How Do They Remove An Enlarged Prostate

Within 30 Days Of Your Surgery

Presurgical Testing

Before your surgery, youll have an appointment for presurgical testing . The date, time, and location will be printed on the appointment reminder from your surgeons office. Its helpful to bring the following things to your PST appointment:

• A list of all the medications youre taking, including prescription and over-the-counter medications, patches, and creams.
• Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
• The name and telephone number of your healthcare provider.

You can eat and take your usual medications the day of your appointment.

During your PST appointment, youll meet with a nurse practitioner . They work closely with anesthesiology staff . Your NP will review your medical and surgical history with you. You may have tests, such as an electrocardiogram to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

Complete a Health Care Proxy form

If you havent already completed a Health Care Proxy form, we recommend you complete one now. If youve already completed one or have any other advance directives, bring them to your next appointment.

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Male Sexual and Reproductive Medicine Program

Do breathing and coughing exercises

Exercise

During Surgery For Prostate Cancer

The most common type of surgery to treat prostate cancer is a radical prostatectomy. This surgery involves removing the entire prostate gland along with nearby tissues .

Since the prostate gland normally connects the bladder to the urethrathe tube inside the penisthe surgeon must also reattach the bladder to the urethra once the prostate gland is removed.

A radical prostatectomy can be performed in three different ways:

• Open radical prostatectomy: The surgeon accesses the prostate gland by making a larger incision over the lower abdomen. Less commonly, the prostate is accessed through an incision made between the anus and scrotum .
• Laparoscopic radical prostatectomy: This minimally invasive approach involves accessing the prostate gland by inserting long, thin instruments through several keyhole-size incisions made in the lower abdomen.
• Robotic-assisted radical prostatectomy: With this approach, the surgeon sits at a computer console and manipulates mini robotic arms/instruments to remove the entire prostate gland. Robotic-assisted is the most common way a prostate is removed for cancer today.

Why Might I Need Turp

TURP is most often done to relieve symptoms caused by an enlarged prostate.This is often due to benign prostate hyperplasia . BPH is not cancer.It is a common part of aging. When the prostate gland is enlarged, it canpress against the urethra and interfere with or block the passage of urineout of the body.

Sometimes a TURP is done to treat symptoms only, not to cure the disease.For example, if youre unable to urinate because of prostate cancer, butsurgery to remove the prostate isnt an option for you, you may need aTURP.

There may be other reasons for your healthcare provider to recommend aTURP.

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Reasons For The Procedure

The goal of radical prostatectomy is to remove all prostate cancer. RP isused when the cancer is believed to be confined to the prostate gland.During the procedure, the prostate gland and some tissue around the gland,including the seminal vesicles, are removed. The seminal vesicles are thetwo sacs that connect to the vas deferens , and secrete semen.Other less common reasons for radical prostatectomy include:

• Inability to completely empty the bladder

• Recurrent bleeding from the prostate

• Bladder stones with prostate enlargement

• Very slow urination

• Increased pressure on the ureters and kidneys from urinary retention

There may be other reasons for your doctor to recommend a prostatectomy.

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Prostate Surgery To Treat Nocturia And Other Symptoms Of Bph

University Hospitals Urology Institute offers a variety of minimally invasive and traditional surgery options to treat benign prostatic hyperplasia. Our minimally invasive procedures typically result in less pain, a shorter recovery time and may allow men to stop taking BPH medications. Your surgical treatment options at UH include:

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When Should I See My Healthcare Provider

Talk to your healthcare provider if you have any of these symptoms after your surgery:

• Bleeding, swelling or drainage from the incisions.
• Inability to have a bowel movement.
• Inability to urinate after catheter removal.
• Increased pain around the incisions.

A note from Cleveland Clinic

Radical prostatectomy is a common surgery to remove the entire prostate gland. This prostate cancer surgery may be robotic surgery or open surgery. Robotic surgery has a shorter recovery time. Full recovery can take weeks, with some side effects lasting for months. Light exercise and medication can help you heal faster.

Last reviewed by a Cleveland Clinic medical professional on 08/03/2021.

References

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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.

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Prostatectomy: What To Expect During Surgery And Recovery

If youve been diagnosed withprostate cancer, your doctor will consider many factors before recommending the besttreatment. For many men, that may mean a prostatectomy. In this surgery,doctors remove the entire prostate.

The Johns Hopkins Hospital performs more of these procedures than almostanywhere else in the world. One of the most common questions they hear frompatients: What should I expect after surgery?

Johns Hopkins urologistMohamad Allaf, M.D., explains the surgery and recovery.

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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Assessing The Symptoms Of An Enlarged Prostate

To help your doctor understand how bothersome enlarged prostate symptoms are for you, the American Urological Association has developed a BPH Symptom Index. This is a brief questionnaire that asks about specific symptoms and how frequently they occur. Each answer is assigned a number — and your total is ranked on a scale ranging from mild to severe.

A score of 0 to 7 is considered a mild symptom score 8 or over is considered moderate to severe.

The AUA recommends the following treatment for an enlarged prostate based on the severity of symptoms:

• Mild symptoms that don’t bother you : If you are not bothered by your symptoms, and they don’t affect your daily life, watchful waiting is the best option for you. You should get regular checkups to make sure that you are not developing complications.
• Moderate to severe symptoms : If you are not bothered by your symptoms, you may choose watchful waiting. However, if your symptoms do start to interfere, you may choose medication, a minimally invasive procedure, or surgery.
• Moderate to severe symptoms with complications: If symptoms are bothersome and you have developed complications such as inability to urinate, you may need a catheter, surgery, or other treatment.

Warning Signs Of Prostate Cancer I Prostate Cancer Symptoms

Prostate enlargement is one of the most common health problems in senior men, and it is even more common in patients with a family history of such diseases. However, this enlargement may be due to benign or malignant causes, and both of them cause a similar array of signs and symptoms. Therefore, it is important to follow the recommendations by your urologist and perform a routine check-up that includes a digital rectal exam and measures of your prostate-specific antigen .

However, it is important to pay special attention to your own symptoms, as they will give you clues to look for medical help when in doubt. The most specific signs and symptoms of prostate cancer are usually found in a late stage of the disease. Early symptoms are difficult to distinguish from benign causes like prostate hyperplasia, but we should take all of them into consideration if we want an early diagnosis and start a successful treatment. Thus, pay attention to the following signs and symptoms associated with postage cancer:

• Recovery

What is prostate surgery for?

The prostate is a gland located underneath the bladder, in front of the rectum. It plays an important role in the part of the male reproductive system that produces fluids that carry sperm.

Surgery for partial or complete removal of the prostate is called a prostatectomy. The most common causes for prostate surgery are prostate cancer and an enlarged prostate, or benign prostatic hyperplasia .

The goal of your surgery is to:

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What Happens During Turp

TURP requires a hospital stay. Procedures may vary depending on yourcondition and your healthcare providers practices.

Generally, a TURP follows this process:

You will be asked to remove any jewelry or other objects that might get in the way during surgery.

You will be asked to remove your clothing and will be given a gown to wear

Youâll be asked to empty your bladder.

An IV line will be put in your arm or hand.

You will be positioned on an operating table, lying on your back.

You will be given anesthesia to put you to sleep for the procedure. Your legs will be placed in stirrups.

Your heart rate, blood pressure, breathing, and blood oxygen level will be monitored during the surgery.

Once youre sedated, a breathing tube may be put through your throat into your lungs and you will be connected to a ventilator. This will breathe for you during the surgery.

The surgeon may first inspect the urethra and bladder with an endoscope. This is done by passing the scope through the tip of the penis, then into the urethra and bladder. This allows the healthcare provider to examine these areas for any tumors or stones in the bladder.

Next, the resectoscope is passed into the urethra. It is used to cut away the pieces of prostate tissue that are bulging or blocking the urethra. Electricity will be applied through the resectoscope to stop any bleeding. The pieces are flushed into the bladder, and then drained out through the urethra.

The resectoscope is removed.

Other Things To Consider

Before you have one of these procedures, talk with your doctor about whether youâll be given something to numb the area or whether youâll be given something so you wonât be awake during the procedure. What you get and where you have it depends on the procedure.

Your doctor will give you instructions on how to prepare for any of them.

Surgery can ease many BPH symptoms, but it may not relieve them all. If there are certain complications, such as a weak bladder, there may still be urinary problems after surgery, although this is rare.

With any BPH surgery, there may be side effects or complications such as bleeding, narrowing of the urine tube also known as urethral stricture, urinary incontinence or leakage, erectile dysfunction, and retrograde ejaculation.

The best treatment for an enlarged prostate is not the same for every man. Talk to your doctor about the risks and benefits of each procedure.

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Symptomatic treatment of an enlarged prostate usually involves a combination of medication and lifestyle changes. A diet rich in fruits and vegetables may be the best option if you suffer from chronic urination. It will help the body adjust to the increased size of the prostate. Also, taking regular urination intervals will help retrain the bladder to function properly. Inactivity also contributes to urine retention, and cold temperatures can increase the urge to urinate.

Invasive treatment of enlarged prostate includes medication that relieves the pressure on the urethra and bladder. However, if the condition is severe, it may require surgical intervention. If treatment is not successful, the enlarged prostate can become a potentially life-threatening disease. As the hormone levels in the body change, the enlarged prostate can lead to various complications, including urinary retention and even cancer. This is why it is critical to see a doctor for further evaluation.

A physician can recommend a number of treatments to address an enlarged prostate. An enlarged prostate will require surgery to relieve the symptoms. In most cases, surgical treatment for an enlargement of the penis is enough. Moreover, a doctor may recommend a course of treatment based on symptoms. A TURP procedure is not painful and requires less recovery time than open surgery. The recovery period will be shorter and less traumatic.

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 doesn’t 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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What Changes Can You Expect

• Ejaculation will cease:Without a prostate gland or seminal vesicles, you will no longer experience ejaculation. Even though your orgasm may feel different, it will still be pleasurable.
• Leaking urine during sex:This is possible but does not happen to all men. Its harmless and temporary.
• Performance anxiety:Dont underestimate the emotional roller coaster of prostate cancer surgery and recovery. Its normal to worry about sex after prostate cancer. Being open and honest with your partner will help.

Keep in mind that your overall health, age, and present ED status are all factors in your recovery to sex after prostate surgery.

Less commonly, the prostate cancer tumor may bulge to one or both sides of the prostate gland, making nerve-sparing surgery extremely difficult or impossible.

Dr. Samadi will help you understand your exact prostate cancer status and the position and size of your tumor. In some cases, a nerve graft can be performed to regenerate the penile nerves for sex after prostate surgery.

• Changes in mood and libido:The psychological impact of surgery can be significant this will leave you tired and irritable, not in the mood for sex so you will need to move towards intimacy slowly and your desire will return back to normal.

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What Is The Best Treatment For Enlarged Prostrate

There is no such best treatment for enlarged prostate. The age-old transurethral resection of prostate with monopolar cautery still is a time twisted and the treatment of choice. But the complication rates with the newer methods like bipolar transurethral resection of prostate, or the transurethral resection in saline , in one way much better than the monopolar transurethral resection of prostate because it will avoid so many postoperative complications, like hyponatremia or TURP syndrome.

The laser and robotics modalities of treatment are one way better when we consider the blood loss, consumption of time if the method is mastered, so laser will take relatively lesser time to inoculate the lobes and then morcellate and extracting glands. Bleeding will be much lesser if the procedure is mastered or done meticulously. Otherwise, these conventional methods of transurethral resection of prostate – monopolar or bipolar are still the best treatment options.

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What Is The Cost Of Enlarged Prostate Surgery In Pace Hospitals

At Pace Hospitals, we offer world-class prostate enlargement treatment to the patients. Enlarged prostate surgery cost ranges vary from Rs 1,00,000 to 1,35,000 and it depends upon the selection of room for hospital stay, type of surgery, any services availed during treatment apart from the surgery package and approvals in case of cashless treatment such as health insurance, central government health scheme , employees and journalists health scheme , employees’ state insurance etc.