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Prostate Surgery

 The prostate gland, located just below the bladder, wrapped around the urethra, can only be found in men and unfortunately, it is a common source of medical problems.

Prostate surgery is one of the multiple treatment options for a variety of prostate conditions, including prostate cancer.

Before Prostate Surgery – Diagnosis and Tests

As part of the general health screening routine recommended over the age of 50, or when experiencing some problems, visit your urologist for a prostate examination.

When to see a doctor?

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  1. Some common signs doctors associate with prostate problems are related to urinating. For some men symptoms include:
  • Problems initiating the urination
  • Urination occur as a series of stops and starts
  • Difficulty emptying the bladder
  • The worst consequence of severe urinary problems is complete urinary detention, which can lead to kidney damage and bladder stone formation.

            2. Another common symptom is the presence of blood in the urine or semen. There may be multiple causes in the background,

            so it is imperative to see a doctor.

            3. Pain, burning sensation and dribbling, are also noted with prostatic problems.

The examination itself involves the inserting of a finger into the rectum to examine the prostate gland. If something abnormal is found, biopsy is the next line of action, which determines whether the prostate condition is benign or malignant and if there is a need for prostrate surgery.

Prostate Surgery

There are several types of prostate surgery available. The two most common conditions addressed by surgery are prostate cancer and BPH or benign prostatic hyperplasia (enlarged prostate).

Prostate surgeries are classified as below:

  • Prostatectomy – It is the surgical removal of the prostate, or a part of it. It is often conducted in prostate cancer treatment or enlarged prostate surgery.
  • There are three types of prostatectomy:
    • Simple – removes just the inside portion of the prostate.
    • Radical – removes the entire prostate and some lymph nodes.
    • Transurethral resection of the prostate (TURP) – removes the entire prostate or a part of it to treat BPH (in enlarged prostate surgery).
  • Robotic Prostate Surgery – is a robotic-assisted laparoscopic prostatectomy. It is a minimally invasive, but inpatient procedure, done using keyhole incisions under general anesthesia. During robotic prostate surgery, through a small incision special instruments and a video camera are inserted and the whole process is controlled by the surgeon or urologist from the computer, which ensures extreme precision.
  • Transurethral Microwave Thermotherapy – an outpatient surgical treatment for benign prostatic hypertrophy (enlarged prostate surgery) due to enlarged prostate or prostate cancer. Under general anesthesia a urinary catheter is inserted into the bladder via urethra. A small microwave antenna is placed inside the prostate gland, which heats up at least 45ºC degrees. The procedure is repeated several times, until tissue death is achieved.
  • Laser Prostate Surgery – used to relieve BPH. A scope is inserted through the tip of the penis into the urethra. The laser prostate surgery delivers energy to shrink and remove the excess tissue blocking the urethra. Laser prostate surgery removes by:
    • Ablation – melting the excess tissue
    • Enucleation – cutting away the tissue
  • Types of laser prostate surgery are:
    • Minimally Invasive Transurethral Electro-Vaporization of the Prostate Surgery (TUEVAP) – a minimally invasive variation of TURP procedure, which uses an electro cautery to remove the prostate tissue.
    • Homium laser ablation of the prostate (HoLAP) – the laser evaporates the excess tissue
    • Holmium laser enucleation of the prostate (HoLEP) – cuts and removes the tissue.

In addition to the standard risks for surgery (bleeding, blood clots, delayed healing, infection) and for anesthesia (increased heart rate, elevated blood pressure), risk for prostate procedures include erectile dysfunction and urination problems.

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