Men's health is an important aspect not only for the physical condition, but also for the psyche. A change in the functioning of the genital organs is noted in urological diseases. The most common of them are pathologies of the prostate gland. The prostate provides normal ejaculation in men and helps to block the exit from the bladder during ejaculation. Prostate diseases can be associated with inflammatory, hyperplastic and oncological processes. Often the treatment method is removal of the prostate. Despite the radical nature of the method, in some cases the operation is considered the only option.
Indications for removal of the prostate gland
Removal of the prostate is performed in cases where conservative therapy is powerless. In most cases, this is an oncological process. Sometimes prostatectomy is performed with benign prostatic hyperplasia. Organ enlargement due to inflammation is not a reason for surgery. The following indications for removal of the prostate are highlighted:
- The initial stages of prostate cancer.
- Calculous prostatitis - accompanied by impaired urination and hematuria.
- Benign organ hyperplasia is an adenoma.
Cancer is considered the main indication for organ removal. Prostatectomy is performed only at stages 1 and 2 of the disease. In these cases, the oncological process is limited to prostate tissue. If timely removal of the prostate is not performed, cancer can spread throughout the body. The operation is performed for men under 70 years of age, since somatic pathologies are contraindications to its conduct.
Prostate adenoma leads to organ enlargement. As a result of this disease, sexual weakness and impaired urination are noted. With the progression of benign hyperplasia and a lack of effectiveness from therapeutic methods of treatment, prostatectomy is performed.
Methods for surgical intervention
There are several ways to remove the prostate. The choice of method depends on the prevalence of pathology. Organ removal can be complete and partial. Surgical options include:
- Transurethral resection of the prostate gland. It is characterized by partial tissue removal, which is performed through the urethra. Resection is performed laparoscopically. It is carried out with benign prostatic hyperplasia.
- Prostate Incision Such surgical intervention involves the dissection of organ tissues. It allows you to expand the lumen of the urethra and prevent compression of the urethra. An incision is made on the prostate, but the organ is not removed.
- Radical prostatectomy. It is carried out with tumor formations and severe benign hyperplasia. The gland is removed together with the lymph nodes. Access to the organ can be different - perineal, supra- and posterolateral. Open surgery is dangerous for complications.
- Laser intervention. It is considered more preferable, as it reduces the risk of bleeding. Laser removal of the prostate is performed for benign gland hyperplasia. There are several techniques for this manipulation. Among them are vaporization (evaporation), enucleation and laser resection of the adenoma.
Currently, less traumatic surgical procedures are preferred. These include laser removal of adenoma, transurethral resection. Nevertheless, it is impossible to replace the open operation with other methods in some cases.
Removal of prostate adenoma: consequences of surgical treatment
Removing the prostate gland is a radical treatment that has a number of health risks. These include complications of the early and late postoperative period. Among them is a violation of the process of urination and ejaculation. After removal of the prostate adenoma with a laser and transurethral resection, the risk of these complications is reduced, compared with open surgery.
This operation is stressful for the whole organism. Therefore, after it there is a violation of 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.
- Lack of ejaculate during sexual intercourse.
- Infertility.
- Erectile disfunction.
- Inflammatory processes in the pelvis.
To prevent these complications from developing, the patient 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 a prostatectomy, the patient's condition is serious. This is due to blood loss and a change in the functioning of the genitourinary organs. At this time, there is a danger of the following complications:
- Wound infection and penetration of germs. The patient’s condition is severe, with fever, local inflammation and signs of peritoneal irritation.
- Bleeding - occurs in 2.5% of cases.
- Urethral obstruction with blood clots, the occurrence of strictures.
- Relaxation of the sphincter of the bladder. Normally, this symptom disappears on its own. Muscle relaxation leads to urinary incontinence.
Diagnosis of early complications is carried out by medical personnel in the hospital. In the case of acute conditions, the help of a surgeon 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, self-urination appears. However, a 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 technique of the operation. To speed up rehabilitation and reduce the risk of late complications, the following requirements must be observed:
- Do gymnastics to strengthen your pelvic muscles. Kegel exercises will help bring the urination process back to normal. Gymnastics consists in alternating tension and relaxation of the pubic muscle.
- Vibrotherapy and massage.
- The use of an electric stimulator or vacuum erector.
After a prostatectomy, heavy objects weighing more than 3 kg cannot be lifted. It is also not recommended to engage in sedentary work and drive a car. Food should be fractional, with a predominance of easily digestible carbohydrates and proteins.
Recovery of urination after prostatectomy
Removal of the prostate often leads to disruption of the urination process. 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. Due to 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, spa treatment is useful.
Intimate life after prostate removal surgery
3 months after a prostatectomy, the patient can begin sexual activity. By this time, the pelvic muscles should recover. In some cases, patients have retrograde ejaculation. Semen is secreted, but it enters the lumen of the bladder. Such a phenomenon is not dangerous, but it prevents conception. To get rid of this symptom, apply vibration massage and vacuum erector. With erectile dysfunction, medications containing sildenafil are prescribed. These include medicines "Cialis", "Viagra."
Doctors reviews about the operation
Doctors say prostatectomy is a complex operation that should only be done when necessary. With prostate adenoma, it is not recommended to completely remove the organ; it is better to perform a resection or laser vaporization. Recovery after prostatectomy is gradual, so you should follow the instructions of the urologist and be patient.