According to statistics, every second man over 40 years of age faces inflammation of the prostate gland. With prostatitis, surgery is prescribed as a last resort, when drug treatment is not able to stop exacerbations or prolong remission.
If you pay attention to the alarming symptoms in a timely manner and consult a doctor, the serious consequences of the pathology can be avoided, but many guys postpone the visit to the hospital until the last, for which they pay with their own health: the transition of the disease to a chronic form, the appearance of complications.
What type of surgical intervention will be performed will be determined by the attending physician, based on the general health of the patient and the current picture of the disease.
The main indications for carrying out
Surgery for prostatitis in men is carried out both for bacterial and non-infectious types of pathology. The main condition for surgical treatment is the relief of an acute attack, i.e. transferring the disease to the stage of remission, even if not persistent.
Indications for which an operation is prescribed for the treatment of a disease by surgery are:
- dysfunction of the genitourinary system, expressed in urinary retention (inability to empty the bladder);
- progression
of the disease against the background of drug therapy or the use of
minimally invasive techniques;
frequent or constant presence of blood in urine (a sign of kidney failure); - stones in the kidneys, bladder or prostate gland, whose formation caused a violation of the outflow of urine (the main symptom of prostatitis);
- frequent infectious diseases of the genitourinary system;
- abscess of the glandular organ;
- inflammation of pararectal tissue (paraproctitis).
Modern medicine is developing new, less traumatic and relatively safe methods of surgical intervention, but any operation is associated with serious risks to health and life, and this should definitely be taken into account.
Types of surgical interventions
Surgical treatment of prostatitis is carried out by the following methods:
- transurethral resection of the prostate (TURP);
- open prostatectomy ;
- laparoscopy;
- laser operation;
- abscess drainage;
- transurethral incision of the prostate gland.
TURP
When using the TURP technique, the inside of the prostate is removed. Today it is the most popular and affordable operation in the field of urology, used in 90% of cases.
It is carried out through the urethra: a resectoscope is inserted into the urethra , which, in addition to removing the tissues of the organ, allows the surgeon to examine the gland itself. After tissue is cut, a fluid is passed through the resectoscope to flush them out of the body.
The intervention lasts from 40 to 60 minutes, then a drainage is installed for the patient – a catheter, which is removed after 2-4 days. A man can leave the hospital 5-7 days after the intervention, the recovery period lasts about two months. The disadvantage is sharp pains when going to the restroom in the first few days after the procedure.
The technique is also effective for sclerosis (narrowing) of the bladder neck, which provokes urinary retention.
Open proctatectomy
Indicated for carrying out with:
- the presence of stones in the gland or organs of the urinary system;
- a strong increase in the size of the iron prostate organ;
- narrow urethra, the size of which is insufficient for the introduction of a resectoscope .
During the intervention, the skin of the lower abdomen and the walls of the bladder is dissected, the gland itself is excised and removed manually with a scalpel. Then a catheter is installed for 7-10 days, after removal of which the patient can be discharged. The postoperative period is 3 months.
In addition to long-term postoperative treatment, the possibility of damage to nerve fibers also stands out from the shortcomings, which often leads to the development of erectile dysfunction.
Laparoscopy
A technique comparable to minimally invasive treatment methods. 3-4 punctures are made in the lower abdomen, through which instruments and a mini-camera are inserted , allowing you to get an overview of the operated area. Removal of affected tissues is carried out with ultrasonic knives that stop bleeding. Recovery after the operation takes no more than one and a half months.
laser
The use of a laser (vaporization, cauterization) avoids blood loss, so that the patient can leave the clinic the very next day after the intervention. The laser is inserted through the urethra, which avoids unnecessary incisions and tissue damage. Among the shortcomings, one can single out the fact that the use of a laser is possible only for patients whose organ sizes are small.
Drainage of an abscess (closed abscess)
The abscess is opened by dissecting nearby tissues: the anus or perineum, after which a rubber drain is inserted into it. If the procedure is successful, the patient fully retains all sexual functions, and recovery takes a short period.
Of the minuses of the intervention, the possibility of incomplete cleansing of pus and re-suppuration is distinguished.
Transurethral incision
The task of the intervention is not to remove the affected organ, but to make several incisions in it, which will reduce the pressure of the prostate on the urethra. This will restore impaired urination, and hence the work of the entire genitourinary system.
Unlike TURP, there is no risk of developing impotence, the postoperative period is 2-3 days. Full recovery of the body is carried out within 1-1.5 months.
The disadvantage is the need for further treatment of the disease.
In chronic prostatitis, surgery is performed only if there are strict indications. There is no single solution for all patients, each intervention has its own advantages and disadvantages. The doctor’s task is to choose the optimal treatment for a man, in which its positive aspects offset the disadvantages of treatment.
Complications
Complications after any type of surgery include:
- violation of the emptying of the bladder;
- blood in the urine or bleeding while going to the bathroom;
- acute urinary retention;
- development of a secondary infection.
General negative consequences include allergic reactions caused by the introduction of anesthesia, fusion of the lumen of the urethra, pain and spasm in the perineum in the first days after surgical treatment.
All these reactions usually disappear without outside intervention in 2-4 weeks. The exception is the development of an infectious process that requires mandatory antibiotic treatment. To alleviate unpleasant symptoms, symptomatic therapy can be prescribed: antispasmodics, analgesics, hemostatic drugs.
Acute urinary retention requires a second procedure. It is to prevent it that a drainage catheter is installed.
Contraindications to the surgical method
Before prescribing surgery on the prostate, the patient is required to undergo a series of examinations, the results of which may cause a ban on surgical intervention.
General clinical blood and urine tests, a biochemical study, an ultrasound scan of the pelvis or glandular organ, and in some cases a tissue biopsy are required.
The task of ultrasound examination is to assess the general condition of the organ and exclude or confirm other pathologies of the genitourinary system: hemorrhoids, varicocele, etc. If his data is not enough, magnetic resonance imaging may be required.
The list of contraindications for carrying out includes:
- acute inflammatory process in the body;
- advanced age of the patient (over 70 years);
- endocrine pathologies (diabetes mellitus, hypothyroidism);
- pathology of the cardiovascular system and lungs in a severe degree;
- hemophilic infection;
- taking medications to thin the blood.
Postoperative recovery
To avoid the development of complications, to recover faster after surgery, you should strictly follow all the recommendations of the doctor.
In addition to taking prescribed medications, it is very important to observe personal hygiene and eat right. The menu should contain products that normalize the digestive system (this will avoid constipation) and have a weak diuretic effect (to avoid fluid retention in the body).
Although advances in the field of surgery and urology can reduce the risks after surgery, no doctor can give a full guarantee for recovery and successful implementation. So, according to statistics, only 43% of patients completely get rid of the disease, the rest have to continue the fight against the disease, but already by medication. And in almost 40% of patients, the reappearance of prostatitis is observed over the next 24 months. It should be remembered that the procedure can cause infertility (if the gland is completely removed) or impotence (in cases where important nerve fibers were affected).
It will be possible to avoid such consequences if you responsibly approach the choice of the clinic and the specialist who will carry out the procedure. You should carefully study the reviews, check the availability of licenses and certificates from the institution, if possible, evaluate the conditions of sterility. But the best way to prevent serious consequences is to try to avoid the pathology itself, then you will not need to resort to the services of surgeons.