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
9
YOUR PROSTATE
PLAN IT OUT AHEAD
There are other ways to live more comfortably with your BPH.
• A long car trip. Plan where you’re going to stop. Most car rides tend to stimulate the urinary tract. This may be partly due to nervous tension if you’re the driver. Figure out where you can stop at least every two hours.
This will allow you to gas up, have a snack and use the bathroom. Some patients with BPH say sometimes on car trips they have been stuck in big cities where there were no filling stations, and by the time they found one they nearly tore the door off the men’s room to get inside.
• Going to a scary or suspenseful movie? Again nervous tension can increase the need to urinate. Performers get this problem before they go on. A really wild movie can do the same thing to most men. Try to use the bathroom before the movie starts. As a precaution, don’t buy a large cola drink to go along with your popcorn.
Remember “a pint in, a pint out,” and often the “pint out” part won’t wait until the movie is over.
• Let’s say you waited too long, your whole crotch is burning and throbbing and you have to urinate so bad you’re almost upset to your stomach. When you at last get to a bathroom, try for the toilet stall. Simply close the door, drop your pants and sit down.
No one seems to know why, but sitting down to urinate relaxes some muscles or the sphincter muscle, or something, and it makes urination at these difficult times much easier. At stress times like this, many BPH patients say it’s taken them five minutes of standing at a urinal or at the bathroom at home before they can get even a drop of urine out.
Spasming of muscles seems to be relaxed, and the whole system simply works easier and much faster in these stress situations, if you can sit down and bend forward toward your knees.
At this point who cares why it works, it does and will work any time you have trouble getting a urine flow started as well. Don’t fight it, just try it!
COPING WITH YOUR BPH
You’ve known that you’ve been living with your BPH for what - a year, three years? You’re a short timer. Most urologists have had literally thousands of years of experience with BPH through their patients. Your doctor may have a dozen little hints and helps like those above that have worked for hundreds of his BPH patients. No, these are not big dramatic findings that can be reported in the New England Journal of Medicine or the Journal of the American Medical Association.
However, your own doctor or urologist may have a small gold mine of tips and hints that he’s picked up over the years to make a big difference in how you can live easier and more comfortably with early and more advanced stages of BPH.
The next time you’re in his office, ask him if he has any of these little gems of BPH trivia advice that might just fit some problem that you’ve been having. The best advice is: Always go to the expert: talk to your urologist.