Removal of the prostate gland: surgery, consequences

Many men in the age of suffering from diseases of the sexual or urinary system. The most problematic organ in them, as a rule, is the prostate gland. Sometimes you can recover from pathologies by conservative methods without resorting to radical surgical intervention. However, there are cases when removal of the prostate gland is the only chance to get rid of a serious ailment. Because of what pathologies do doctors prescribe this operation? What are the indications and contraindications for it? How is the removal process going? How to behave properly in the rehabilitation period? Let's try to answer these questions in our article.

Indications for the removal of the prostate

Removing the prostate gland is a serious surgical procedure 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 a traditional way for some reason. According to statistics, older men usually operate, who initially turned to the doctor with complaints about urination problems. As a rule, they are diagnosed with benign or malignant tumors.

Let's list the main indications for this procedure:

• Chronic prostatitis, accompanied by frequent urination and severe pain in the lower abdomen;
• Prostatitis, complicated by the presence of stones in the prostate gland;
• Adenoma of the prostate gland is a benign tumor that usually does not endanger human life;
• Frequent urination or urinary retention;
• Constant expressed hematuria (presence of blood in the urine);
• False urge to urinate, not amenable to conservative treatment;
• Prostate cancer - surgery, as a rule, patients are subjected to the first or second stage of the disease, when the tumor did not go beyond the body.

Contraindications to the operation

Operation is a serious blow to the body, which not all patients can bear. Therefore, removal of the prostate gland can not be done to all people. The neglect of the disease is the most frequent reason for refusing surgical intervention. Also, the basis may 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 history and the results of his analysis.

The most common reasons for refusal to perform this operation are the following contraindications:

• Inflammatory diseases of the urogenital system in acute form;
• Viral diseases and fever;
• Severe chronic pathologies of the cardiovascular and respiratory system;
• Launched malignant tumors, accompanied by numerous metastases throughout the body;
• Pathology of the thyroid or pancreas, including diabetes, goiter and hypothyroidism;
• Elderly age - the operation is contraindicated for men over 70;
• Diseases that cause blood clotting disorders, including hemophilia;
• Taking medications that dilute the blood - 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 a part of the organ is removed, not the entire prostate gland. The removal operation can be performed by the following methods:

• удаление простаты — проводится через наружное отверстие мочеиспускательного канала. Transurethral removal of the prostate is performed through the external opening of the urethra. резектоскопа происходит поэтапное удаление предстательной железы или только ее пораженной части. Using a resectoscope , a gradual removal of the prostate gland or only of its affected part occurs. The absence of a cut is the main advantage of this method. Also, the rehabilitation period is significantly reduced.
• аденомэктомия — открытая операция, при которой хирург делает разрез между пупком и лобком. Transvezical adenomectomy is an open operation in which the surgeon makes a cut between the navel and the pubis. It is used for the removal of adenoma or malignant tumor of large size.
• Laparoscopic resection - during the operation the doctor makes several punctures in the anterior abdominal wall, where the device equipped with a camera enters. This way you can completely remove the entire prostate or only part of it.

Preparing for an operation

Before you start the operation, it is necessary to conduct a thorough diagnosis of the body in order to prevent the occurrence of complications. The patient must submit a general and biochemical blood test. Вассермана (обнаружение сифилиса), ВИЧ и вирусные гепатиты. Blood tests are also conducted for Wassermann's reaction (detection of syphilis), HIV and viral hepatitis. The patient is also required to provide doctors with information about his blood group and Rh factor. It is necessary to pass the general analysis of urine and to make its separate crop on sensitivity to antibiotics. To assess the state of the cardiovascular system, an ECG is performed. To exclude tuberculosis and other pathologies of the lungs, it is necessary to make a fluorography.

Removal of prostate cancer begins with an ultrasound of the urino-genital organs to determine the presence of residual urine. Further the patient visits the therapist, urologist and anesthesiologist. In the evening before the operation, the patient is obliged to make an enema, and also pubic hair is shaved. Since that time, he should not eat or drink.

Removal of the prostate: consequences

The appearance of possible complications in surgical intervention depends on the neglect of the disease. So, surgery to remove adenoma of the prostate gland usually has no serious consequences. In addition, it is much more dangerous to conduct the procedure through an open incision. The risk of complications also depends on the level of the surgeon's qualification.

которыми чаще всего сталкиваются пациенты: We list the main postoperative complications that patients most often encounter:

• Infections of the genitourinary system, brought into the body during resection;
• The appearance of hematuria (the presence of blood in the urine);
• Temporary or permanent impotence;
• Relapse of the disease;
• приводит к затрудненной деуринации ; Constriction of the urethra, which leads to hindered deurination ;
• Retrograde ejaculation is the transfer of semen into the bladder cavity.

How is the operation to remove the prostate gland?

Depending on the complexity of the forthcoming surgical intervention, either general or spinal anesthesia is used. The technique of performing the operation depends on the method by which it will be performed. трансуретральной резекции инструмент с осветительным прибором и камерой вводится в мочеиспускательный канал пациента. Thus, with transurethral resection, a tool with a lighting device and a camera is inserted into the patient's urethra. Through it, it enters the bladder. For his manipulations, the surgeon observes on the screen of the monitor. резектоскопа он медленно удаляет простату или ее часть, отщипывая от нее небольшие куски, одновременно прижигая пораженные кровоточащие сосуды. Using a resectoscope, it slowly removes the prostate or part of it, pinching off small pieces from it, while simultaneously burning the affected bleeding vessels. After resection, the doctor places a catheter in the bladder through which the urine will later enter the urine collection. Laparoscopy is similarly performed. резектоскоп вводится не через мочеиспускательный канал, а через небольшие отверстия на передней стенке брюшной полости. The main difference is that the resectoscope is inserted not through the urethra, but through small openings in the anterior wall of the abdominal cavity.

You can also perform the removal in an open way. The prostate gland in this case, as a rule, is removed completely. The surgeon makes a cut between the pubis and the navel of the patient, passes through the muscle tissue and the walls of the bladder. Then he removes the enlarged part of the prostate with his hands. At the end of the operation, a catheter and a drainage tube are also inserted, which goes through the incision. The rehabilitation period after this type of operation lasts much longer.

Features of surgery for the removal of cancer

лимфоузлов , чтобы не допустить появления и распространения метастазов. The operation to remove prostate cancer is additionally accompanied by a complete resection of the abdominal lymph nodes to prevent the occurrence and spread of metastases. Additionally, the seminal vesicles are removed. лапароскопические действия, нанося минимальные повреждения пациенту. For small tumors of early stages, Da Vinci can be used during the operation, performing precise laparoscopic actions, causing minimal damage to the patient. The surgeon and anesthesiologist in this case are constantly next to the patient and monitor his condition. This method allows you to fully preserve the potency of men.

Initial rehabilitation period

After the operation, the patient is connected to a continuous bladder emptying system in time to remove the accumulated fluid and blood clots from there through the catheter. Through it, the organ is washed with a special solution, for example, furacilin. Depending on the complexity of the operation performed, the system can run from several hours to several days. 2 hours after the procedure, the patient is allowed to drink some water, and the meal 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 from the menu fatty, fried, salted and smoked food.

Is it possible to restore the potency after removal of the prostate gland?

As a rule, not always to the loss of potency leads resection (removal). The prostate gland is surrounded by a multitude of muscles that are responsible for the ability of a man to have an erection. If the surgeon during the operation manages to avoid their damage, then the potency with time is restored. 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 surgery to remove the prostate

After discharge from the hospital, the patient can still feel discomfort for a while. With simple surgical interventions the patient is sent home within 4-5 days. The operation to remove adenoma of the prostate or cancer requires a long recovery under the supervision of doctors. The first time a man will be forbidden to supercool and engage in heavy physical labor. Loads can be restored 1-2 months after resection. A week after discharge, the patient can return to work.

Summing up

Thus, removal of the prostate gland can be called a non-hazardous procedure. The consequences of it entirely depend on the disease at which it was carried out. As a rule, after resection, the patient's condition improves, and he eventually recovers. Even with resection of the body in the presence of malignant tumors there is a high probability of a positive outcome, especially if it was carried out in the early stages. In this case, the survival of patients after removal of prostate cancer is 90-100%. Choose a proven clinic and surgeon who has a lot of positive feedback to reduce the likelihood of medical error and the appearance of possible complications.