitant diseases of the cardiovascular, respiratory and endocrine systems;
- related diseases of the lower urinary tract;
- previously undergone surgery on the bladder, prostate, the abdominal wall, the intestines;
- combined BPH with chronic prostatitis;
Indications for surgery
TOUR helps reduce symptoms in most men with BPH.This procedure is best suited for men who have prostate quite large, which causes the symptoms of moderate to severe.TOUR gives long-term results, unlike many other drugs and treatments for an enlarged prostate.
Mochevyeh symptoms caused by benign prostatic hyperplasia, may include:
- Frequent, urgent need to urinate
- Difficulties with the start of urination
- Slow and prolonged urination
- Increased frequency of urination at night (nocturia)
- Intermittent urination
- The feeling of not completely emptying the bladder
- urinary tract infections.
TURP may also be done to treat or prevent complications due to blocked urine flow due to the following reasons:
- Recurrent urinary tract infections
- kidney damage or
kidney - Damage to the bladder, which can lead toinability to control urination (incontinence)
- Blood in the urine
- bladder stones.
How to prepare to transurethral resection of the prostate
Before the operation, the patient is generally carried out a full medical examination, including blood tests, ECG, chest X-ray, ultrasound of the genitourinary system, as well as consultations with the therapist andanesthesiologist.
- 1-1.5 weeks prior to surgery should stop taking medications that can thin the blood, such as aspirin, ibuprofen, naproxen, vitamin E, clopidogrel (Plavix), warfarin, and others.
- The night before the operation is necessary to shave the pubic area and make a cleansing enema.
- Do not eat or drink after midnight the night before surgery.
- the day of the surgery, take only the prescribed drugs your doctor, with sips of water.
operation is usually performed under general or spinal anesthesia, and takes about 1-1.5 hours.
surgeon inserts into the urethra resectoscope optical fiber, which is a thin tube, approximately 30.5 centimeters long, 1 centimeter in diameter.Resectoscope consists of a light source, a liquid valve to wash the region of operation, and an electric loop which removes or vaporizes tissue and cauterize blood vessels.You do not need to make the incision and stitches.
After all the procedures usually requires 1 - 2 day stay in hospital.
After surgery, the patient is usually set Foley catheter that stays in place for 1 - 3 days to carry out urine.This device is a tube inserted through the penile opening for urine outlet.The catheter may cause temporary spasms of the bladder, which can be painful.The catheter can be removed while the patient is in hospital or after he goes home.
- Treatment of prostate cancer: a comparison of methods, side effects of treatment
- removal of the prostate (radical prostatectomy)
- Benign prostatic hyperplasia (BPH): causes, symptoms, treatment, complications
- prostate biopsy
urine flow is enhanced almost immediately after TUR procedures.After catheter removal, patients often feel some pain or discomfort during urination.These sensations usually last about a week, and then gradually go down.Complete healing takes about two months.
Below are some tips to speed up the recovery and avoid complications:
- During recovery to avoid driving, heavy equipment management, lifting, sudden movements, and stresses the lower part of the muscle, such as during a bowel movement.
- consumption required to 8 glasses of water a day after the operation, which promotes recovery and flushes the bladder.
- is necessary consumption of foods that help prevent constipation, such as fruits and vegetables.laxatives may be needed If you experience constipation.
- Strengthening the pelvic floor muscles can help reduce incontinence.Recommended exercises at 3:57 sets of 30 contractions daily.
- Resuming sexual activity is possible only after doctor's permission.
- Tell your doctor about all the medicines and herbs you are taking to make sure that they do not provoke bleeding and are safe for you at the moment.
Complications of transurethral resection of the prostate
tour operations, are generally safe, but there are some risks to the short-term and long-term complications.
Short term postoperative complications:
- Bleeding. presence of blood in the urine can be normal after TUR operation, but stable heavy bleeding is a sign of more serious complications.In rare cases, when severe bleeding, patients need blood transfusions.
- Infection. Urinary tract infections are more common during long-term use of a catheter.
- urinary problems. Urinary incontinence is common after surgery and usually takes place during the month.Temporary urinary retention (inability to urinate) can be observed for several days after the operation (which is why a catheter is used to help remove urine).
- TUR syndrome. Syndrome water intoxication.It occurs in a very small percentage of patients and is a very serious complication.To remove excess liquid used diuretics.
long-term postoperative complications:
- Retrograde ejaculation. Retrograde ejaculation, also known as a dry orgasm, it is very often the case.When this occurs the emission of sperm into the bladder rather than outward through the urethra.Retrograde ejaculation does not affect sexual pleasure, but it has an impact on fertility.
- Erectile dysfunction. Erectile dysfunction - the inability to maintain an erection is sometimes the case.
- Urinary incontinence. Temporary incontinence often occurs after TUR surgery in rare cases, some men become completely unable to hold back urine.
- Repeated surgery. Up to 10% of patients who underwent TUR require re-operation within 5 years.Sometimes, scars in the bladder can be so severe that they can lead to obstruction, this may require additional surgery within a year after the operation - of transurethral incision.Most often, when injury of the urethra narrows, usually this condition can be corrected by a simple stretching procedure performed in a doctor's office.