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Transurethral surgery of the prostate and bladder

Prostate adenoma is a benign neoplasm that is formed due to the proliferation of glandular and connective tissue. It occurs among the male half of the population aged 50 years. One of the symptoms of the disease is blood staining of urine, also the adenoma manifests itself as a urination disorder (difficult, sluggish stream, frequent urination in small portions; feeling of incomplete emptying of the bladder, etc.), and urinary tract infection.

Not so long ago, an operation for prostate adenoma should have been performed through a large incision in the abdomen and under general anesthesia. After the intervention, the patient was forced to lie in the hospital for more than a week, suffering from postoperative pain, drainage and leakage of urine. Reviews of such interventions were not the best. But, the development of endoscopic surgery has radically changed the situation.

About operation

Transurethral resection of the prostate, or TURP for short, is one of the most effective and today one of the most popular methods designed to treat prostate adenoma or, as it is called, benign prostatic hyperplasia. TURP is a minimally invasive operation aimed at removing prostate tissue, narrowing the urethra and obstructing the outflow of urine from the bladder. TURP is the "gold standard" in the surgical treatment of adenomas. The operation is performed transurethrally, that is, through the urethra, without external incisions and sutures. Such a procedure can be performed using a resectoscope tool. At its end, a loop is installed, which with the help of an electrosurgical generator becomes an “electric knife”. Under the control of a video camera, the urologist performs many separate sections, forming the lumen of the urethra and removing "excess" tissue. Fragments of tissue at the end of the manipulation are evacuated outward and sent for histological examination. The total operation time rarely exceeds 60 minutes. Intervention is performed under conduction anesthesia - an injection into the spine allows for the duration of the operation to eliminate pain sensitivity below the injection zone. In this case, the patient is fully conscious and can maintain communication with the surgeon. The effectiveness of this intervention largely depends on the experience and qualifications of the surgeon, as well as on the level of technical equipment of the operating room.

Our experts use the latest bipolar equipment, providing the highest accuracy of cuts and reliable vascular coagulation.

  • minimal surgical trauma - all surgical procedures are performed transurethrally. Intervention is carried out under visual control, which ensures targeted accuracy and increases the radicalism of the operation, without injuring surrounding tissues.
  • fast recovery - in most cases, staying in a hospital does not exceed 2-3 days, and the entire rehabilitation period lasts 10-14 days.
  • low percentage of complications - the use of modern equipment avoids traditional complications for open intervention
  • minimum of contraindications - high qualification of specialists and modern equipment allows us to perform TUR of prostate adenomas even in age-related, weakened and patients undergoing neurosurgical and cardiosurgical interventions.

Indications for surgery

An indication for surgery is a pronounced violation of the quality of urination against the background of an increase in the size of the prostate gland. An enlarged prostate alone is not a sufficient basis for surgery.

The main indications for surgery for this disease are:

  • acute urinary retention, not resolved after a single catheterization;
  • the formation of bladder stones;
  • recurrence of hematuria (blood in the urine), the source of which is the vessels of the prostate;
  • relapse of urinary tract infection and / or prostatitis;
  • large diverticulum (hernia) of the bladder;
  • a large amount of residual urine;
  • the development of renal failure due to chronic urinary retention in the bladder;
  • inefficiency of conservative therapy.

Transurethral resection of the prostate is contraindicated in case of acute inflammatory process in the prostate, inability to exclude prostate cancer, impaired blood coagulation or with the use of blood-thinning drugs, with the general serious condition of the patient and high risk of surgery due to the presence of serious concomitant diseases.

Preparation, diagnostics

Preparation for TUR of the prostate is standard for all endoscopic interventions on the urinary system. Preoperative examination includes:

  • consultation of a urologist;
  • laboratory tests of blood and urine;
  • electrocardiogram, ECHO-KG;
  • fluorography;
  • correction of taking blood thinners;
  • instrumental research methods - ultrasound of the bladder, biopsy, transrectal ultrasound of the prostate, uroflowmetry;
  • consultation of a therapist, cardiologist, anesthetist.
  • 5-7 days before the intervention, correction of drugs that affect blood coagulation (aspirin, heparin, cardiomagnyl, etc.) may be required. In the presence of a chronic infection, preventive antibiotic therapy is prescribed.

Rehabilitation period

The operation is completed by installing a catheter through the urethra into the bladder and connecting the flushing system. It is necessary because there may be some admixture of blood in the urine. After the operation, the patient returns to the ward, where after a few hours he can eat and begin to consume the liquid. In the morning on the day after the procedure, he can independently get up and walk. In this case, severe pain or discomfort will not be felt. If pain will bother you can take painkillers.

The catheter from the bladder will be removed after 1-2 days. Do not be afraid that at first urine with an admixture of blood will flow through the catheter. At first, this is the norm.

Home rehabilitation and rehabilitation

As for recovery after the procedure at home, here it is necessary to remember some important points. This will help not only to avoid possible complications, but also significantly accelerate the recovery process.

Drink as much as possible (about 2.5 liters of fluid per day). This is necessary in order to accelerate healing. natural urination process. It is best to drink during the day or in the morning, it is important to avoid heavy consumption in the evening and night hours.

It is necessary to achieve adequate intestinal function. It is important to exclude the load until the full recovery (usually this occurs 1-1.5 months after surgery). Until complete recovery, we recommend that patients refrain from having sex. It should be understood that the healing process of the area of operation in contact with urine is a rather lengthy process. Immediately after removal of the catheter, the quality of urination will most likely not be ideal. For the final normalization of the act of urination, it may take from several weeks to several months. At the same time, most patients feel confident after 10-14 days and can return to work that is not associated with physical stress for the first 1.5 months. Even if there are no infectious complications, it is still necessary to follow the rules and recommendations for antibacterial and other drug therapy indicated by the doctor at discharge.

We are in touch with our patients around the clock, providing full medical advisory support.

Service record

Specialists

All specialists
Rasner
Pavel Ilyich

Head of the Urology Clinic, Deputy Chief Physician for Urology, Urologist

Doctor of Sciences, PhD, professor

Kamalov
Armais Albertovich

Chief Consultant in Urology, Urologist

Academician, professor, Doctor of Sciences, PhD

Osmolovsky
Boris Evgenyevich

Head of the Department of Urology, Urologist

PhD

Ahvlediani
Nika Dzhumberovich

Urologist, andrologist

Doctor of Sciences, PhD

Tereshchenko
Suren Alexandrovich

Doctor urologist-andrologist

Doctor of Sciences, PhD