Can Enlarged Prostate Be Removed

Who Is A Candidate For Urolift

For men older than 50, benign prostatic hyperplasia is the most common prostate problem. For most of these men, medication is often the first choice of treatment.

However, for patients with a relatively small to moderate sized prostate gland who do not want to take a daily dose of medication, the UroLift treatment is ideal.

Natural Ways To Treat An Enlarged Prostate

Symptoms of an enlarged prostate gland are most of often mild at first, but usually will get more bothersome over time. Its very reasonable and safe to just keep an eye on it until it becomes bothersome enough to justify further treatment.

If the symptoms are getting worse, you and your doctor can then discuss medications. If you begin to have serious complications like urinary retention, it may be time to have a surgical procedure.

In follow-up visits every six to twelve months, your primary care doctor or urologist will measure your symptoms and perform a physical exam . He or she may also do a bladder scan after you use the bathroom to urinate to be sure your bladder is emptying as it should. This test measures what is called post void residual.

Your doctor also may order blood and urine tests. Blood tests could include a blood urea nitrogen and creatinine to check your kidney function and a prostate specific antigen . He or she might also ask for a urine sample to be sure there is not any prostate inflammation or infection.

Robotic Surgery For Benign Prostatic Hypertrophy

At Temple Health, we offer robotic surgery to treat men with benign prostatic hypertrophy who have a severely enlarged prostate.

Many men with an enlarged prostate caused by BPH can be treated with medications to shrink the gland or improve urine flow and bladder emptying. When men have worsening urinary obstructive symptoms due to prostatic enlargement that failed medical therapy, they may be candidates to undergo a transurethral surgical procedure to alleviate their obstruction and improve the urinary symptoms. Procedures such as Transurethral Resection of Prostate and Urolift are examples of effective surgical procedures to help remove or destroy the obstructing prostate tissue and create a wider channel.

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Immediately After A Prostatectomy

After the operation, you can expect that:

• Nurses will monitor your vital signs.
• You may be given oxygen for up to 24 hours following surgery.
• You will probably be given antibiotics to prevent infection.
• For a day or so, you will have a catheter in your urethra and bladder with a continuous wash-out. This is to prevent blood building up and clotting, which could cause a blockage.
• If you had an open prostatectomy, your wound will be dressed and you will have a tube draining your abdomen. The tube will be removed after several days.
• Pain will be managed with injections, tablets or both. Pain is rarely a significant problem following TURP.

Transurethral Resection Of The Prostate

Transurethral resection of the prostate is a urological operation that involves cutting away a section of the prostate. It is most often used to relieve symptoms of urinary blockage, not necessarily to treat prostate cancer.

An instrument called a resectoscope is inserted through the opening of the urethra and the surgeon removes the inner part of the prostate gland .

The intervention lasts about an hour and it is most often used for non-cancerous blockage, but may also be used in cases of prostate cancer. The doctor doesnt need to make any incisions on the body. While most people can go home the same day, it is also likely that patients spend one or two days in the hospital. After the surgery, a urinary catheter will be placed because of the swelling that blocks urine flow.

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Radical Prostatectomy Perineal Approach

You’ll be placed in a supine position in which the hips and knees will be fully bent with the legs spread apart and elevated with the feet resting on straps. Stirrups will be placed under your legs for support.

An upside-down, U-shaped incision will be made in the perineal area .

The doctor will try to minimize any trauma to the nerve bundles in the prostate area.

The prostate gland and any abnormal-looking tissue in the surrounding area will be removed.

The seminal vesicles may be removed if there’s concern about abnormal tissue in the vesicles.

The Initial Causes Problems With Prostate Stone Removal 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.

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Medication And Surgical Treatments

There are several treatment options for an enlarged prostate. You can take alpha-blockers such as terazosin or tamsulosin to help relax the prostate and bladder muscles.

You can also take dutasteride or finasteride , a different kind of medication for reducing BPH symptoms. These block the hormones that cause the prostate to grow.

Combining several types of medications may also be recommended. Your doctor might also recommend surgery to remove the extra prostate tissue. One common surgical procedure for BPH is known as transurethral resection of the prostate .

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What Is A Prostatectomy

A prostatectomy is a surgical procedure for the partial or complete removalof the prostate. It may be performed to treatprostate cancerorbenign prostatic hyperplasia.

A common surgical approach to prostatectomy includes making a surgicalincision and removing the prostate gland . This may beaccomplished with either of two methods, the retropubic or suprapubicincision , or a perineum incision .

Prior to having a prostatectomy, it’s often necessary to have aprostate biopsy. Please see this procedure for additional information.

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Do Laser Treatments Have Any Advantages Over Turp

As well as the standard approaches such as TURP, there are a number of other surgical techniques. They mainly differ in terms of the instruments and sources of energy used to remove or destroy the prostate tissue. Most of the other techniques are carried out using laser beams. Like in TURP, the instruments are inserted into the urethra and guided to the prostate.

The laser treatments include:

• Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. N Engl J Med 1995 332: 75-79.

• IQWiG health information is written with the aim of helpingpeople understand the advantages and disadvantages of the main treatment options and healthcare services.

  Because IQWiG is a German institute, some of the information provided here is specific to theGerman health care system. The suitability of any of the described options in an individualcase can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by ateam ofhealth care professionals, scientists and editors, and reviewed by external experts. You canfind a detailed description of how our health information is produced and updated inour methods.

Types Of Prostate Surgery

There are several ways of removing the prostate keyhole surgery either by hand or robot-assisted, and open surgery.

Although robot-assisted keyhole surgery is the newest technique, the most recent research suggests all three techniques are as good as each other for treating prostate cancer, as long as the surgeon is experienced. They also have similar rates of side effects.

The advantages of keyhole surgery, both by hand and robot-assisted, are that you are likely to lose less blood, have less pain, spend less time in hospital, and heal more quickly than with open surgery.

Keyhole surgery

Keyhole surgery .

• Robot-assisted keyhole surgery Your surgeon makes five or six small cuts in your lower abdomen and a slightly bigger cut near your belly button, and removes the prostate using special surgical tools. These include a thin, lighted tube with a small camera on the tip. The image will appear on a screen so the surgeon can see what theyre doing. Your surgeon controls the tools from a console in the operating room via four or five robotic arms. Although its called robot-assisted, its still a surgeon who does the operation. You may hear the equipment called the da Vinci® Robot.
• Keyhole surgery by hand As with robot-assisted keyhole surgery, the surgeon will make four or five small cuts in your abdomen. But they will hold the surgical tools in their hands, rather than using robotic arms.

Open surgery

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What Happens During Surgery

The aim of surgery is to make the prostate gland smaller so that it no longer pushes against the bladder and urethra. In most of the approaches, tiny instruments are guided through the urethra until they reach the prostate, where they are used to remove tissue or widen the urethra. This kind of procedure is known as keyhole surgery. If the prostate gland is very large, it may be operated on from the outside, through a cut in the abdominal wall . This is rarely necessary, though.

Many different surgical techniques and many different instruments and devices can be used to remove prostate tissue in different ways.

Treatment Options For Bph

SLUCare urologist Dr. Lindsay Lombardo is one of the first specialists in the St. Louis region to offer Rezum, a new, FDA-approved procedure that can be performed in the doctors office under local anesthesia in about an hour. Rezum uses blasts of water vapor to shrink enlarged prostate tissues, easing the symptoms of BPH. There is minimal downtime or after-care following the procedure, and patients may begin to see improvement in urinary function as early as two weeks after treatment. Best of all, Rezum has no sexual side effects, common with BPH medications. The procedure is effective for about 95% of patients, meaning no additional follow-up procedures are required.

UroLift is a good option for men who did well on BPH medication, but would prefer a solution that relieves symptoms without medication. UroLift is a minimally invasive outpatient procedure in which the surgeon inserts a small device, relieving pressure on the urethra and allowing urine to flow more freely. It accomplishes this without cutting or removing the prostate, thereby preserving sexual function. Men go home the same day with no catheter and no medications.

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Bilateral Orchiectomy Or Surgical Castration

This is another type of prostate surgery, in which both testicles are removed. It is recommended in order to treat or prevent testicular cancer, prostate cancer, and male breast cancer. Bilateral orchiectomy lowers testosterone, the hormone that causes prostate and breast cancer to spread more quickly. By decreasing the levels of testosterone, cancer may spread at a lower rate, and some symptoms, such as bone pain, may be more tolerable.

This procedure usually lasts between 30 and 60 minutes and most people usually go home the day of the surgery, as it has a short recovery time.

Large Prostate With Significant Symptoms

For patients who have moderate or severe symptoms that have failed medical therapy from very enlarged prostates, the optimal treatment is often surgery. For very enlarged prostates, there are four main surgical options:

Open prostatectomy – The surgeon makes an incision and removes some of the enlarged prostate. This is done rarely today because less invasive surgeries through the urethra work well with fewer side effects.

Transurethral resection of the prostate – Going in through the urethra, with the aid of a small camera, the surgeon removes tissue to open up the channel, which can help the urine flow and take some of the pressure off the bladder. Tissue is removed with bipolar energy that shaves off pieces of the prostate. While this method is less invasive than open prostatectomy, it still can have side affects, such as bleeding, infection, need for repeat resection, erectile dysfunction, and scarring.

Transurethral laser ablation of the prostate – This is where the urine channel is opened up using a high-powered holmium laser to vaporize the prostate tissue. Like TURP, the procedure can help urine flow and symptoms from enlarged prostate. The use of the laser may decrease the need for a catheter or reduce bleeding after the procedure. A high-powered laser that uses “Moses effect” pulses has the potential to remove the tissue more efficiently, so the procedure time can be shortened.

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How Do These Surgical Options Compare

Prostate Artery Embolization
Risks
Its less invasive with no risk of bleeding and other surgical complications.	Your prostate is slowly deprived of its blood supply, so it may take up to six months for you to see the full benefit of PAE.
Larger prostates can be treated effectively with PAE.	Difficulty in finding small prostate arteries may lead to PAE failure in around 10 percent of cases. In these cases, you may benefit from traditional TURP surgery.
There is usually no hospital stay required.	As a relatively new procedure the long term effectiveness is unclear, although data up to around five years shows a good long term benefit.
There is no impact on erectile or sexual function.	There is a small risk of non-target embolization where particles go to the wrong area in the pelvis.

The Initial Causes Can An Enlarged Prostate Be Removed

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.

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The Initial Causes Can A Prostate Lesion Be Benign

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.

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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.

An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.

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