If treatment with medicine does not give the desired result, that you forget what life is without pain, and came up with the violation of potency, have to ask for help to the surgeons. In the case of adenomas is assumed partial, less than complete removal of the prostate.
Modern medicine in its arsenal has a great number of methodologies that allow for the quick and effective resolve in the literal sense of the ms problem painful. Below are some of the most widely used of the methods, as well as the methods by which the future.
Open prostatectomy (traditional version)
It is one of the first methods, which was adopted by the medicine.
Advantages and disadvantages
In comparison with the modern techniques drawbacks of this method are many:
- high risk of occurrence of complications.
- the recovery of long-term after the intervention;
- the pain of the operation;
- the appearance of the postoperative scars;
- a great loss of blood (a great risk, if the affected person, the clotting of blood or sample receiving anticoagulants).
The consequences of the intervention
This type of manipulation may be accompanied by complications, in particular:
- Inflammatory conditions of the disease.
- The hemorrhage.
- The violation of potency, including retrograde ejaculation (50% of the men).
- The incontinence of the urine.
- Stenosis of the urethra canal.
- The thrombosis of the veins of the shins.
The recovery period
Usually take several weeks. In the early days it is not allowed to rise, which increases the risk of the occurrence of thrombosis. For the recovery of normal micturition is applied to a catheter, which is then eliminated through 1-3 weeks.
Transurethral resection (TUR) of the prostate
Today this method is the "gold standard" of treatment of adenoma. The removal of tissue from the breast is performed at the expense of the influence of the electric current. The method does not involve cuts, tool surgeon (resectoscope) is inserted through the urethra. Over all handling is carried out a visual control on the operative field, is performed under local or regional anesthesia, takes about an hour.
The pros and cons
This method has much more advantages in comparison with open surgery:
- good tolerance of the patient;
- short recovery period;
- the risk of bleeding has been reduced;
- lower percentage of complications.
- the absence of scarring, the seams.
As drawbacks we can point out the presence of constraints:
- the removal of adenomas of small size;
- the possibility of occurrence of post-surgery bleeding people who take blood thinners (before the operation, you must stop taking).
What to expect after the manipulation
This method of removal of the prostate has its complications and unintended consequences:
- The hemorrhage.
- The syndrome of water intoxication of the body (TOUR-syndrome).
- The damage to the urinary tract.
- The incontinence of the urine.
- The violation of the power.
In general, the percentage of those who after the operation there are complications to be relatively small, 15 to 30 %, while the efficiency is 90 %.
Features of the recovery
After the conclusion of the manipulation of the bladder drainage catheter. The catheter is removed in 3-4 days, and since 5 to 7 days in case of the absence in this period any kind of complications of the patient are breast-discharge from the hospital for outpatient care.
Transurethral endoscopic surgery laser
Today for the removal of the prostate is widely used the method of the TOUR. However, instead of this come the most modern methods, in particular the manipulation with the use of laser.
The advantages of the operation of removal of the prostate with laser in the case of adenoma of today are already evident: the use of this technology makes it possible to achieve precision and to avoid accidental damage nearby organs, tissues, and nerves (it is important for the conservation of power), reduce the risk of bleeding at the expense of the union of the fabric with laser
On the method of
Removal laser occurs at the expense of the influence of the authority of the laser beams of different lengths. The beam penetrates into the tissue, causing its destruction (vaporization, coagulation) the influence of the increase of the temperature.
More well-studied, and widely used in the techniques of laser surgery is:
- transurethral photo selective vaporization of the prostate (PVP), with the participation of potassium and titanium-phosphate laser (KTF or "green" laser);
- transurethral enucleation of prostate using laser (HoLEP).
If one considers the second method, the manipulation involves the introduction of the laser system through the urethra. The apparatus is equipped with an optical system that allows the manipulation of laser under the control of the view.
The laser energy focused at the tip of the fiber, can cut the tissue of the breast, to remove, without affecting the capsule of the prostate. After this tissue is moved into the bladder and are removed. Coagulation of bleeding vessels is done by removing the tip of the fiber is 3 to 4 mm of the capillary. This procedure allows you to remove an adenoma of large dimensions (more than 200 cc).
Advantages and disadvantages
The advantages of this method are:
- Excellent portability (surgery careful).
- Unwanted, complications and effects, including bleeding, are very rare.
- The recovery and rehabilitation.
- Life without the loss of power (the percentage of complications is less than 1 %).
- The possibility of applying in patients who take anticoagulants, the risk of bleeding.
- The removal can be carried out in any volume of the adenoma.
And that after the operation?
The effectiveness of the method is close to 100% with minimal risk of appearance of complications and recurrence. In particular is not in any violation of the power. The urine becomes the norm, almost immediately after the surgery. The operation without the shedding of blood, and that means that the risk of loss of blood is very low.
The operation lasts for an hour or two, depending on the size of the adenoma. After 2-3 days of hospitalization, the catheter, and the patient was discharged on outpatient treatment.
As you can see, the options of removal of the prostate much, however, the choice of method is different. It depends on the age, the importance of the conservation of the power, the size of the adenoma and is determined by the attending physician. But the fact that modern technologies allow to many to have a full life, health and being the man in any situation, it is undeniable!
The level of the adenoma of the prostate is a procedure?
Almost 50% of men who have attained 50 years of age, found a nasty disease, which in medicine is called benign prostatic hyperplasia or prostate hypertrophy. Is pathological overgrowth of the prostate tissue. The causes of its emergence have not been studied, but physicians are inclined to the opinion that the changes occur because of violations hormone.
There are only three stages of the disease, which are different to those of the sintomatologa and the methodology of treatment. The second stage is characterized by the violation of the functioning of the bladder, the kidneys, the urinary tract. The first non-empty when you urinate. The muscles of the authority difficult to degenerative changes. The urine in the bladder does not move, the volume of the authority begins to increase. For the complete emptying of the authority, and extract from it the liquid patient have to strive and, consequently, strongly increases the blood pressure.
The treatment of adenoma of prostate gland must be comprehensive. In the initial phase of improving the state of the patient using conservative methods. Is the diet of the hormone replacement therapy, folk remedies. If the pharmacological treatment is not effective, you must perform a surgical procedure, the doctor removes the excess fabric with a special tool.
The indications for the realization of the operation
Bph may gradually increase in size at the expense of the expansion of the prostate tissue. This leads to serious complications, as well as compressed adjacent organs (bladder, kidney) and is worried about his job.
In this case, the diet and medications do not help, it is necessary to perform a surgical intervention. The operation is assigned in these cases:
- the persistent difficulties with the emptying of the bladder;
- the partial emptying of the bladder;
- spotting of blood in the urine;
- causing congestion in the bladder, and the formation of sediments.
- infectious diseases;
- the inflammation of different etiology;
- the penetration of the urine into the blood, poisoning the organism;
- the renal failure.
According to the statistics, 70% of the cases of efficient way to solve the problem by using diets and drugs.
Today there are several techniques that help to get rid of the condition and return to normal life.
Treatment of benign prostate hyperplasia can be performed with the help of the laser. It is the most gentle of the way that is shown to men regardless of the age of the patient and their state of health. After the laser therapy occurs the restoration of the functionality of the organs of the urinary system, is presented in the statement of urination, the rehabilitation period lasts for a little bit.
The main advantages of the treatment of hyperplasia benign of prostate with laser:
- the method helps to obtain the maximum positive results;
- the risk to the health of the patient is reduced to a minimum;
- the patient remains in the hospital in two days;
- has almost no contraindications;
- the collection of the urine catheter is carried out only for 24 hours;
- it reduces to a minimum the risk of bleeding during or after surgery.
The laser ablation
It is one of the two types of laser therapy, after the proliferation of the prostate tissue is stopped, and all the excess is removed with the help of the evaporation or burning. This technique is effective, if the adenoma has not yet had time to grow to the size of not more than 140 cm3. It is recommended to men of young age. The positive result of 98%.
This methodology includes the removal of laser beams of all the benign tumours of the entities of the prostate. Is assigned to patients diagnosed with bph second and third grade. The procedure allows you to safely remove the education of a large size. Accordingly, reset the functions of the urinary tract, normalizes urination, returns the power.
After the conclusion of laser enucleation, the tissue is sent to a laboratory for investigation, to exclude the possibility of development of prostate cancer.
This technique is the most popular among the patients diagnosed with the adenoma of the prostate. It is prescribed after a thorough study of the body, if there are no contraindications and if the treatment is ineffective.
The surgery is performed through a surgery of the appliance, that allows access to the prostate through the urethra. The surgeon widens the urethra or eliminates the adenoma. To perform the operation, you will require an epidural.
Once the doctor has completed the operation, all of the appliances are recycled, and the tissue is sent to a laboratory. The patient can not be emptied, so that it will introduce a catheter to the reflux of the urine and blood. The prescription after a week if there are any type of complications. In the period of rehabilitation should be to follow a strict diet with the exception of alcoholic beverages, fatty and spicy foods, as well as all the products that have even a slight diuretic action.
This methodology focuses on the removal of the adenoma of prostate. Before you begin the intervention, it is necessary to epidural or spinal anesthesia.
The advantage of this therapy is that the physician has access directly to the adenoma and can without obstacles of pushing with the finger. Tiny percent of the patients who face complications of urination after the procedure, thanks to the section of the urethra. The treatment of the benign prostatic hyperplasia this method allows to reduce to a minimum the possibility of occurrence of injuries of the bladder.
After the completion of the surgery, the patient needs care. You establish catheter expenditure of blood and of urine, observe the indicators of the hemodinmica. To reduce the intensity of painful sensations, are prescribed painkillers.
The first two days after surgery, the patient must follow a liquid diet. The period of rehabilitation after the removal of the benign prostatic hyperplasia, which lasts from four to six weeks.
Adenectomy is assigned to patients with a diagnosis of benign prostatic hyperplasia, adenoma reached a size of 75 grams, while the conservative treatment does not contribute to the improvement of the condition of the patient. Carried out the surgical intervention, the doctor-surgeon, specialist in urology.
You can not always carry out the operation of the benign prostatic hyperplasia, as there are a number of contraindications. You can't solve the problem by means of surgical intervention of patients:
- varicose veins, which extended the vein of the bladder;
- heart failure and other heart problems;
- disorders of coagulation.
- acute diseases of any of the organs;
- ankylosis of the hip.
If contraindication to performing a surgical intervention did not, adenoma slowly, but increases in size, it is not worth to continue putting it off. The sooner it is performed the treatment of hyperplasia benign of prostate through surgery, the faster the patient can return to your normal life.