What is the prostate and what are its functions?
It is a walnut-sized (10-20gr) glandular tissue through which the external urinary tract, located just below the urinary bladder (bladder) in men, passes. The prostate gland secretes the necessary fluids for sperm cells in the semen. What are the Most Common Prostate Diseases? Prostatitis (Inflammation of the Prostate Gland) It is an inflammatory disease of the prostate tissue and the most common findings are fever, weakness, pain, burning during urination, difficulty urinating, sudden urgency, painful ejaculation and erection problem. It usually improves with medical treatments.
Benign Prostate Enlargement What is Benign Prostate Enlargement?
With age, the enlargement of the prostate gland compresses the urethra that passes through it, and as a result, urination problems occur. Troubles increase in the 50s and 60s. The incidence increases with increasing age. Benign prostate enlargement protects against kidney failure, urinary incontinence, formation of bladder stones, and bladder cancer due to chronic irritation with early diagnosis and treatment. In addition, it significantly improves the life comfort of patients.
What are the symptoms?
Frequent urination, frequent urination at night (more than 2) Sudden urge to urinate, urinary incontinence Burning or bleeding in urination Weakness in the urine stream Difficulty urinating Intermittent urination Feeling of not fully emptying the bladder and dripping at the end of urine.
Prostate Enlargement is Most Commonly Confused With Which Diseases?
External urinary tract strictures and stones Bladder tumor Urinary tract infection Overactive bladder Neurogenic bladder Pelvic pain syndrome Bladder stone.
How is Benign Prostate Enlargement Diagnosed?
The first evaluation is made with the patient's medical history and complaints. Physical examination and when necessary; PSA (prostate specific antigen) test, Uroflowmetry (urine flow rate), Ultrasonography, Cystoscopy (examination of the external urinary tract and bladder with a special instrument) are used. How is Benign Prostate Enlargement Treated? Treatments to be applied in benign prostate enlargement; Close monitoring Drug therapy Focal therapies (REZUM) Surgical procedures (TUR-P, Prostate Vaporisation, HOLEP ) Medication Medication Alpha blocker (channel expanders) 5alpha reductase inhibitor (prostate shrinker) Muscarinic receptor antagonists (to reduce frequent urination) Pd5 inhibitor (urine) Phytotherapy (herbal treatment) Combination treatments Focal Treatments (Rezum ) What is Rezum? In patients with benign prostatic enlargement, the prostate tissue is reduced by the water vapor formed as a result of thermal energy and the part that blocks the urinary canal is opened. Under local or sedoanalgesia, the urethra is entered with a camera (closed) through the urinary tract, and water vapor is injected into the prostate tissue with a needle, and the tissue is destroyed and the part that blocks the duct is opened.
What is the difference of Rezum?
Rezum is the ideal choice for elderly patients who have health problems that prevent surgery or who do not want to take the risk of anesthesia. The procedure takes 10 minutes and there is no need to stay in the hospital after the procedure. Recovery after the procedure and returning to daily life is faster than in surgeries. In young patients, the risk of recurrent ejaculation (retrograde ejaculation), which is common after surgery, is almost non-existent. The effect of Rezum usually becomes evident in 2-3 weeks, but this period can be extended up to 6 weeks. Rezum has protective properties of the external urinary tract.
Rezum has been applied to over 35,000 patients in developed countries since 2017. Surgical Methods Transurethral Resection of the Prostate (TUR-P) It is an endoscopic (closed) surgical method, which is accepted as the most commonly applied gold standard technique in the surgical treatment of benign prostate enlargement (BPH). How is Transurethral Prostate Resection (TUR-P) Surgery Performed? Under general or spinal anesthesia, the prostate tissue is cut into small pieces and removed by entering the external urethra with a special device under the guidance of a camera. It can be done with two energy sources, monopolar and bipolar.
Bipolar energy can also be used safely in patients with pacemakers, since no electrical current passes through the patient's body. Today, the most frequently used energy source in TUR-P methods is bipolar energy. After the operation, a catheter is placed in the urethra for 2-3 days. Since the surgery is performed with the endoscopic (closed) method, no incision is made. Therefore, recovery is very fast. Patients start to eat and drink 6 hours after the operation and are usually discharged on the 2nd day. Prostate Surgery with Holep What is Holep? (Holmium Laser Enucleation of the Prostate) It is a surgical method in which advanced laser technology is used in the treatment of benign prostate enlargement (BPH). It is a closed procedure that can clean and remove the entire part of the prostate tissue that closes the urinary canal. Prostate surgery with Holep is a comfortable method.
What are the Benefits of Holep Surgery?
Even in very large prostates, the procedure is performed without making any incisions in the body. It is an alternative method to open surgery. There is little to no chance of re-operation. It does not harm sexual functions. There is no need for blood transfusion in the surgery. In obligatory cases, even those who use blood thinners can be treated. Since it is applied with the laser separation principle in patients whose catheters are removed after the surgery, the patient who has the catheter removed does not experience a burning sensation while urinating. Holep surgery; Patients can return to their normal lives in a short time, as it offers advantages such as low bleeding risk, short hospitalization period and fast recovery period. The nerves that regulate sexual functions are not damaged. Therefore, post-operative erection problems are not expected in patients. Since no burning defect develops in the tissues removed after surgery, pathologists can examine the tissue more easily and the possibility of possible malignant formations to be overlooked decreases.
Who Is Holep Surgery Suitable For?
The majority of patients with prostate disease who are considered for surgery are suitable for Holep. Holep is a suitable surgical method for anyone who needs prostate surgery. Holep technique is applied safely. In the presence of bladder stones accompanying prostate enlargement, it is successfully applied in the same session and simultaneous stones can be broken with a closed laser. Again, in patients with stenosis in the urinary canal, this stenosis can also be opened with laser during the procedure. It can be applied more safely than other techniques in patients with cardiovascular diseases, stent in the heart vessel, undergoing bypass, and using blood thinners due to vascular occlusion.
How is HOLEP surgery performed?
General anesthesia or spinal (by numbing the waist down) anesthesia is performed. It is performed by entering through the urinary canal with an endoscope. Since no incision is made, the patient can return to daily life very quickly. The enlarged prostate tissue is carefully separated from the capsule by laser and thrown into the bladder. The prostate tissue thrown into the bladder is broken up with another device (morcellator) and vacuumed and taken out of the body. The procedure is terminated by inserting the probe. The removed prostate tissue is sent to pathology to evaluate the possibility of possible cancer. Generally, patients start to eat and drink 6 hours after the surgery and are usually discharged on the 2nd day.