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Surgery on the prostate: technique, indications, contraindications
Surgery on the prostate: technique, indications, contraindications

Every second man after the fifty-year line of life has a urological pathology - prostate adenoma. Symptoms of the disease are associated with changes in the process of urination due to the compression of the lumen of the prostate gland by the tumor.

The neoplasm in the gland is constantly increasing in size, squeezing the nearby urinary canal, rectum, which leads to stagnation of urine, constipation, accompanied by pain in the lower abdomen. This condition provokes negative consequences in the work of the genitourinary system: the formation of stones, the spread of infections.

The neglect of the process, in which the disease progresses, leads to surgical intervention in the area of the prostate gland.

What is prostate surgery

Patients diagnosed with prostate adenoma with subsequent kidney damage or blockage of the urethra are referred for an operation called transurethral resection of the prostate (TURP). Excision of the gland tissue occurs in a closed way through the urethral canal. The plan for its implementation was developed in the first half of the 20th century.

It is a common type of treatment for prostate adenoma among elderly and senile men, since the surgical technique does not require opening the abdominal cavity, and recovery after the procedure is quick, without serious complications.

In some cases, the prostate gland affected by the neoplasm is removed by an open method.

Radical methods of treating adenoma are considered extreme, they are used in the case of advanced forms of the disease, when negative consequences appear, for example, the tumor begins to turn into a malignant one.

In what cases is the operation indicated?

Surgical therapy is provided in cases where the patient has complex consequences in the state of the genitourinary system:

  • The urine does not go away, it is delayed even after the catheter is inserted into the bladder. A significant amount of it remains in the body;
  • The infection affects the kidneys and urinary tract;
  • In the bladder, there is an intense formation of stones;
  • There is a syndrome of paradoxical ischuria, which is characterized by involuntary urination;
  • In the area of the prostate gland, seminal vesicles, purulent abscesses are formed;
  • Cystic neoplasms appear in the prostate;
  • Blood appears in the urine or only erythrocytes, the number of which exceeds the norm. This pathological condition is called hematuria.

The specialist can prescribe the operation for other indications, which he determines independently, specifically for each patient.

Features of preparation for surgical treatment

A radical method of therapy involves preparatory measures for it. It is mandatory to conduct an examination, which traditionally includes the delivery of blood and urine tests. The anesthesiologist must first determine what type of anesthesia will be used: general, local or regional, when anesthesia is performed by injecting a solution into the space of the spinal cord.

Additional measures in the preparatory period include drainage of the urinary tract, normalization of the functions of the liver, heart, blood vessels.

Especially in the evening before the operation, it is necessary to carry out cleansing procedures with the patient's intestines using an enema.

Surgical therapy technique

After local or spinal anesthesia is performed, the process of introducing a special instrument through the urethra into the bladder begins, a resectoscope, which consists of a light source, a reservoir for fluid, and a metal loop for removing adenoma.

The object to be resected is clearly visible by the surgeon. And with the help of an electrically heated loop, the doctor excises the affected tissue while sealing the blood vessels to prevent bleeding. Since the blood streams pollute the object of influence, the pumped liquid containing solutions of glucose, urea, it is constantly washed.

The operation ends with the removal of the cut pieces using a washing system, pumping out the liquid. The procedure lasts from half an hour to an hour, after which a catheter is inserted into the urethra for three days to remove the accumulated blood masses in the cavity and rinse the bladder.

A similar method is used to evaporate the affected tissues with powerful laser radiation. Such an operation to remove the gland is suitable for patients with severe vascular ailments, diabetes mellitus. Recovery after removal of a diseased organ is quick, the patient does not need hospitalization.

Of course, there is a risk of complications for any intervention, but they are quite rare. Possible consequences include bleeding, which stops a week after resection, and fusion of the urethra can be prevented by increasing the amount of fluid drunk per day.

During the procedure, for prophylactic purposes, local hypothermia is used by cooling the liquid for washing, adding vasoconstrictor drugs of adrenaline to it.

Cases of contraindications for prostate removal

It is absolutely forbidden to carry out surgical treatment of prostate adenoma to patients who have severe disorders in the work of organs, systems:

  • In the abdominal part of a person, an aortic aneurysm is often observed, characterized by an expansion of the lumen of the artery trunk in a certain area. During the procedure of resection of the prostate, an aneurysm may rupture, which is fraught with massive bleeding, collapse, acute heart failure;
  • Renal failure is characterized by a symptom of hypoisostenuria, in which the specific gravity of urine is reduced during the day due to damage to the kidney tubules. Urinary tract infections, manifested by cystitis, pyelonephritis, are an obstacle to performing excision of the prostate;
  • With vascular disorders, which include atherosclerosis, cor pulmonale, when the movement of blood through the channels is disturbed, surgical treatment is impossible.

Patients who have contraindications to surgical intervention for the removal of prostate adenoma, select another method of treatment that helps to return to a full life.

Features of the rehabilitation period

The gradual return to the usual way of life under the supervision of the attending physician is the main condition for rehabilitation in the postoperative period.

  1. For some time, you can not perform any sudden movements, load yourself with physical work, as this will lead to damage to the scar.
  2. After a two-week rest after resection, it is necessary to engage in special gymnastics, even in spite of old age. You need to start with a minimum load, gradually increasing it. The daily morning activity is complemented by an afternoon activity of hiking.
  3. In the first months after a radical intervention, it is necessary to refrain from sexual intercourse, not to drink strong drinks, to follow a diet.
  4. Proper nutrition plays an important role in the further restoration of the patient's health. The use of dairy products and plant foods is especially recommended. The inclusion of buckwheat, corn, oatmeal cereals in the diet will help strengthen the man's body. And green onions, garlic will supply it with the substances necessary for health: zinc, iron. Operated patients should forget about mustard, canned food, alcohol, smoked meats, fatty meat products, eggs, but consume as much liquid as possible.

Consulting a urologist will help you avoid the severe consequences of prostate surgery.

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