Getting to know about prostate surgery

 

Prostate surgery or prostatectomy is a surgical procedure to remove part or all of the prostate gland, which is a gland owned by men. Sometimes is also done network <> strong around prostate gland. This gland is located under the male bladder, and serves to produce semen.

Getting to know about prostate surgery

There two main techniques in prostate surgery through the stomach, namely:

  • Radical prostatectomy, is a procedure for removing all prostate gland tissue along with the tissue around the gland. Radical prostatectomy is generally done to treat prostate cancer. This procedure can be done openly through a wide incision in the skin, or assisted with a laparoscope (laparoscopic prostatectomy) through a smaller incision in the skin.
  • Simple prostatectomy, is a partial removal procedure prostate gland without lifting all prostate tissue and surrounding tissue. Simple prostatectomy is generally done to treat the enlarged prostate gland. This method is known as the Transurethral Resection of the Prostate (TURP) or Transurethral Incision of the Prostate (TUIP). Both are done by cutting off the part of the prostate gland that blocks the urinary tract, then the piece will come out together with urine when the patient urinates.

    Indications of Prostate Surgery

    Prostate surgery is done as a treatment for prostate cancer, other than through chemotherapy, radiotherapy, or hormone therapy. In addition, this procedure can also be done to overcome the symptoms of prostate enlargement ( benign prostatic hyperplasia / BPH). BPH can inhibit the flow of urine and cause complications in the sufferer.

    The symptoms that indicate that a person may need treatment through prostate surgery are:

    • Frequent desire to urinate often (micturition).
    • Feeling difficult at the beginning of urination.
    • Urinate with a long duration, and the flow of urine is slow or faltering.
    • No can urinate completely.
    • Have a urinary tract infection.
    • Increased frequency of wanting to urinate at night ( nocturia ).
    • Feel urination is not complete after completion.

    Warning for Prostate Surgery

    Prostate surgery generally does not have a special condition that causes the patient not to undergo this surgery at all. However, specifically for patients with prostate cancer, patients are not advised to undergo simple prostatectomy. Prostate cancer patients are required to undergo a biopsy examination first so that the prostate surgery technique will be determined. In addition, if the patient is taking blood-thinning medications, such as warfarin or clopidogrel, or if he has a blood clotting disorder, it is recommended to inform the doctor to prevent heavy bleeding during surgery.

    Preparation for Prostate Surgery

    Before undergoing prostate surgery, patients will undergo a cystoscopy procedure first. Cystoscopy is performed to check the condition of the prostate gland and urethra visually. Patients can also undergo other tests, such as blood tests, urine flow tests, and prostate size checks. To prevent surgical wound infection, the patient will be given antibiotics by the doctor a few days before undergoing surgery.

    In addition, several other things that are included in the preparation of prostate surgery are:

    • The doctor will ask the patient about medications that are being consumed, especially blood thinning drugs and pain relievers, such as aspirin and ibuprofen. If you are taking one of the two types of medicine, your doctor will ask the patient to stop it before undergoing prostate surgery.
    • Patients will be given laxatives to clean the digestive tract, and will be asked to fast a few hours before undergoing surgery.
    • Patients who are allergic to certain drugs, must notify the doctor.
    • Patients are asked to leave jewelry, dentures, contact lenses, and glasses at home before undergoing surgical procedures.
    • Patients should be accompanied by a family before and after undergoing surgery, including for pick-up purposes. Generally, patients can go home a few hours after surgery and do not need hospitalization.

    Procedure for Prostate Surgery

    Prostate surgery is usually performed in a patient's condition unconscious due to general anesthesia (general anesthesia). In some cases, the patient is only given half-body anesthesia so that he remains conscious during the operation, but does not feel anything. Patients will also have a urine catheter to drain urine from the bladder without going through the urethra, during surgery.

    Patients undergoing open prostatectomy will begin by making skin slices, either in the front of the prostate (retropubic) or in the behind the prostate (perineal). Skin slices on open retropubic prostatectomy are made from below the navel to approach the pubic bone. Whereas skin slices on perineal open prostatectomy are made near the anus to reach the area near the scrotum. After the skin slices are opened, the urologist will remove the patient's prostate gland. If needed, along with the surrounding tissue, such as lymph nodes. After removal of the prostate gland is complete, the skin slices are closed again using sutures.

    While laparoscopic prostatectomy is performed using slices the size of the keyhole, but numbering more than one. Skin slices in laparoscopic prostatectomy are made in the abdominal area to insert a special surgical instrument (laparoscope) to the part near the prostate with the help of a camera at the end of the laparoscope. When the laparoscope reaches the prostate gland, the doctor then cuts and removes the prostate gland using the laparoscope. In hospitals that have applied more sophisticated technology, laparoscopic prostatectomy can be assisted by robotic technology to facilitate removal of the prostate gland.

    To reduce blockages in the urinary tract, especially for patients who have prostate enlargement (BPH), can undergo prostate surgery without going through an incision in the abdominal wall, but through the ureter and urethra. These operations include:

    • Prostate surgery with This procedure aims to cut the prostate gland that has enlarged using a laser. The laser device in the form of a long hose will be inserted through the urinary hole to reach the prostate gland. When it reaches the area of ​​the prostate gland, the laser is then activated to cut the prostate gland. The cut prostate tissue will be removed through urine.
    • TURP . Transurethral Resection of the Prostate (TURP) is done using special sterile threads.
    • TUIP. TUIP or Transurethral Incision of the Prostate is performed using a special surgical instrument that cuts the prostate gland into several parts of the urinary tract narrowing site.

    Patients who undergo prostate surgery with an incision in the skin, will be sewn back to cover the incision. The suture area is then covered with sterile bandages to avoid infection, and the catheter will remain attached to drain urine during the recovery period.

    After Prostate Surgery

    After undergoing prostate surgery , the patient can feel the following:

    • Pain in the area of ​​the surgical suture.
    • The appearance of blood in the urine.
    • Difficulty holding urine at the time of urination.
    • Pain when urinating.

    Patients who have undergone prostate surgery will be given painkillers. The first painkillers will be given in the form of intravenous fluids, and will be replaced with drinking drugs in the following days. The patient will still be fitted with a catheter to help urinate for several days, at least 5-10 days after surgery. The doctor will advise the patient to take a mild walk to help with postoperative recovery. If it feels good enough, the patient will be allowed to go home. If not, the patient will undergo treatment for several days in the hospital.

    Keep in mind that patients must be picked up from the hospital by family members after completing surgery. During the recovery period, the patient will be asked not to do heavy physical activity, and to increase his physical activity gradually. The doctor will also schedule a re-control during the recovery period and will tell the patient when to resume normal sexual activity.

    Risk of Prostate Operation

    Apart from various prostate surgery techniques performed, the risks that can occur in patients include:

    • Allergic reactions to anesthesia.
    • Surgical wound infection.
    • Blood clots.
    • Bleeding.
    • Damage to organs near the prostate gland.
    • Urinary tract infection.
    • Urinary incontinence.
    • Don't reach orgasm during intercourse.
    • Urethral stricture.
    • Impotence.
    • The formation of cysts in the lymph nodes near the prostate gland.

    Patients undergoing prostate gland surgery often cannot experience erections for several weeks after surgery. In some cases, prolonged impotence can be caused by damage to the nerves that regulate the erection.

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