Many older men suffer from diseases of the reproductive 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. Due to what pathologies do doctors prescribe this operation? What are the indications and contraindications for it? 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 prostate removal
Removal of the prostate gland is a serious surgical intervention, which is performed only when there is no other way to cure the patient. Therefore, it is prescribed only for serious pathologies, which cannot 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 withcomplaints of problems with urination. 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 sharp pains in the lower abdomen;
- prostatitis complicated by prostate stones;
- prostate adenoma is a benign tumor that usually does not threaten human life;
- frequent urination or urinary retention;
- constant severe hematuria (blood in the urine);
- false urge to urinate, not amenable to conservative treatment;
- prostate cancer - operations are usually performed on patients with the first or second stage of this disease, when the tumor has not spread beyond the organ.
Contraindications for surgery
An operation is a serious blow to the body, which not all patients can endure. Therefore, removal of the prostate gland can not be performed for all people. The neglect of the disease is the most common reason for refusing surgery. Also, the presence of serious chronic diseases or even the age of the patient can become the basis. The final decision is made by the attending physician or medical commission, based on the patient's history and test results.
The most common reasons for refusing to perform this operation are the followingcontraindications:
- inflammatory diseases of the genitourinary system in acute form;
- viral diseases and fever;
- severe chronic pathologies of the cardiovascular and respiratory systems;
- advanced malignant tumors, accompanied by numerous metastases throughout the body;
- pathologies of the thyroid or pancreas, including diabetes mellitus, goiter and hypothyroidism;
- old age - surgery is contraindicated for men over 70;
- diseases that cause bleeding disorders, including hemophilia;
- taking blood-thinning drugs - 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 an incision is the main advantage of this method. The rehabilitation period is also significantly reduced.
- Transvesical adenomectomy is an open surgery in which the surgeon makes an incision between the navel and the pubis. Used to remove an adenomaor a large malignant tumor.
- Laparoscopic resection - during the operation, the doctor makes several punctures on the anterior abdominal wall, where he inserts a device equipped with a camera. In this way, you can remove the entire prostate or only part of it.
Preparation for surgery
Before proceeding with the operation, it is imperative 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 are also carried out for the Wasserman reaction (detection of syphilis), HIV and viral hepatitis. The patient is also required to provide doctors with information about his blood type and Rh factor. It is necessary to pass a general urine test and make it a separate crop for 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 do a fluorography.
Removal of a prostate tumor begins with an ultrasound of the genitourinary organs to determine the presence of residual urine. Then the patient visits the therapist, urologist and anesthesiologist. In the evening before the operation, the patient is required to do an enema, as well as shave the pubic hair. From now on, he cannot eat or drink.
Prostate removal: consequences
The occurrence of possible complications in surgical intervention depends on the neglect of the disease. So, surgery to remove prostate adenomausually has no 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.
Let's list the main postoperative complications that patients most often face:
- 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;
- disease recurrence;
- narrowing of the urethra leading to difficult deurination;
- retrograde ejaculation is the reflux of semen into the bladder cavity.
How is prostate surgery going?
Depending on the complexity of the forthcoming surgical intervention, either general or spinal anesthesia is used. The technique for performing the operation depends on the method by which it will be carried out. So, during transurethral resection, an instrument with a lighting device and a camera is inserted into the patient's urethra. Through it, it enters the bladder. The surgeon watches his manipulations on the monitor screen. With the help of a resectoscope, he slowly removes the prostate or part of it, pinching off small pieces from it, while cauterizing the affected bleeding vessels. After resection, the doctor installs a catheter in the bladder, through which urine will subsequently flow into the urinal. Similarly, laparoscopy is performed. The main difference isThe resectoscope is not inserted through the urethra, but through small openings on the anterior wall of the abdominal cavity.
Open method can also be removed. 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 he removes the overgrown part of the prostate with his hands. At the end of the operation, a catheter and a drainage tube are also placed, which exits through the incision. The rehabilitation period after this type of operation lasts much longer.
Features of surgery for cancer removal
An 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, the seminal vesicles are removed. For small tumors in the early stages, the Da Vinci robot can be used during surgery, which performs 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 maintain potency in men.
Initial rehabilitation period
After the operation, the patient is connected to a continuous bladder emptying system in order to timely 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 theoperations, the system can work from several hours to several days. 2 hours after the procedure, the patient is allowed to drink some water, and food intake 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, s alty and smoked foods from the menu.
Is it possible to restore potency after prostate removal?
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 a man's ability to have an erection. If the surgeon manages to avoid damage to them 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 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. An operation to remove prostate adenoma or cancer requires a long recovery under the supervision of doctors. At first, a man will be forbidden to supercool and engage in hard physical labor. Loads can be restored 1-2 months after resection. A week after discharge, the patient can return to work.
Summing up
Thus, a non-hazardous procedure can be called the removal of the prostate gland. Its consequences entirely depend 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 carried out in the early stages. In this case, the survival of patients after removal of prostate cancer is 90-100%. Choose a trusted clinic and a surgeon who has many positive reviews to reduce the likelihood of medical errors and possible complications.
