Transurethral prostate resection is a closed surgical method that is most frequently applied in the surgical treatment of benign prostatic hyperplasia (BPH) and has been accepted as the gold standard treatment method in many scientific environments. It can be used in BPH patients whose weight does not exceed 80 grams. In this method, after the patient is given general or spinal-epidural anesthesia, the urinary tract is entered with a special tool called resectoscope and the prostate tissues are cut, often using plasmakinetic energy. While the prostate tissue is cut into strips, bleeding is stopped with the help of the device. The prostate tissues accumulated in the urinary bladder are then removed with the vacuum system. After the operation, a catheter is placed in the urinary tract and kept for an average of 2-3 days.
Post-operative recovery is quite fast and easy. Many patients can stand up within 6-8 hours with water and food intake, and can return to normal life the day after the operation. Discharge may be possible on the 3rd day of the surgery following removal of the catheter.
IS THERE A NEED FOR OPEN SURGERY IN BENEFITS OF PROSTATE ENLARGEMENT?
Especially the prostate weight is 80-100 gr. It is the method that can be preferred primarily in patients with TUR and above, but even prostates of this size can be treated with the closed method by surgeons with very good TUR experience. Therefore, the choice of surgical method (TUR or Open surgery) in patients with advanced benign prostatic hyperplasia should be left to the surgeon. Open prostate surgery is performed through an incision made below the navel under general or spinal-epidural anesthesia. The bladder (urinary bladder) is opened and the prostate is accessed, and the part of the prostate blocking the urinary tract is removed. Postoperative recovery and catheterization time are longer than closed methods (5-7 days on average).
CAN BENEFITED PROSTATE ENLARGEMENT BE OBSERVED WITHOUT TREATMENT?
In patients who do not have complaints related to benign prostatic hyperplasia, if the kidneys and bladder are found to be normal in the urological evaluation, the patient can be followed up. Before follow-up, prostate cancer must be excluded by performing a digital rectal examination and checking PSA. The patient's complaints started Up to 6 months or 1 year follow-up can be programmed.
WHEN AND WHERE SHOULD DRUG TREATMENT IN BENEFITS PROSTATE ENLARGEMENT?
When complaints about benign prostate enlargement begin to disrupt the person's daily activities and quality of life, drug treatment can be started, but the side effects of the drugs and the duration of use must be clearly explained to the patient before treatment. Detailed information should be shared, especially about drug groups that may impair patients' sexual performance or affect ejaculation quality. In this way, future situations that may force the patient to avoid prostate treatment will be determined in advance.
a) Alpha-blockers: Located in the bladder neck and prostate. They relax the smooth muscle structures, causing the urinary tract to widen. It is taken orally once a day. Side effects may include headache, dizziness, fatigue, weakness, and drop in blood pressure.
b) 5-Alpha reductase inhibitors: Dihydrotestosterone, the active form of testosterone. They act by blocking the conversion of a (DHT). It is reported that in this way, they provide a certain shrinkage of the prostate and a 50% decrease in PSA. Side effects include loss of libido, impotence (loss of sexual function), breast enlargement and tenderness.
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