The most common indication for surgery in men is prostate adenoma. Symptoms of this disease are caused by proliferation of prostate tissue . Signs of the disease include pain, the development of erectile dysfunction, and urinary retention. If you do not seek medical help in a timely manner, with medications alone, it is impossible to overcome prostate adenoma without surgery. The only way to cure a patient is surgery.
Today, operations with prostate adenoma are carried out mainly in a minimally invasive way. Thanks to modern surgical techniques, a complete recovery of the patient occurs within a matter of weeks.
Indications for surgery
The decision on the need to remove the gland (partial or complete) is made by the doctor individually. The choice of surgical technique depends on several conditions:
- the intensity of the pain syndrome - if at the initial stages the use of analgesics and antispasmodics is sufficient to eliminate the pain, then in the later stages the drugs are ineffective;
- the age of the man - surgery is not performed for patients over 65 because of the huge risks to life, especially in cases of cardiovascular system disorders;
- the rapid progression of adenoma - drug treatment with rapid proliferation of prostate tissue in most cases is considered inappropriate.
Classic tumor removal methods
Previously, with prostate adenoma in men, surgery was performed only in one way - abdominal. A prostatectomy is performed through a large incision at the bottom of the abdomen. However, today the traditional abdominal surgery is recognized as unsafe, as it has many contraindications and is fraught with the development of complications, in particular, erectile dysfunction. Surgeons resort to this method if it is impossible to conduct the operation in another way.
Adenoma removal method such as TUR - transurethral resection is widely used. The essence of surgery for prostate adenoma is the introduction of a special endoscope through the urethra. The first tour was completed over 90 years ago. Despite the emergence of new methods for the removal of a benign prostate tumor, transurethral resection remains one of the most popular surgical techniques.
Modern methods of getting rid of adenoma
Compared with traditional types of prostate adenoma surgery, the latest surgeons have several advantages. New techniques of surgical intervention are distinguished by a shortened period of patient rehabilitation (on average, recovery takes from 3 to 7 days), almost complete absence of risks for reproductive and urinary functions. In addition, they provide a reduction in the load experienced by the body during surgery, and do not allow the development of side effects.
The effectiveness of minimally invasive techniques is largely determined by the size of the affected gland before the planned intervention. Before the operation, men are prescribed drug steroid therapy, which can reduce the volume of the enlarged prostate to 80 cm³ or less.
Oral prostatectomy and transurethral resection are different from more modern approaches in the treatment of prostate glands at an affordable cost. The price of removal of prostate adenoma depends mainly on the chosen medical institution, while the difference in the cost of operations performed in foreign and domestic clinics can be multiple.
Arterial embolization
During this surgical procedure, prostate tissue is not excised. The technique is based on the principle of blockage of blood vessels and arteries that feed the tumor. As soon as the blood flow to the prostate gland is reduced, it will decrease in size, previously disturbing symptoms will become less pronounced. Surgery for prostate adenoma does not imply blood loss and incisions on the body. In addition, the embolization performed does not threaten the man with a weakening of potency. However, this method of treatment is most relevant for prostate adenoma at the initial stage.
Laser vaporization
This is an innovative way to treat prostate diseases that is better known as Green Light Laserscope. The therapeutic effect is achieved due to the effect of a green laser on individual sections of the prostate gland. A beam focused on fragments of the prostate creates a powerful thermal field, acting exclusively on glandular tissue.
Laparoscopic surgery
This type of surgery is designed to remove a tumor with a volume of more than 100 cm³. Instruments have access to the gland through several small incisions in the lower abdominal cavity, through each of which trocars and an endoscope are inserted to remove excess tissue. After surgery, prostate adenoma decreases in size, and the patient himself is discharged from the inpatient department in literally 3-5 days.
Needle ablation
The principle of needle ablation technique was first applied back in the 30s of the last century. Moreover, this method began to be widely used in urological surgery not so long ago, therefore it is considered one of the newest. Its essence lies in the injection of glandular tissue with special needles through which high-frequency radio waves pass. The consequence of this effect is the heating of glandular tissue and its subsequent atrophy.
Threats and risks of surgery for prostate adenoma
The consequences of surgery cannot be ruled out in any of the clinical cases. Each patient is instructed on the rules of the postoperative period, but in order to minimize the risks of developing complications of the patient, they are informed in detail about the possible consequences of treatment. There is always a chance:
- infection;
- blood loss during surgery and the development of repeated bleeding;
- disorders of the cardiovascular system due to anesthesia;
- sepsis.
And although minimally invasive methods of surgical treatment have a lower burden on the body and minor side effects, they can also have complications and lead to negative consequences in men. The operation for prostate adenoma performed according to all the canons of urological surgery is only half the success on the path to recovery. Otherwise, everything depends on whether the patient will strictly adhere to medical recommendations during the rehabilitation period.
Complications after prostatectomy
Regardless of the method of the operation, the patient may encounter some complications that either go away on their own, or require medical correction. For instance:
- Minor bleeding in the form of blood clots in urine should not cause concern in the first 2-3 weeks after surgery.
- Urinary incontinence is the result of swollen prostate gland, but more often men after surgery have to face urine retention during urination or spontaneous leakage. To solve this problem, a patient is placed a catheter for the rehabilitation period.
- Due to the removal of prostate adenoma during surgery, sperm enters the bladder unhindered, so a man can observe the absence of ejaculate during intercourse. This phenomenon is called dry orgasm. Most often, it occurs after abdominal prostatectomy or TUR. For spouses planning a pregnancy, these treatment methods are not suitable.
Minimally invasive surgical techniques are more popular because they require a shorter recovery of reproductive functions in full.
Does surgery affect potency
Since the prostate gland itself is braided by nerve endings, their slightest damage can adversely affect the patient's erectile function. It is almost impossible to predict whether potency will be fully restored after the intervention. According to statistics, in 75% of cases, patients regain masculine strength and retain reproductive functions.
Sometimes it happens that during surgery on the prostate adenoma the surgeon discovers a malignant lesion that affects the plexuses. In this case, there is no alternative solution - the fibers are removed, regardless of the patient's desire to maintain erectile function.
Restrictions after surgical treatment for men
Surgery for prostate adenoma requires an adjustment to lifestyle. Particularly careful and attentive must be during the first weeks after the intervention. Careless and rash actions can lead to a deterioration in well-being, the appearance of bleeding, and the development of the inflammatory process. In the postoperative period, it is important to avoid a prolonged sitting position. This restriction also applies to long trips by car, work on a computer. The patient should not take a hot shower, bath, drink alcohol.
As the patient recovers, a course of physiotherapy and physiotherapy is prescribed, but we must not forget that physical activity and hard work for a man remains under strict prohibition: you can not lift more than 10 kg. To comply with these restrictions for the rehabilitation period, the patient should apply for a sick leave.
Diet after prostatectomy
The recommendations regarding the diet after surgery to remove prostate adenoma do not differ fundamentally from the diet prescribed for any other surgical treatment. The main rule is as follows: throughout the postoperative period, foods that are heavy for the digestive system cannot be consumed. An equally important condition for the patient is a plentiful drink.
Based on the actual well-being of the patient, the attending physician reserves the right to revise recommendations for further nutrition. As you recover, the need for a strict diet will disappear. A fully restored man needs to eat balanced, including vitamin-containing foods in his diet. According to some experts, the most preferred diet is “Table No. 5”.
What medicines to take after removal of the prostate
Treatment of the prostate continues after surgery. Drug therapy in the postoperative period, the administration of drugs of the following pharmacological groups:
- antibacterial drugs - these drugs will help to cope with the infection that got into the body during the removal of hyperplasia (antibiotics are taken for 7-10 days);
- antispasmodics and painkillers, because during the first days after the intervention, severe pain can be observed.
Physiotherapy
Rehabilitation of the patient is more dependent on the patient’s efforts to adhere to the doctor’s recommendations. Regular performance of special exercises plays a huge role for speedy recovery.
It is important to understand that not all loads are equally useful for men who have had surgery on the prostate gland. Strength exercises associated with pressure on the pelvic area are completely excluded, cycling is also contraindicated.
An ideal option for physical exercises during the rehabilitation period is swimming in the pool, which helps to reduce the load on the prostate and internal organs. Kegel exercises are beneficial for erectile function and ability to control urination. Their essence lies in the training of the muscles of the pelvis.
If the operation is performed correctly, and the patient complies with all the doctor’s prescriptions, the chances of an early recovery without any complications are quite high. However, no doctor can exclude the likelihood of developing a relapse of prostatic hyperplasia. The disease can reoccur 10-15 years after the intervention.