Men's health is an important aspect not only for the physical condition, but also for the psyche. Change in the functioning of the genitalia is noted in urological diseases. The most common of these are prostate gland pathologies. Prostate provides normal ejaculation in men and helps to block the exit from the bladder during ejaculation. Diseases of the prostate gland can be associated with inflammatory, hyperplastic and oncological processes. Often the treatment is to remove the prostate. Despite the radical nature of the method, in some cases the operation is considered the only option.
Indications for the removal of the prostate
Prostate removal is performed when conservative therapy is impotent. In most cases, this is an oncological process. Sometimes prostatectomy is performed with benign prostatic hyperplasia. The increase in the organ due to inflammation does not pertain to the reasons for the operation. The following indications for the removal of the prostate are distinguished:
- The initial stages of prostate cancer.
- Calculous prostatitis - accompanied by a violation of urination and hematuria.
- Benign hyperplasia of the organ - adenoma.
Cancer is considered the main indication to remove the organ. Prostateectomy is performed only at stages 1 and 2 of the disease. In these cases, the oncological process is limited to the tissue of the prostate gland. If the prostate is not removed in a timely manner, the cancer can spread throughout the body. The operation is done for men younger than 70 years, since somatic pathologies are contraindications to its conduct.
Adenoma of the prostate gland leads to an increase in the organ. As a result of this disease, sexual weakness and impaired urination are noted. With progression of benign hyperplasia and lack of efficacy from therapeutic methods of treatment, prostatectomy is performed.
Methods of surgical intervention
There are several ways to remove the prostate. The choice of method depends on the prevalence of pathology. Removal of the organ can be complete and partial. Options for surgery include:
- Transurethral resection of the prostate. It is characterized by partial removal of tissues, which is produced through the urethra. Resection is performed laparoscopically. It is performed with benign prostatic hyperplasia.
- Induction of the prostate. Such a surgical intervention involves dissecting the tissues of the organ. It allows you to expand the lumen of the urethra and prevent compression of the urethra. The prostate gland is cut, but the organ is not removed.
- Radical prostatectomy. It is carried out with tumor formations and expressed benign hyperplasia. The gland is removed together with the lymph nodes. Access to the organ can be different - perineal, supra-and retropubic. Open surgery is dangerous for the development of complications.
- Laser intervention. It is considered preferable, as it reduces the risk of bleeding. Prostate removal by the laser is performed with benign gland hyperplasia. There are several methods for carrying out this manipulation. Among them - vaporization (evaporation), enucleation and laser resection of adenoma.
At present, preference is given to less traumatic surgical procedures. These include laser removal of adenoma, transurethral resection. Nevertheless, it is impossible to replace an open operation with other methods in some cases.
Removal of prostatic adenoma: consequences of surgical treatment
Removal of the prostate gland is a radical way of treatment, which is accompanied by a number of health risks. These include complications of the early and late postoperative period. Among them - violation of the process of urination and ejaculation. After removal of the prostate adenoma with a laser and using the method of transurethral resection, the risk of these complications decreases, in comparison with an open surgical procedure.
This operation is a stress for the whole body. Therefore, after it, there are irregularities in the functioning of the genitourinary system. Normally, they gradually pass. In 2-10% of cases violations remain. The negative consequences of prostatectomy include:
- Urinary incontinence.
- Absence of ejaculate during sexual intercourse.
- Erectile disfunction.
- Inflammatory processes in the small pelvis.
To prevent these complications, the patient's condition is monitored in the first days after removal of the prostate. At discharge, the recommendations of the urologist should be followed. This will help reduce the risk of late complications.
Early postoperative period
During the first days after prostatectomy, the patient's condition is severe. This is due to blood loss and changes in the work of the genito-urinary organs. At this time there is a danger of developing the following complications:
- Infection of the wound and penetration of microbes. The patient's condition is severe, fever, local inflammation and signs of irritation of the peritoneum.
- Bleeding - occurs in 2.5% of cases.
- Obturation of the urethra with blood clots, the emergence of strictures.
- Relaxation of the sphincter of the bladder. Normally this symptom passes by itself. Relaxation of the muscles leads to urinary incontinence.
Diagnosis of early complications is carried out by medical personnel in the hospital. In the case of development of acute conditions, the surgeon's assistance is required.
Recovery period after prostatectomy
The early postoperative period is several days (5-7 days). During this time the patient's condition is normalized, there is an independent urination. However, full recovery after removal of prostate cancer or adenoma can occur only after a few months. It depends on the age of the patient, the characteristics of his body and the procedure for conducting the operation. To accelerate rehabilitation and reduce the risk of late complications, the following requirements must be observed:
- Do gymnastics to strengthen the pelvic muscles. Exercises by the method of Kegel help to bring the process of urination back to normal. Gymnastics consists of alternating tension and relaxation of the pubic muscle.
- Vibration therapy and massage.
- Application of an electrostimulator or vacuum-erector.
After prostatectomy, heavy objects weighing more than 3 kg should not be lifted. Also it is not recommended to engage in sedentary work and drive a car. Food should be divided, with the predominance of easily digestible carbohydrates and proteins.
Restoration of urination after prostatectomy
The removal of the prostate often leads to a violation of the process of urination. In the first days after surgery, a catheter is inserted into the urethra. It is necessary for the evacuation of fluid from the bladder. After a few days or weeks, the catheter is removed. Because of the weakness of the pelvic floor muscles, urination is difficult to control. But gradually the process is getting better. To accelerate rehabilitation, it is necessary to do gymnastics, it is useful to sanatorium treatment.
Intimate life after surgery to remove the prostate
After 3 months after prostatectomy, the patient can begin to have sex. By this time, the pelvic muscles must recover. In some cases, patients experience retrograde ejaculation. Seed fluid is secreted, but it enters the lumen of the bladder. Such a phenomenon is not dangerous, but it hinders conception. To get rid of this symptom, apply vibromassage and vacuum-erectors. With erectile dysfunction prescribe drugs containing sildenafil. These include drugs "Cialis", "Viagra".
Doctor's comments about the operation
Doctors say that prostatectomy is a complex operation that should be carried out only when necessary. With prostate adenoma, it is not recommended to remove the organ completely, it is better to perform resection or laser vaporization. Recovery after prostatectomy occurs gradually, so it is worth to follow the instructions of the urologist and be patient.