Jul
19
RETROPUBIC PROSTATECTOMY w5tbpqac7u
In this surgery the same type incision is made as in the suprapubic operation. The muscle is separated and the sac containing the intestines is moved away from the bladder.
Now the surgeon makes an incision into the prostate capsule and removes the enlarged gland. The tissue removed is tested by a pathologist to determine if there is any cancerous growths present.
Now the surgeon sutures or cauterizes the bleeding vessels and the catheter with the three way tube is placed into the bladder. This catheter is usually the same type as used in a TURP operation. Next the balloon is inflated to keep the catheter in place.
All that is left is for the surgeon to “close”. The prostate capsule is sutured shut and the muscles, fascia and skin are put back in place and stitched closed.
This operation differs from the previous one since the bladder itself was not opened. It’s slightly simpler with less violation of the body. This means there is no need for the second catheter through the belly to drain the bladder.
The draining and irrigation of the prostate needed can be done with the usual three-way catheter. Most urologists say that this operation is less stressful to the patient since the bladder is not cut open, so it doesn’t have to recover.
General recovery procedures and time is about the same for either type of operation. Which type your urologist might suggest would be determined by the individual patient’s condition and sometimes the doctor’s preference.
In surgery for the prostate, the general rule is that a medium sized enlarged prostate and smaller ones can be successfully removed by the TURP method. However when the gland swells in size to over fifty to sixty grams, the urologist will usually do one of the other operations because of the difficulty in scraping out that much tissue and drawing it out of the urethra.
In these cases the larger prostate removal by the retropubic or suprapubic is simply the most efficient method to be used for the well being of the patient.
OTHER TYPES OF PROSTATE SURGERY
Perinea) prostatectomy is another kind of open surgery for the prostate but it is seldom used today. This procedure is quick and simple to do, but almost always severs the nerve bundles that control erection and leaves the patient Impotent.
Doctors back in the 1930’s often used a two stage operation for the prostate. The first stage was opening and draining the bladder. Then two weeks later they would go in and remove the prostate. It is seldom used today.
With the new treatments now coming into focus for the prostate, particularly BPH, there may be a general slowing in the number of surgeries needed. Any surgery has risks but with the prostate the risks seem to be reasonable in regards to impotence and incontinence, the two problems most men fear the most.
With the development of the new drugs, we may see products that will cause the enlarged prostate to shrink without objectionable side effects. With the increased use of the balloon as at least a temporary treatment for BPH, and other inventive methods, some experts are predicting that the use of surgery will not be required as often in future years as it is today. Only time will tell. As the public learns more about the male prostate and BPH, more men will demand non-intrusive treatments whenever possible. Right now a lot of men are hanging their hopes on the new drugs Hytrin and Proscar.
Jul
7
BENIGN PROSTATIC HYPERPLASIA (BPH)
Benign Prostatic Hyperplasia, sometimes called Hypertrophy, is the medical way of saying that the prostate gland has enlarged. In early stages this enlargement may not cause any problems. As it enlarges more and more with a man’s increasing age, it may squeeze the urethra smaller and smaller.
This reduces the force and size of your urine stream, and if left untreated, BPH could lead to the closure of the urethra resulting in severe sickness and even death.
Doctors say that in BPH the glandular tissue within the prostate capsule enlarges, grows, and no one seems to know why it happens or how to prevent or stop this growth.
This is a benign growth. That means it is not cancerous, it does not spread to other parts of the body or attack other tissues or cells. If it were malignant, as in cancer of the prostate, it would destroy and attack other tissue or cells and spread.
In the drawings here, notice how the urethra is fully open in the first one. It passes through the prostate allowing normal flow of urine from the bladder through the urethra and out the penis.
In the second drawing, the darker growth of benign tissue has begun and already has taken the bulge out of the urethra. In the third drawing, the BPH tissue has almost closed the tube the urine must pass through, making urination extremely difficult and bringing on all sorts of BPH symptoms and problems.
We come back to the apple example. Your prostate is like an apple with the core taken out. Through the core goes the urethra. The size of the urethra may begin to shrink when the prostate starts to enlarge when most men are about forty to forty-five. Often by the time a man is in his fifties he’s noticing some changes in his urination pattern.
It is just outside the urethra where the benign growth of the prostatic tissue begins, and it usually grows in both directions, which at once impacts the size of the urethra.
The growth of the tissue usually is not uniform or consistent all along the urethra. It may develop in one section and not in another, so the urethra is not compressed all along its length, at least not at first.
However, as with any tube or a garden hose, pressure at any one spot can shut off the tube entirely and cause all sorts of problems.
The new growth in the prostate consists of the same types of tissue as the normal prostate gland has, but in different proportions. The new, benign growth is going to have more of the glandular type of tissue.
The new growth in the prostate usually develops in both an inward and outward direction, toward the urethra and toward the exterior of the gland. When it grows outward it compresses the normal prostatic tissue against the sturdy outer capsule of the prostate.
When this outer growth takes place in the two lobes of the prostate nearest the rectum, a specialist can feel this with a digital examination. The outward growth does not narrow the urethra so there would be none of the usual BPH symptoms.
In most cases, however, when there is an outward growth of the tissue, it also grows toward the inside as well. Now we get the narrowing of the urethra over the years, and the normal symptoms of BPH.
The prostate has several sections, and digital examination can touch only the back part of the prostate. The sections that can’t be felt can harbor benign or malignant growth. This is one of the reasons for other tests for prostatic cancer that we’ll explain in detail later.