Good day, dear readers! One of the most common problems faced by men over 60 (sometimes even earlier) is an enlarged prostate gland (prostate adenoma). Prostate adenoma is the old name for benign (non-cancerous) prostatic hyperplasia (BPH). Surgery to remove prostate adenoma is the most effective treatment of all the available options.

The prostate gland is located just below the bladder and connects to the urethra (urethra), through which urine passes from the bladder. When the prostate is enlarged, excessive growth of cells is observed in it. With a significant increase in the prostate, it can exert mechanical pressure on the urethra, interfering with normal urination. If the symptoms are serious enough and the man is unable to urinate, then this is an emergency situation in which you should immediately contact your urologist.

Surgery to remove prostate adenoma improves symptoms. However, it must be remembered that there are certain side effects that must be considered when deciding to perform an operation to remove prostate adenoma. If you are very worried about the symptoms of BPH, you should weigh the pros and cons of this treatment option before choosing it.

Prostate tour is the most common operation for prostate adenoma.

Transurethral resection of prostate adenoma (TURP) is the most popular operation performed in BPH. It is considered the “gold standard” for treating an enlarged prostate. This is a treatment with which new treatment methods are often compared.

The operation involves the insertion into the urethra through the tip of the penis of a special endoscopic instrument (resectoscope), with the help of which resection (removal) of excess prostate tissue is performed.

During the first part of the TURP procedure, the urologist checks for problems in the bladder itself, such as bladder tumors or stones. In the absence of these problems, the urologist resets the extra tissue of the prostate gland adjacent to the urethra using an electric loop. An electrical loop is also used to control bleeding where the operation was performed.

Prostate tissue, which is removed, is sent for analysis to the laboratory to verify the absence or presence of prostate cancer . During surgery, a urine catheter is inserted into the bladder through the urethra. He will stay there for about a week.

TURP is usually performed in a hospital under spinal anesthesia. Hospital stay is approximately 7 days under the supervision of a physician. When discharging a patient, the urologist must give instructions on how to take care of himself after discharge from the hospital and possible complications.

Recovery after TURP

After returning home, men usually observe traces of blood in their urine. This can last up to three weeks. If the urine is intensely red, you should immediately consult a urologist.

What should be done during the recovery period?

• Be sure to rest in bed immediately after surgery and drink plenty of fluids. This will wash away any deposits of blood clots and prevent the formation of a blood clot, which can lead to blockage of the urinary tract.
• Follow the diet prescribed by your doctor.
• Take medication prescribed by your doctor.
• Avoid sudden movements and weight lifting.
• Do not strain during defecation.
• If you have constipation, consult your doctor for advice on how best to cope with it (do you have a laxative?)
• Eliminate sexual relations during recovery.

Side effects TURP

During the first few months after the procedure, you may experience discomfort when urinating. First, there may be a very strong urine flow that is difficult to administer. When the catheter is removed from the urethra, the surgical wound will open, so pain will be felt when urinating. Within a few months, the urinary flow is stabilized and uncontrolled urination subsides.

Some men may have complications after surgery. The main side effect is  retrograde ejaculation , in which sperm gets into the bladder during orgasm, and not into the urethra as usual. This, of course, may not be very critical for men who do not want to have children. However, this is one of the common causes of male infertility .

Long-term erectile dysfunction and urinary incontinence can also be side effects, which should also bother men before surgery. Therefore, it is necessary to find out from the urologist what part of the men with your symptoms may eventually suffer from prolonged erectile dysfunction and urinary incontinence. The probability of such events, of course, difficult to predict. Urinary incontinence is usually less common (usually about 1%) than erectile dysfunction. To combat incontinence, you can use Kegel exercises .

After the TURP procedure, a stricture (narrowing) of the urethra may occur as a result of scarring of the surgical wound tissue, which may lead to some compression of the urethra and a decrease in urine flow.

Open prostatectomy for an enlarged prostate

Sometimes it is not possible to remove prostate tissue using a transurethral procedure due to the very large volume of the prostate, therefore an open prostatectomy may be required – surgical removal of the entire prostate. Another reason for which an open procedure may be required is the presence of stones in the bladder.

This article describes the operation to remove prostate adenoma. Other types of surgeries for an enlarged prostate are given in the article . Other materials on the prostate gland can be found here .