An overview of effective operational methods removal of the prostate
If medication does not give the desired result, you forget about what a life without pain, and there was violation of potency, have to seek the assistance of surgeons. In the case of the adenoma, it is assumed partial, rarely complete removal of the prostate.
Modern medicine has in its Arsenal a large number of methods that allow you to quickly and effectively solve literally painful problem. Below are some of the most widely used methods, as well as the latest techniques for the future.
Open prostatectomy (traditional version)
This is one of the first ways that has been adopted by medicine. Distinguish potadromous (used more often), and perineal prostatectomy.
In the case posadilla method the abdomen is cut with a length of about 10 cm, through which iron is removed. During the operation, the urethra is sewn directly into the bladder, once catheter is placed, which is removed when the restoration of function of urination. The operation takes several hours and is performed under General anesthesia. Shown a small number of patients with a considerable size of the adenoma.
Advantages and disadvantages
Compared to modern methods disadvantages of this method are many:
- high risk of the complications;
- long recovery after the intervention;
- the appearance of postoperative scars;
- significant blood loss (greater risk if a person has impaired blood clotting or shown receiving anticoagulants).
The advantages of this method of removal of the prostate can be attributed to the availability of a large number of experienced professionals working in Russia.
The effects of surgical intervention
This kind of manipulation may be accompanied by complications, in particular:
- Infectious inflammatory diseases.
- Violation of potency, including retrograde ejaculation (50% men).
- Stricture urethral channel.
- Thrombosis of the veins of the legs.
The recovery period
Usually takes several weeks. In the early days not allowed to rise, which increases the risk of thrombosis. To restore the normal urination is used the catheter which will be removed after 1-3 weeks.
If we talk about the cost of manipulation, it is about 40,000 in Russia and about 450 thousand clinics of Europe and Israel.
Transurethral resection (TUR) of the prostate
Today this method is the "gold standard" treatment of the adenoma. Removal of the gland tissue is due to the influence of electric current. The method is notinvolves incisions, the surgeon's tool (resectoscope) is inserted through the urethra. Throughout the manipulation is carried out visual inspection of the surgical field, it is performed under local or regional anesthesia, lasts about an hour.
The pros and cons
This method has more advantages compared to open surgery:
- 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:
- removal of adenomas of small size;
- the possibility of postoperative bleeding in people taking anticoagulants (before surgery you must stop taking).
What to expect after the procedure
This method of removal of the prostate has its own complications and unintended consequences:
- The syndrome of water intoxication (TURP syndrome).
- Damage to the urinary tract.
- Infectious-inflammatory complications.
- Violation of potency.
Overall, the percentage of those who have after the surgery there were complications, a relatively small ‒ 15-30 %, whereas the efficiency reaches 90 %.
The features of recovery
After the manipulation, the bladder is drained with a Foley catheter. The catheter is removed 3-4 day, and 5-7 days in case of absence during this period, any complications patient is discharged from hospital for outpatient treatment.
The cost of this surgery varies depending on the clinic and country. So, in Russia, the average operation is about 50,000, while treatment in Europe will cost at least 600 thousand.
Transurethral endoscopic laser surgery
Today for the removal of the prostate widely used method ROUND. However, it is substituted with more modern methods, in particular the manipulation with the use of a laser.
Undeniable advantages of surgery to remove prostate by laser in case of the adenoma today is obvious: the use of this technology allows to achieve higher precision and to avoid accidental damage to nearby organs, tissues, nerves (important for preserving potency), to minimize the risk of bleeding due to the "seal" fabric with a laser
About the method
Laser removal is due to the impact on the laser beams of various lengths. The beam penetrates the tissue, causing its destruction (vaporization, coagulation) effect of elevated temperature.
The most well-studied and widely used methods of laser surgery is:
- photoselective transurethral vaporization of the prostate (PVP) with the assistance ofpotassium-titanium-phosphate laser (KTF or green laser);
- transurethral enucleation of prostate using holmium laser (HoLEP).
If we consider transurethral enucleation, the manipulation involves the introduction of the laser system through the urethra. The device is equipped with an optical system that enables the manipulation of the laser under direct vision.
Laser energy focused on the tip of the fiber, allows to cut the breast tissue to remove it without affecting the capsule of the prostate. After this "taken out of the context of" laser-tissue displaced into the bladder and removed morcellation. Coagulation of bleeding vessels is produced by converting the fiber tip 3-4 mm from the capillary. This procedure allows you to remove the adenoma of large sizes (over 200 CC).
Advantages and disadvantages
The advantages of this method are:
- Excellent tolerability (surgery gentle).
- Unwanted complications and consequences, including bleeding, occur very rarely.
- Faster recovery and rehabilitation.
- Life without loss of potency (percentage of complications ‒ less than 1 %).
- Possibility of use for patients taking anticoagulants are prone to bleeding.
- The removal can be carried out at any volume of the adenoma.
Drawback ‒ high price, and therefore lower accessibility, since most of the specialists in this complex skill, operate in foreign clinics. The cost ranges from 100 thousand Russian clinics) to 1 million rubles (Israeli hospital).
And what after the surgery?
The effectiveness of the method is close to 100% with minimal risk of complications and recurrences. Including we are not talking whatsoever about any violations of potency. Urination returns to normal almost immediately after surgery. The operation is bloodless, and therefore 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, goes to a catheter, and the patient is discharged to outpatient treatment.
As you can see, ways to remove prostate a lot, but the choice of method is individual. It depends on age, the importance of preserving potency, adenoma size, and determined by the treating physician. But the fact that modern technology allows many to find a life, health and to remain a man in any situation, is undeniable!