Men's he alth is an important aspect not only for the physical condition, but also for the psyche. A change in the functioning of the genital organs is noted in urological diseases. The most common of them are prostate pathologies. The prostate ensures normal ejaculation in men and helps to block the exit from the bladder during ejaculation. Prostate diseases can be associated with inflammatory, hyperplastic and oncological processes. Often the treatment is to remove the prostate. Despite the radical nature of the method, in some cases, the operation is considered the only option.
Indications for prostate removal
Removal of the prostate is performed in cases where conservative therapy is powerless. In most cases, this is an oncological process. Sometimes a prostatectomy is performed for benign prostatic hyperplasia. An increase in the organ due to inflammation is not a reason for surgery. The following indications for prostate removal are distinguished:
- Initialstages of prostate cancer.
- Calculous prostatitis - accompanied by impaired urination and hematuria.
- Benign organ hyperplasia - adenoma.
Cancer is considered the main indication for organ removal. Prostatectomy is performed only at stages 1 and 2 of the disease. In these cases, the oncological process is limited to prostate tissue. If the prostate is not removed in a timely manner, the cancer can spread throughout the body. The operation is performed on men under 70 years of age, since somatic pathologies are contraindications to its implementation.
Prostate adenoma leads to an increase in the organ. As a result of this disease, sexual weakness and impaired urination are noted. With the progression of benign hyperplasia and the lack of effectiveness of therapeutic methods of treatment, a prostatectomy is performed.
Methods of surgical intervention
There are several ways to remove the prostate. The choice of method depends on the prevalence of pathology. Removal of an organ can be complete or partial. Surgical options include:
- Transurethral resection of the prostate. It is characterized by partial removal of tissues, which is performed through the urethra. Resection is performed laparoscopically. It is performed for benign prostatic hyperplasia.
- Prostate incision. Such a surgical intervention involves the dissection of the tissues of the organ. Itallows you to expand the lumen of the urethra and prevent compression of the urethra. An incision is made in the prostate gland, but the organ is not removed.
- Radical prostatectomy. It is carried out with tumor formations and severe benign hyperplasia. The gland is removed together with the lymph nodes. Access to the organ can be different - perineal, supra- and retropubic. Open surgery is dangerous for the development of complications.
- Laser intervention. It is considered more preferable, as it reduces the risk of bleeding. Removal of the prostate with a laser is performed with benign gland hyperplasia. There are several methods for performing this manipulation. Among them are vaporization (evaporation), enucleation and laser resection of adenoma.
Currently, less traumatic surgical procedures are preferred. These include laser removal of adenoma, transurethral resection. However, it is not possible to replace an open operation with other methods in some cases.
Removal of prostate adenoma: consequences of surgical treatment
Removal of the prostate gland is a radical treatment that comes with a number of he alth risks. These include complications of the early and late postoperative period. Among them - a violation of the process of urination and ejaculation. After removal of prostate adenoma with a laser and transurethral resection, the risk of these complications is reduced compared to opensurgery.
This operation is stressful for the whole organism. Therefore, after it, there are violations of the functioning of the genitourinary system. Normally, they gradually disappear. In 2-10% of cases, violations remain. Negative effects of a prostatectomy include:
- Urinary incontinence.
- Lack of ejaculate during intercourse.
- Infertility.
- Erectile dysfunction.
- Inflammatory processes in the pelvis.
To prevent these complications from developing, the patient's condition is monitored in the first days after prostate removal. When discharged, you should follow the recommendations of the urologist. This will help reduce the risk of late complications.
Early postoperative period
During the first days after prostatectomy, the patient's condition is severe. This is due to blood loss and changes in the functioning of the urinary organs. At this time, there is a risk of developing the following complications:
- Infection of the wound and penetration of microbes. The patient's condition is severe, with fever, local inflammation and signs of peritoneal irritation.
- Bleeding - occurs in 2.5% of cases.
- Obstruction of the urethra with blood clots, the occurrence of strictures.
- Relaxation of the bladder sphincter. Normally, this symptom goes away on its own. Muscle relaxation leads to urinary incontinence.
Diagnosis of early complications is carried out by medical staff in a hospital. In case of development of acute conditions, it is requiredsurgeon assistance.
Recovery period after prostatectomy
The early postoperative period is several days (5-7 days). During this time, the patient's condition is normalized, there is an independent urination. However, full recovery after removal of prostate cancer or adenoma may occur only after a few months. It depends on the age of the patient, the characteristics of his body and the technique of the operation. To speed up rehabilitation and reduce the risk of late complications, the following guidelines must be followed:
- Do gymnastics to strengthen the pelvic muscles. Kegel exercises will help bring the process of urination back to normal. Gymnastics consists in alternating tension and relaxation of the pubic muscle.
- Vibrotherapy and massage.
- Using an electrostimulator or vacuum erector.
After a prostatectomy, you can not lift heavy objects that weigh more than 3 kg. It is also not recommended to engage in sedentary work and drive a car. Nutrition should be fractional, with a predominance of easily digestible carbohydrates and proteins.
Restoration of urination after prostatectomy
Removal of the prostate often leads to disruption of the urination process. In the first days after surgery, a catheter is inserted into the urethra. It is necessary for the evacuation of fluid from the bladder. The catheter is removed after a few days or weeks. Due to weaknesspelvic floor muscles urination is difficult to control. But gradually the process is getting better. To speed up rehabilitation, you need to do gymnastics, spa treatment is useful.
Intimate life after prostate surgery
After 3 months after prostatectomy, the patient can start sexual activity. By this time, the pelvic muscles should recover. In some cases, patients experience retrograde ejaculation. Seminal fluid is released, but it enters the lumen of the bladder. This phenomenon is not dangerous, but it prevents conception. To get rid of this symptom, vibromassage and vacuum erectors are used. With erectile dysfunction, drugs containing sildenafil are prescribed. These include medicines "Cialis", "Viagra".
Reviews of doctors about the operation
Doctors say prostatectomy is a complex operation that should only be done when necessary. With prostate adenoma, it is not recommended to completely remove the organ; it is better to perform resection or laser vaporization. Recovery after a prostatectomy is gradual, so you should follow the instructions of the urologist and be patient.
