Surgical treatment of benign prostatic hyperplasia
Benign prostatic hyperplasia (also: prostate; prostate) is the most common disease affecting this organ, with the incidence increasing with the age of patients. It affects about half of men in their 60s and 90% in their 90s. Pharmacological treatment is required for one in three men with this diagnosis, while due to its ineffectiveness, ultimately one in five patients must undergo surgical treatment for benign prostatic hyperplasia.
Criteria for initiating treatment of prostatic hyperplasia
Operative treatment depends primarily on the size of the prostate itself. Additional factors influencing the treatment of prostatic proliferation are the number and severity of comorbidities. The co-occurrence of bladder diverticula and bladder stones is also an important factor. Before starting treatment for hypertrophy, the doctor also needs to know if the patient is sexually active and if he or she cares about preserving semen ejaculation.
At Medicus Clinic, we have decided to create the first facility in this part of Poland for the comprehensive and modern treatment of benign prostatic hyperplasia, selecting the most optimal surgical treatment method for the individual patient, from TUIP, through HoLEP and Rezum, to laparoscopic adenomectomy with our own modification. As the safety of our patients is our priority, it is therefore standard practice for us to leave patients for overnight observation, with the option to extend it if a particular clinical situation requires it.
Find out more about the surgical treatments available for benign prostatic hyperplasia at Medicus Clinic.
TUIP – transurethral incision of the prostate gland
A method for the endoscopic treatment of small prostate glands, which usually do not exceed 30 g in size and there is no distinct third lobe. The procedure is mostly recommended for patients whose main urinary outflow disorder is a narrowing of the bladder neck in addition to the prostate tissue itself.
REZUM method – transurethral vaporisation of prostatic glandular tissue using steam
This procedure, unlike the others, is usually performed under local anaesthesia in a same-day procedure. Sexually active men with adenomas up to 80 g in size, who are keen to preserve sperm ejaculation and minimise the risk of side effects, are usually qualified for this method.
Laparoscopic adenomectomy
A procedure involving the extraction and removal of a prostate adenoma using laparoscopic instruments inserted through the abdominal cavity. It is primarily reserved for patients with prostate glands larger than 130-150 g. In addition, due to the possibility of intraoperative restoration of mucosal continuity and the lack of traumatisation of the external urethral sphincter, the risk of prolonged stress urinary incontinence and the presence of increased irritative symptoms is reduced. This method provides the best functional results at the cost of a slightly more invasive procedure compared to transurethral procedures.
Indications for the treatment of benign prostatic hyperplasia
Increased urinary problems unresponsive to pharmacological treatment, such as a weak or intermittent urine stream, frequent urination at night, difficulty initiating micturition or uncontrolled urine leakage due to overfilling of the bladder, may indicate a serious disorder. Additional alarm signals are the need for a urinary catheter due to inability to urinate, chronic or recurrent urinary tract infections, and the presence of bladder stones. In advanced cases, there may be multiple or large bladder diverticula, renal failure secondary to chronic urinary retention and secondary failure of the bladder detrusor muscle, responsible for generating adequate pressure of the urine stream.
Umów wizytę – urolog Wrocław
