Many older men suffer from diseases of the genital or urinary system. The most problematic organ in them, as a rule, is the prostate gland. Sometimes, pathologies can be cured by conservative methods, without resorting to radical surgical intervention. However, there are cases when the removal of the prostate gland is the only chance to get rid of a serious illness. What pathologies do doctors prescribe this operation for? What indications and contraindications are there? How is the removal process going? How to behave in the rehabilitation period? Let's try to answer these questions in our article.
Indications for removal of the prostate gland
Removal of the prostate gland is a serious surgical intervention that is performed only when there is no other way to cure the patient. Therefore, it is prescribed only for serious pathologies, which can not be eliminated in the traditional way for any reason. According to statistics, older men are most often operated on, who initially went to the doctor with complaints of problems with urination. As a rule, they are diagnosed with benign or malignant tumors.
We list the main indications for this procedure:
- chronic prostatitis, accompanied by frequent urination and sharp pains in the lower abdomen;
- prostatitis, complicated by the presence of stones in the prostate gland ;
- prostate adenoma - a benign tumor that usually does not threaten a person’s life;
- frequent urination or urinary retention;
- persistent severe hematuria (the presence of blood in the urine);
- false urination, not amenable to conservative treatment;
- prostate cancer - operations are usually performed on patients with the first or second stage of the disease, when the tumor has not gone beyond the body.
Contraindications for surgery
An operation is a serious blow to the body that not all patients can tolerate. Therefore, the removal of the prostate gland can be performed not for all people. Neglect of the disease is the most common reason for refusing surgery. The basis may also be the presence of serious chronic diseases or even the age of the patient. The final decision is made by the attending physician or medical commission, based on the patient's medical history and the results of his analyzes.
The most common reasons for refusing to perform this operation are the following contraindications:
- inflammatory diseases of the genitourinary system in the acute form;
- viral diseases and fever;
- severe chronic pathologies of the cardiovascular and respiratory system;
- neglected malignant tumors, accompanied by numerous metastases throughout the body;
- thyroid or pancreas pathologies, including diabetes mellitus, goiter and hypothyroidism;
- advanced age - the operation is contraindicated in men older than 70 years;
- diseases that cause bleeding disorders, including hemophilia;
- taking blood thinners - in this case, the operation is performed only after they are completely removed from the body.
Types of Surgery
Depending on the severity of the disease, doctors use different methods of surgical intervention. Sometimes only part of the organ is removed, and not the entire prostate gland. The removal operation can be carried out by the following methods:
- Transurethral removal of the prostate - is carried out through the external opening of the urethra. With the help of a resectoscope , a gradual removal of the prostate gland or only its affected part occurs. The absence of a cut is the main advantage of this method. The rehabilitation period is also significantly reduced.
- Transvesical adenomectomy is an open operation in which the surgeon makes an incision between the navel and the pubis. It is used to remove adenomas or large malignant tumors.
- Laparoscopic resection - during the operation, the doctor makes several punctures on the anterior abdominal wall where the device equipped with the camera enters. In this way, you can completely remove the entire prostate or only part of it.
Preparation for surgery
Before proceeding with the operation, it is necessary to conduct a thorough diagnosis of the body in order to prevent complications. The patient must pass a general and biochemical blood test. Blood tests for Wassermann reaction (detection of syphilis), HIV and viral hepatitis are also conducted . The patient is also required to provide doctors with information about his blood type and Rh factor. It is necessary to pass a general analysis of urine and make it a separate culture for sensitivity to antibiotics. To assess the state of the cardiovascular system, an ECG is performed. To exclude tuberculosis and other lung pathologies, fluorography is necessary.
Removal of a prostate tumor begins with an ultrasound of the genitourinary organs to determine the presence of residual urine. Next, the patient visits a therapist, urologist and anesthetist. In the evening, before the operation, the patient must be given an enema, and pubic hair is also shaved. From now on, he should not eat or drink.
Removal of the prostate gland: consequences
The appearance of possible complications during surgery depends on the neglect of the disease. So, an operation to remove prostate adenoma usually does not have serious consequences. In addition, it is much more dangerous to carry out the procedure through an open incision. The risk of complications also depends on the skill level of the surgeon.
We list the main postoperative complications that patients most often encounter:
- infections of the genitourinary system introduced into the body during resection;
- the appearance of hematuria (the presence of blood in the urine);
- temporary or permanent impotence;
- relapse of the disease;
- narrowing of the urethra, which leads to difficult deurination ;
- retrograde ejaculation is the injection of sperm into the cavity of the bladder.
How is the operation to remove the prostate gland?
Depending on the complexity of the upcoming surgical intervention, either general or spinal anesthesia is used. The technique of the operation depends on the method by which it will be performed. So, with transurethral resection, an instrument with a lighting device and a camera is inserted into the urethra of the patient. Through it, he enters the bladder. The surgeon observes his manipulations on the monitor screen. With the help of a resectoscope, he slowly removes the prostate or part of it, pinching small pieces from it, while cauterizing the affected bleeding vessels. After resection, the doctor places a catheter into the bladder through which urine will subsequently enter the urinal. Laparoscopy is similarly performed. The main difference is that the resectoscope is not inserted through the urethra, but through small holes on the front wall of the abdominal cavity.
An open method can also be used for deletion. The prostate gland in this case, as a rule, is completely removed. The surgeon makes an incision between the pubis and the navel of the patient, passes through the muscle tissue and the walls of the bladder. Then, with his hands, he removes the overgrown part of the prostate. At the end of the operation, a catheter and a drainage tube are also inserted, which exits through the incision. The rehabilitation period after this type of operation lasts much longer.
Features of surgery to remove cancer
The operation to remove prostate cancer is additionally accompanied by a complete resection of the abdominal lymph nodes to prevent the appearance and spread of metastases. Additionally, seminal vesicles are also removed. With small tumors of the early stages during the operation, they can use the Da Vinci robot, which performs precise laparoscopic actions, causing minimal damage to the patient. The surgeon and anesthetist in this case are constantly next to the patient and monitor his condition. This method allows you to fully maintain the potency in men.
Initial rehabilitation period
After the operation, the patient is connected to a continuous bladder emptying system to timely remove accumulated fluid and blood clots from there through a catheter. Through it, the organ is washed with a special solution, for example, furatsilinom. Depending on the complexity of the operation, the system can work from several hours to several days. 2 hours after the procedure, the patient is allowed to drink some water, and eating is resumed the next morning. In the first days after resection, it is recommended to drink at least 2 liters of water, and also to exclude fatty, fried, salty and smoked foods from the menu.
Is it possible to restore potency after removal of the prostate gland?
As a rule, resection (removal) does not always lead to a loss of potency. The prostate gland is surrounded by many muscles that are responsible for the man's ability to have an erection. If the surgeon manages to avoid damage during the operation, then the potency is restored over time. A negative prognosis is usually given to patients with extensive malignant tumors. In the absence of complications, the potency returns to the man 4-5 weeks after the resection.
Life after prostate removal surgery
After discharge from the hospital, the patient may still feel discomfort for some time. With simple surgical interventions, the patient is sent home after 4-5 days. Surgery to remove prostate adenoma or cancer requires a long-term recovery under the supervision of doctors. At first, a man will be forbidden to supercool and engage in heavy physical labor. Loads can be restored 1-2 months after resection. One week after discharge, the patient may return to work.
To summarize
Thus, removal of the prostate can be called a non-hazardous procedure. Its consequences depend entirely on the disease in which it was carried out. As a rule, after resection, the patient's condition improves, and he recovers over time. Even with organ resection in the presence of malignant tumors, there is a high probability of a positive outcome, especially if it was performed in the early stages. In this case, the survival rate of patients after removal of prostate cancer is 90-100%. Choose a trusted clinic and surgeon who has many positive reviews to reduce the likelihood of a medical error and the appearance of possible complications.