What Surgery Is Done For Enlarged Prostate

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

You’ll 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.

What If I Can’t Have Surgery

Surgery isnt always an option you may not be fit or well enough for an operation, or you may not like the idea of it. If surgery isnt suitable for you and lifestyle changes and medicines havent worked, your doctor or nurse may suggest using a catheter. This is a thin, flexible tube used to drain urine from your bladder. The catheter may be permanent or temporary.

A permanent catheter is passed up into the bladder through your penis, or through a small cut in your abdomen. The catheter is usually attached to a drainage bag, which you strap on to your body under your clothing. Your doctor or nurse will usually change your catheter every 12 weeks.

A temporary catheter is where you put a catheter in yourself when you need to urinate, rather than leaving one in all the time. Your doctor or nurse will show you how to put the catheter in and tell you how often to use it. Some men can urinate quite well without a catheter and only use it once a day to make sure they empty their bladder regularly. Other men need to use a temporary catheter several times a day.

You can lower your chances of getting a urine infection by keeping your catheter and the area around it clean. You may find the following tips helpful.

Let your nurse know if your catheter isnt draining properly. If urine hasnt drained from your bladder for 2 to 3 hours, contact your GP or district nurse straight away.

Herbal Therapies For An Enlarged Prostate

Several herbal supplements are marketed for enlarged prostates. Saw palmetto, beta-sitosterol, and pygeum are all are widely used in Europe. They are available in the U.S. and don’t require a prescription.

However, researchers and doctors are cautious about advising patients to try herbal supplements. Because they are not FDA-regulated, there are concerns about a product’s quality from batch to batch, according to the NIH’s Office of Dietary Supplements. Also, the safety of an herbal product depends on many things — the chemical makeup, how it works in the body, how it is prepared, and the dosage.

Something else to consider: Like any drug, a herbal remedy can affect how other medications or treatments work, or interact dangerously with your other medications. They can also have side effects. And, the AUA points out, they have not been well-studied for effectiveness or safety.

Before trying any alternative treatment, learn as much as you can about it, the AUA says. Most importantly — talk to your doctor before you try an herbal remedy. Many doctors consider alternative therapies like saw palmetto to “have no effect on symptoms, except as expensive placebos,” Slawin tells WebMD.

Beta-sitosterol: This compound is extracted from pollen of rye grass. There has been some evidence that it provides relief from urinary symptoms. However, in four studies the supplement did not increase urinary flow rates, shrink the prostate, or improve bladder emptying.

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What Are The Side Effects

Initially, the urethra and surrounding area will be inflamed, and it will be difficult to urinate. The catheter and flushing process can also be uncomfortable and cause bladder cramping.

The urethra, penis, and lower abdominal area will be tender, red, and swollen for a few weeks after surgery, which can interfere with urination. Most people also feel very weak and tire easily for several weeks.

Common side effects of TURP surgeries include:

• difficulty completely emptying the bladder
• urinary urgency or the sudden urge to urinate
• discomfort during urination
• small dribbles or clots of blood in the urine, for up to 6 weeks

The minor side effects associated with TURP surgeries usually go away as the urethra and prostate tissues become less inflamed, usually within a few weeks.

Though TURP surgeries may or may not be associated with erectile difficulty in some people, they can decrease the volume of semen produced during ejaculation.

As with any medical procedure, especially those involving anesthesia, the surgery for BPH is associated with some medical complications.

Possible but rare risks associated with TURP procedures include:

• excessive bleeding

How Does Holep Treat Bph

Holmium laser enucleation of the prostate is a type of laser surgery used to treat the obstruction of urine flow as a result of benign prostatic hyperplasia. The holmium laser is a surgical laser that has been found particularly effective in performing several types of urological surgeries. In the case of HoLEP, the laser is used to cut and remove the bulky prostate tissue that is blocking the flow of urine.

Patients who are appropriate for HoLEP are typically symptomatic due to very large prostates. Patients may not be candidates for HoLEP if they have bleeding problems or have had certain types of prior prostate treatments.

HoLEP requires the patient to be under general anesthesia. If a patient cannot have general anesthesia for some reason, a spinal anesthetic can be usedthis allows him to remain awake but blocks all feeling from the waist down.

A surgical instrument called a resectoscope is inserted through the urethra. The resectoscope includes a camera that allows the surgeon to view the internal structure of the prostate gland, and to see where incisions are being made during surgery.

The laser is inserted into the resectoscope and is used to enucleate the enlarged prostate tissue from the outer shell of the prostate, and then to seal up any blood vessels. The tissue that has been removed is deposited in the bladder. When tissue removal is complete, the resectoscope is withdrawn and a urinary catheter is put in place.

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Enlarged Prostate Surgery: The Real Risks And Side Effects

Enlarged prostate surgery unfortunately has real risks and side effects that are often downplayed or minimized by urologists making you the guinea pig with very possible impotence and incontinence as a result.

Furthermore, you will often have to repeat the operation later on as your prostate continues to grow because the real causes of this prostate disease have not been addressed by radical surgeries.

Also known as a TURP surgery or BPH surgery, this is the gold standard of prostate surgeries for enlarged prostate symptoms.

TURP stands for Transurethral Resection of the Prostate. The surgery consists of passing a flexible instrument up your penis and into the prostate gland to shave off pieces of the prostate.

The bloody pieces are removed allowing more space for the urethra tube to pass urine from your bladder.

The operation is done under anesthesia… and you will usually spend a couple of days recovering. You will have to wear a catheter for some time while you heal, and then it can be removed.

It would be great if that was all there was to it. Yet, it’s not so simple…

Side Effects Of Conventional Prostate Bph Treatments And Enlarged Prostate Surgery

If you are very lucky you may well have an improved urinary function and few side effects after enlarged prostate surgery. Unfortunately, that is not the case overall.

If you think that BPH operations are harmless, think again. In my experience, side effects are not fully explained and are minimized. Why? Because doctors:

• think they are providing the best treatment based on what they know and what they have available to offer,
• often directly benefit financially from the procedures, and
• are unaware of any other options.

If they do know of alternative options, they could risk losing their medical license by offering those alternative treatments.

All of the conventional treatment options I mention on this page have consequences of:

• major discomfort to pain
• possible incontinence
• impotence and sexual difficulties
• retrograde ejaculation
• and often the treatment will need to be repeated at a future date with scarring occurring with each attempt, which makes each procedure less successful and exacerbates the side effects.

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Prostate Surgery: What To Expect On The Day Of Surgery

• After

There are a few prostate surgery types and techniques, and what you can expect from your procedure depends on which one your surgeon uses. An incision may or may not be required all, some, or none of prostate gland may be removed and some surrounding tissue may or may not be excised as welljust to name a few differences.

The choice in prostate surgery largely comes down to whether you are having it to treat prostate cancer or the urinary symptoms or complications of an enlarged prostate, a.k.a. benign prostatic hyperplasia .

Surgery For Prostate Cancer

Surgery is usually used to treat cancer that hasn’t spreadoutside of the prostate. The type of surgery you have depends mainly on thestage of the cancer. When planning surgery, your healthcare team will alsoconsider other factors, such as your age, overall health and life expectancy.

Surgery may be done for different reasons. You may havesurgery to:

• completely remove the tumour
• remove as much of the tumour as possible beforeother treatments
• reduce pain or ease symptoms
• treat cancer that comes back after other treatments

The following types of surgery are commonly used to treatprostate cancer. You may also have other treatments before or after surgery.

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Men Suffering With Symptoms From An Enlarged Prostate Could Be Offered A New Type Of Nonsurgical Treatment Thanks To Changes In Nice Guidance

25 April 2018

NICE the National Institute for Health and Care Excellence has for using Prostate Artery Embolisation as a treatment of benign prostatic hyperplasia.

The prostate is a small walnut sized gland found only in men. It produces the fluid component of semen and grows naturally with age. Problems occur when the change in size puts pressure on the tubes that drain urine from the bladder.

Benign prostatic hyperplasia is the medical term used to describe a noncancerous enlargement of the prostate. Symptoms like needing to pass urine more frequently, trouble starting to urinate and loss of bladder control affect more than a third of men over the age of 50.

There are a number of current treatments for an enlarged prostate including medication or surgery. However, these treatments can have side effects and do not suit all patients.

PAE offers an alternative option. It blocks the blood supply to the prostate with small particles, which causes the prostate tissue to shrink and die. It can be performed under local anaesthetic, which will help patients who cannot tolerate general anaesthetic. And it can be done as a day case, which will mean the patient does not need to be admitted to hospital.

NICE first looked at PAE in 2013, but felt that more research was required to determine whether the procedure was effective and safe.

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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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.

Are There Side Effects From Having A Urinary Catheter

Yes, there can be side effects or unwanted changes in your body when you use a urinary catheter. Side effects are different from person to person. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. There are several side effects that you may have if you have a urinary catheter. They are bladder spasms, blood in your urine, and infections.

Bladder spasms. Sometimes, men have bladder spasms while the catheter is in their penis. Bladder spasms may feel like bad cramps or pains in the area above your pubic hair or in your rectum and can hurt. These spasms may be caused by the catheter bothering your bladder. If you have a bladder spasm, sometimes urine will leak around your catheter. If this happens you may want to put a towel on your bed to protect your mattress. Call your doctor or health care team right away if you start having bladder spasms. Your doctor can give you medicine that will stop the spasms. When the catheter is taken out, the bladder spasms will stop.

Urinary tract infections. Infections of the urinary tract are very common. An infection is when germs enter your body causing you to have a fever or pain, redness, and swelling in one part of your body. To lower your risk of getting an infection:

It is important that you clean the skin around your catheter tubing and your catheter at least two times each day.

Keep your urine collection bag below your bladder .

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Other Surgical Procedures For Prostate Disease

Alternative surgical procedures to TURP include:

• open enucleative prostatectomy this involves making a cut in the abdomen to remove a very enlarged prostate. This is the least common form of surgery. The average hospital stay is seven to 10 days
• laser TURP a laser is used to remove prostate tissue from the middle part of the prostate, which has the advantage of less bleeding and therefore safer for people on anti-coagulation therapy for other problems, including coronary stents, heart valve or vascular disease
• transurethral incision of the prostate similar to TURP except that no prostate tissue is taken out. One to three cuts are made in the prostate near the bladder neck to release the ‘ring’ of enlarged tissue and make a larger opening around the urinary tract
• UroLift® this technique is useful for men for whom medication has not been successful but their prostates are not so enlarged that they need a TURP. It involves the transurethral insertion of staples to separate the lobes of the prostate. It has minimal side effects and preserves ejaculatory and erectile function.