Transurethral prostatectomy

Description:

Before the procedure to you will carry out the general anesthesia or will anesthetize below a waist by means of spinal blockade. The surgeon enters the device (resectoscope) into an urethra and uses small cutting instruments to remove excess tissue of a prostate gland.

You can  be late in hospital within one-three days after operation. During your recovery    the uric catheter can be established to you,  most of patients can remove a catheter next day after operation. At first you can feel some pain or imperative desires to an urination when urine passes on the field of operation.  This discomfort has to pass gradually.  You can expect emergence in urine of a small amount of blood or small clots after the TOUR of a prostate.

The transurethral prostatectomy is  the most effective surgery which quickly reduces prostate adenoma symptoms.  Within several days at most of men the urination improves.

In certain cases the TOUR of a prostate can become the reason of impotence and decrease in control of a bladder. Usually these states have temporality. The exercises strengthening muscles of a pelvic bottom (Kegel) help to recover control of a bladder.  Normal sexual function  is returned during from several weeks to several months.

Other more frequent side effect of operation — a retrograde ejaculation, but at you will not be obstacles for achievement of a culmination point and feeling of an orgasm. At a transurethral prostatectomy injuries and an urethrostenosis or necks of a bladder are possible.  This state can be corrected by extension of fabrics of a hem which  is carried out in out-patient conditions.  Some men who postponed the TOUR of a prostate need repeated operation if the prostate expands again or cicatricial fabric it is necessary to remove from the previous operation.

The transurethral resection (TOUR) of a prostate is used for treatment of adenoma of a prostate (a benign hyperplasia of a prostate, DGPZh). The transurethral resection (TOUR) of a prostate is the most frequent method  of surgical treatment at prostate adenoma, making about 90% of  all operations at prostate adenoma.

In time the TOUR of a prostate the doctor  uses the surgical device to remove the expanded prostate gland tissue. At most  of men  after the TOUR of a prostate pressure upon  an urethra (a tube on which urine is removed from an organism, an urethra) is effectively weakened, reducing symptoms of the lower uric ways of adenoma of a prostate.  These symptoms  can include difficulties at an urination (ischuria), the frequent and urgent need to urinate, and the increased urination frequency at night.

The transurethral prostatectomy is less aggressive operation with the subsequent  more bystry recovery, in comparison with an open adenomectomy.

Indications to a transurethral prostatectomy:

Relief of symptoms of adenoma of a prostate
Your doctor can offer a transurethral resection (TOUR) of a prostate  if  you  have moderately expressed or heavy symptoms of the lower uric ways caused by prostate adenoma such as:

- Difficulties at an urination (ischuria)  
- The speeded-up urination
- The urgent need to urinate
- Increase in frequency  of an urination at night

TOUR of a prostate helps to lower symptoms of the lower uric ways at most of men with prostate adenoma.  The transurethral prostatectomy is most effective at men with big sizes of adenoma of a prostate with a large number of annoying symptoms.  Even men with the serious damage of a bubble caused by prostate adenoma feel improvement after the TOUR of a prostate.

Complications and risks of a transurethral prostatectomy:

The transurethral prostatectomy is  a  safe procedure. Serious side effects or complications are rare. Possible complications can include the TOUR of a prostate:

- A retrograde ejaculation (at an orgasm sperm is thrown in a bladder)
- Problems with an erection  
- Urodynia
- Recurrent  infections of uric ways
- Narrowing of a neck of a bladder (stricture)
- Urethrostenosis (urethra stricture)
- Blood in  urine (hamaturia)
- Urine incontience

Syndrome TOUR of a prostate:

Other possible complication from this procedure - a syndrome the TOUR of a prostate. It occurs when your blood stream absorbs too much liquid (solution for irrigation) used during the procedure to wash away excess tissue of a prostate gland in a bladder.  To lead absorption of too large amount of solution for irrigation to decrease in concentration of sodium in blood. Modern  surgical techniques made a syndrome the TOUR of a prostate rare, and it is easily adjusted. In certain cases, the surgeon can use the TOUR system of a prostate in which saline solution is used, but not traditional solution  for irrigation, thus, eliminating risk of a syndrome the TOUR of a prostate.

Preparation for surgery:

You need not to eat and not to drink during certain time before a transurethral prostatectomy.  Besides, if you  take  the aspirin or other drugs liquefying blood such as  warfarin (Kumadin), you, perhaps, have to stop reception of these  drugs prior to a procedure. Discuss with the doctor special preparation to the TOUR of a prostate which is necessary in  your situation.

Technique of carrying out a transurethral prostatectomy:

In time ROUND of a prostate to you will be held  or back anesthesia which  will allow you to be awake during the procedure, but not to feel pain  in surgical area, or the general anesthesia, then during operation you will be unconscious.

After anesthetic worked, through a penis  enter the device which is called the resectoscope into an urethra.  No external cuts    are required.  Length of the resectoscope  makes about 12 inches (30.5 centimeters),    diameter of 12 inch  (1 centimeter). The resectoscope  contains  a light source, valves for  liquid to wash out the field of operation, and the electric loop which deletes  or is evaporated by fabric and cauterizes blood vessels.

During  60-or  90-minute operation your surgeon uses an electric loop of the resectoscope to remove the expanded fabric  from an internal part  of a prostate, to create a cavity and to reduce pressure upon an urethra.  Only an internal part of your  prostate is removed.  This fabric by means of solution for irrigation gets into a bladder, and then is removed at the end of operation.

Adenoma of a prostate is not a symptom of a prostate cancer and does not increase risk of development of a prostate cancer.  But your doctor can recommend that prostate gland tissue after a transurethral resection was sent to laboratory to investigate on the hidden cancer cells.

After  a transurethral prostatectomy

After the TOUR of a prostate you will be  in hospital during one - two days. Emergence of a small amount of blood or small blood clots in your urine  after operation is possible. To you, perhaps,  the uric catheter within several days will be necessary. In the first days after the TOUR of a prostate you will be disturbed by an urodynia or urgent desires to an urination because urine irritates the operated area.

Gradually this state improves during more than one - four weeks. You can be returned to work at  office approximately in two weeks, and to hard physical work  through four - six weeks. You will probably be able to renew sexual activity approximately through four - six weeks after the TOUR of a prostate. Specify recommendations at the doctor.

Results of operation:

The transurethral prostatectomy quickly and  effectively reduces uric symptoms. Within several days most of men experiences considerable improvement of outflow  of urine.

In rare instances  repeated operation, several years later after the TOUR of a prostate is required from some men because their  prostate increased again or because of insufficient removal of fabrics of adenoma for the first time. However,  this unusual phenomenon and much less probable, in comparison with other methods of treatment of adenoma of a prostate.

After a transurethral prostatectomy it is necessary to visit the urologist of times a year for a manual rectal research to control your state and in time to reveal a prostate tumor. Methods of treatment of adenoma of a prostate do not affect that area of a prostate where the prostate cancer can develop, thus, without eliminating risk of formation of a tumor.  If you notice some deterioration  in symptoms of the lower uric ways, then surely see the doctor.