Transurethral Electro Resection Of The Prostate
Removing the enlarged part of the prostate is usually the best long-term treatment for an enlarged prostate gland. The portion of the gland that is not squeezing the urethra stays in place. The outside capsule around the gland is also untouched.
Transurethral electro-resection of the prostate is the traditional way to remove prostate tissue using minimally invasive surgical techniques. No outside incision is needed. There’s less pain, fewer complications and faster healing.
With TURP, an instrument called a resectoscope is inserted through the penis. This device is about 12 inches long and half an inch around. It has a light, valves for controlling irrigating fluid and an electrical loop that cuts tissue and seals blood vessels. During the surgery, the surgeon uses the wire loop to remove the tissue one piece at a time. The pieces are carried by the fluid into the bladder and then flushed out at the end of the operation. The surgery lasts about 90 minutes.
The Initial Causes Is It Safe To Masturbate After Prostate Surgery
One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.
Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.
If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.
Reducing Your Risk Of Complications
You can help reduce the chance of certain complications by:
- following activity, dietary, and lifestyle restrictions and recommendations before surgery and during recovery
- notifying your doctor immediately of any concerns, such as bleeding, bloody urine, , an increase in pain, or a change in urination
- seeing your doctor as instructed before and after surgery
- taking your medications exactly as directed
- telling all members of your care team if you have any
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How Do I Clean My Urinary Catheter
You need to wash your penis and the whole catheter tube gently with soap and warm water two times a day. It will be easier to remember to do this regularly if you plan to do it in the morning and before you go to bed at night. You may clean your penis and whole catheter tube this with warm soapy water and a wash cloth or in the shower. Do not take a tub bath while you have your catheter in place. It is important to keep your penis and the catheter clean so that you do not get an infection. Cleaning your catheter in the shower. When you take a shower to clean your catheter:
- Do not use very hot or cold water when you shower.
- Wash your penis and the catheter tubing very gently. Be careful not to pull or tug on the tubing.
Cleaning your skin and catheter out of the shower.
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Life After Prostate Removal: Postoperative Care And Recovery
The duration of time people stay in hospital after their prostatectomy varies, though it will usually be between two and three days. However, if open surgery is performed this timeframe may rise to seven or more days in hospital, depending on which hospital and country the surgery is performed in.
After this, it will be necessary to spend some recovery time at home while the surgery site heals the length of this may vary depending on the type of operation. It is possible, particularly if the procedure was a laparoscopic prostatectomy, to recover sufficiently to return to work after a period of two to three weeks. Nearly everybody who undergoes a prostatectomy recovers sufficiently to return to work after six weeks.
As soon as the operation is complete, and while the person undergoing the procedure is still in the operating room, a temporary suprapubic catheter will be inserted to assist them in urinating during the immediate recovery process. A suprapubic catheter is a hollow, flexible tube which is inserted into the bladder through an incision in the stomach above the navel . The catheter is left in place for one or two weeks and helps drain the urine from the bladder whilst the area, which has undergone surgery, is healing. In some cases, instead of the suprapubic catheter, a transurethral catheter leading from the exit of the urethra at the tip of the penis to the bladder may be inserted.
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Your Care After Radical Prostatectomy
You have been diagnosed with prostate cancer. Your type of treatment for prostate cancer depends on the extent and stage of your cancer. Treatment options include:
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Watchful waiting
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Perineal radical prostatectomy
External beam radiation
Brachytherapy
Hormone ablation therapy
This handout tells you what to expect after surgery for prostate cancer. You can have either the robotic-assisted laparoscopic prostatectomy or the open radical retropubic prostatectomy. The perineal prostatectomy is rarely done. The entire prostate gland is removed. In some cases, we may biopsy the lymph nodes in the pelvis and lower abdomen.
RoboticAssisted Laparoscopic Prostatectomy
You will have 5-6 small incisions in your lower abdomen. We close these incisions with glue on the skin surface. You will likely stay in the hospital for one night.
Open Retropubic Radical Prostatectomy
You will have one incision from your belly button down to your pubic bone. We close the incision with staples on the skin surface. We will take the staples out at your 2 week follow-up visit. You will stay in the hospital two nights.
Perineal Radical Prostatectomy
You will have an incision between the scrotum and the rectum. We will close the incision with sutures that will dissolve over time. You will likely be in the hospital two nights.
Risks of Surgery
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Scarring at the bladder neck
Before Surgery
To be in the best health before surgery:
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Exercise
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Take iron supplement only if ordered
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Do not smoke
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Do Kegel exercises
Diet
‘just Cant Wait’ Card
You can get a card to show to staff in shops or pubs etc. It allows you to use their toilets, without them asking awkward questions. You can get the cards from Disability Rights UK or the Bladder and Bowel Community. They also have a map of all the public toilets in the UK.
You could get a key to disabled toilets if you need to access them quickly. You buy the RADAR key from Disability Rights UK. But this should only be used by people who need quick access to a disabled toilet due to a disability or medical condition.
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About Your Prostate Surgery
A radical prostatectomy is a surgery to remove your entire prostate gland and seminal vesicles. Some of the lymph nodes in your pelvis are removed as well. This is done to prevent cancer from spreading from your prostate to other parts of your body.
A radical prostatectomy can be done in 1 of 2 ways. One way is through an open incision , which is called an open prostatectomy. Another way is to use a laparoscope, which is a tube-like instrument with a camera. Your surgeon will talk with you about the best surgery option for you.
Open prostatectomy
In an open prostatectomy, your surgeon will make an incision that goes from your pubic bone towards your belly button . Theyll remove the pelvic lymph nodes first, followed by the prostate gland, and then the structures next to it.
Figure 2. Open prostatectomy incisions
Laparoscopic or robotic-assisted prostatectomy
During a laparoscopic or robotic-assisted prostatectomy, your surgeon will make several small incisions in your abdomen . Theyll insert a laparoscope into 1 of the incisions and use gas to expand your abdomen. Surgical instruments will be inserted into the other incisions to remove the prostate. Some surgeons at MSK are specially trained to use a robotic device to assist with this procedure.
Figure 3. Laparoscopic or robotic-assisted prostatectomy incisions
Radiation Cystitis Causing Hematuria
Less common but challenging to treat is what we call radiation cystitis. This occurs in 1-2% of men after radiation treatment to the pelvis all the prostate. The bladder and the prostate become friable and bleed easily. Hematuria as a result of radiation cystitis typically occurs many years after treatment. A number of treatment options available, including fulguration, intravesical instillations, medical treatment. Hyperbaric oxygen treatment has been shown to be beneficial for men with persistent intermittent hematuria.
If you experience blood in urine before, after, or during treatment for prostate cancer, urological evaluation should be sought.
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Less Common Side Effects Of Turp
Less common unwanted effects of surgery include:
- urinary symptoms do not change sometimes surgery does not cure your urinary problems. Even though the blockage has been cleared, the bladder irritability may continue and you may still have symptoms such as being unable to empty your bladder completely, and nocturia
- erectile dysfunction some men are unable to get or maintain an erection sufficient for sexual intercourse after surgery. This is more of a problem for men who had erectile difficulties before their operation. This problem may be treated by medication
- urethral strictures when scarring occurs in and around the urinary tract, it can cause further blockage to urine flow. Strictures may need to be dilated or need further surgery
- urinary incontinence sometimes surgery results in being unable to hold or control the flow of urine. This may be due to continuing bladder problems or, less often, to sphincter muscle damage
- infertility retrograde ejaculation is not harmful, but it can result in infertility. It causes the seminal fluid to collect with the urine and it doesnt come out as ejaculate. This makes natural insemination impossible. However, in vitro fertilisation may be used to achieve a pregnancy. The sperm can be removed from the urine and injected into the womans harvested eggs.
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Biopsy: Things You Need To Know
The first thing you should know is that theres still plenty of room for confusion after a biopsy. The prostate in a young man is about the size of a walnut with age and BPH it can get bigger think of a lime, or a lemon, or even an orange. Now, imagine that you have about 14 tiny needles each needle has a hollow center, and when it is stuck into the prostate, it takes out a very small core of tissue. Theres a lot of potential to miss any cancer that might be hiding in there.
This is why many men end up getting multiple repeat biopsies, says NYU urologist Stacy Loeb, M.D. This means that you might have a PSA that is elevated. Your doctor orders a biopsy, and no cancer is found. But the PSA keeps on creeping up, so your doctor recommends another biopsy, and maybe even another. About a third of men in one study got another biopsy within five years of a negative biopsy, says Loeb. If the PSA is elevated, do we do another biopsy, or what do we do? This is where some of the second-line PSA tests, like the Prostate Health Index or 4K Score, can be helpful.
A urine test, called the PCA3 test, may also be helpful. Unlike the PSA test, which is prostate-specific but not cancer-specific , the PCA3 test targets genes produced by prostate cancer cells.
First, it can hurt. To get to the prostate, the doctor goes through your rectum. With needles. To minimize pain, your urologist may use conscious sedation or an anesthetic called a prostatic block .
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Management Of Blood In Urine By Prostate Cancer Patients
There is no standard treatment for blood in urine and prostate cancer. Thats because blood in the urine is a symptom and not a disease in itself. So, to manage the problem, physicians start by evaluating it. In addition to asking about a patients medical history and appearance of the blood in urine, physicians request a urine sample to be analyzed in a test called urinalysis, and/or a urine cytology, which consists of microscopically seeking abnormal cells in the urine.
Blood tests may be ordered to look for high levels of wastes that kidneys are supposed to remove. Additional exams that may be requested include a computed tomography scan, a kidney ultrasound, an intravenous pyelogram , a cystoscopy, or a biopsy. If prostate cancer is confirmed, treatment options include watchful waiting or active surveillance, surgery, radiation therapy, cryosurgery, hormone therapy, chemotherapy, vaccine treatment and bone-directed treatment.
The treatment plan is defined by a physician or a multi-disciplinary team of physicians, including urologists and oncologists. Treatment depends on factors like the cancers stage and grade, patients age and expected lifespan, and additional health conditions. Other considerations include the patients and physicians opinions about the urgency of treating the cancer, potential side effects from each treatment, and the probability of each treatment in curing the cancer.
The Morning Of Your Surgery
Instructions for drinking before your surgery
You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.
Take your medications as instructed
If your healthcare provider told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.
Shower with a 4% CHG solution antiseptic skin cleanser
Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before.
Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.
Things to remember
- Wear something comfortable and loose-fitting.
- If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
- Dont wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
- Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
- Leave valuable items at home.
What to bring
Once youre in the hospital
Get dressed for surgery
When its time to change for surgery, youll get a hospital gown, robe, and nonskid socks to wear.
Meet with a nurse
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Infections At The Surgery Site
The parts of the body which are most likely to be infected after surgery are located in the abdomen . Infections after prostate surgery, if they occur, are usually due to the intestine being injured during surgery, which is more common in cases where the operation has been carried out by keyhole surgery than when an open approach has been used.
Surgical Methods For Performing A Prostatectomy
Traditionally, prostatectomies are carried out by open surgery, in which the surgeon makes a single, long incision in the skin and then removes the prostate gland and any other required surrounding tissues. However, due to technological advancements, it has become possible to carry out a prostatectomy using less invasive methods such as laparoscopic surgery , or its subtype, robotic prostatectomy.
Good to know: In cases where only part of the prostate is to be removed, it is possible to perform the procedure without cutting into the surrounding skin at all. For example, a transurethral resection of the prostate can be performed by inserting a thin tube called a resectoscope into the bladder through the urethra to remove the prostate tissue.
The three main surgical methods of prostatectomy are:
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Treatment For Blood Clots In Urine
If you see a change in the color of your urine and you are thinking if it may be blood, you must initially consider what the possible causes are, which may include presence of your menstrual period or current drug intake. You may want to observe if the blood in urine persists after a few times you have urinated or after a day. Observe for other symptoms like pain, fever, or changes in urine character. It may help to rest, in the case of bleeding after strenuous exercise, and increase fluid intake, in mild cases of urinary tract infections. Over-the-counter pain relievers can also help relieve mild pain and fever.
In the presence of other symptoms, do not attempt to take home remedies on your own. It is advisable to get proper medical advice.
Medical Treatment
Most cases of gross hematuria will need proper diagnosis and treatment:
How Is Postoperative Bleeding Diagnosed
Your healthcare provider will look for the source of your bleeding. He will ask about your health, and if you or anyone in your family has a bleeding disorder. He will ask what medicines you take, including over-the-counter medicines, and vitamin or herbal supplements. You may also need any of the following:
- Blood tests may be done to show how well your blood clots.
- Procedures such as endoscopy and angiography may be used to find the source of your bleeding, or to control it. An endoscope is a long, bendable tube with a light on the end of it. An angiogram is a picture of your arteries. You may be given a dye to help the blood vessels show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.
- Surgery may be done in the same area to pinpoint where the blood is coming from.
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