What is prostate surgery
Surgical intervention as part of a prostate operation does not result in one in all patients complete removal of the prostate. This is how it will be scaled downso that it no longer presses on the urethra and bladder. For this purpose, small instruments are used that are passed through the urethra to the prostate. Tissue can then be removed there or the urethra can be dilated. These procedures are called in medicine minimally invasive operations designated.
In contrast, one open surgery an incision is made in the abdominal wall to reach the prostate and operate. However, this procedure is only necessary comparatively rarely, for example when the prostate is greatly enlarged.
When is prostate surgery necessary?
Usually in men whose prostate has a benign enlargement having, no urgent needto perform prostate surgery. Therefore, most people can calmly weigh the pros and cons of such an intervention.
Ultimately, opting for an operation can different reason to have:
- very stressful complaints that cannot be satisfactorily alleviated by conservative treatment methods
- Recurring secondary diseases, such as bladder stones or frequent inflammation of the urinary tract
- if conservative treatment with medication cannot be carried out for medical reasons
In rare cases, a benign enlargement of the prostate can cause the sufferer do not urinate any more or only very little can because the urethra is squeezed from the prostate. In this case, it is necessary to empty the bladder using a catheter. This is followed by an operation.
Surgery is also inevitable for prostate cancer, the most common cancer in men. Here, the prostate and the two seminal vesicles are completely removed. This procedure is called radical prostatectomy designated.
In advanced disease, chemotherapy offers the opportunity to slow down tumor growth. A cure through chemotherapy is not possible, only the life span of patients with prostate cancer can be extended and pain can be alleviated. Since such treatment is also associated with undesirable side effects, the form of treatment for prostate cancer must be tailored to the individual situation of the patient.
What procedures are there?
The so-called transurethral resection of the prostate - also called TURP for short - is that Standard surgical procedures. During this procedure, the surgeon introduces Resectoscope, a thin tube, into the urethra and pushes it forward to the prostate.
In addition to a small camera, there is also a camera in this thin tube electric wire loop. With the help of this, the prostate tissue can be removed mechanically. Since the loop is heated at the same time, the blood vessels can close again very quickly. The resectoscope also has valves with which the removed tissue can be rinsed out.
A TURP will either under ambulatory or general anesthesia carried out and takes around 90 minutes. After the procedure, the patient must have one for a few days Urinary catheter and allow for a hospital stay of two to seven days.
In addition to TURP, there are other surgical procedures that are also part of the standard treatments and comparable results and consequences like a classic TURP. Which includes:
- the transurethral vaporesection (TUVRP)
- the plasma kinetic enucleation of the prostate (PkEP)
- transurethral electro-vaporization (TUEVP)
- photoselective vaporization of the prostate (PVP)
Also the transurethral incision of the prostate (TUIP) has proven itself as a prostate operation. There is no removal of prostate tissue, but rather one Relief of the urethra. To do this, the surgeon makes one or more incisions at the transition between the prostate and bladder neck. This creates space for the narrow urethra, which brings relief for the patient.
The advantage of this process is that some side effects less common are to be observed. However, a TUIP is only suitable for patients in whom the prostate is not overly enlarged. In addition, it can happen that the procedure has to be carried out again after a while.
What complications are possible?
Various side effects can occur, especially when the prostate is completely removed.
In the course of the first few months after the operation in particular, it can become too unintentional leakage of urine come, often when lifting heavy loads, when coughing or sneezing.
Since there are various blood vessels and nerves in the direct vicinity of the prostate that are necessary for an erection, radical prostatectomy can lead to it Erectile dysfunction or impotence come. Possible erectile dysfunction after the procedure can be treated with medication.
Complete removal of the prostate is, in most cases, associated with infertility. If family planning has not yet been completed, one should consider before the procedure: Freeze sperm allow.
A retrograde ejaculation, dry ejaculation, is a common side effect that can occur after TURP. The Seminal fluid is done during the effusion not outwards, but into the urinary bladder submitted. This process is not harmful to your health and has no effect on a satisfactory orgasm, but it does affect fertility.
TUR syndrome can be triggered by TURP. Here the patient suffers from temporary confusion, nausea, or vomiting. Comparatively rarely - in studies about two to three percent of the operated persons were affected - the TUR syndrome can lead to cardiovascular problems.
In principle, regeneration after a radical prostatectomy can take place more quickly under professional guidance. One such guide is either outpatient or inpatient possible. The costs for this are borne by the cost bearers. If the person concerned wants inpatient rehabilitation, this can be organized in the hospital around the third day after the prostate operation. Rehabilitation can begin a few days after discharge from hospital. As a rule, the rehab lasts about three weeks.
If the patient suffers from urinary incontinence after the operation, specific measures can help to strengthen the muscles in the pelvic floor that were affected by the operation. For this purpose, special continence training is usually used for men, possibly with the support of measuring devices that display the pelvic floor activity and reflect it back to the patient (biofeedback). This means that control over the bladder function can be regained more quickly.
The recovery of urinary continence is an essential point in rehabilitation. Corresponding measures can also be carried out on an outpatient basis in a physiotherapy practice that is trained in this form of rehabilitation.
Last changed on: 10/29/2018
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