The prostate is a little-known gland, if not at the time of the onset of a disorder: does it explain what it is and what it is used for? Also, what are the signs and symptoms to recognize benign gland enlargement and what impact do they have on the patient's quality of life?
The prostate is a very important sexual gland because it enriches the seminal fluid with its secretions , thus contributing to fertility.
The classic symptomatology is that of the patient who often goes to urinate, even at night, with possible burning and pain during urination, symptoms that are often also connected to bacterial inflammation of the prostate. These patients may present sexual disorders due to the involvement of neurological pathways which are connected to the genital area and which play an important role on the sexual sphere.
The enlargement of the prostate is a phenomenon that occurs with age, generally has its peak around 50 years. The particular symptomatology of benign prostatic hypertrophy is linked to the very particular position in which the prostate is located: it is positioned below the bladder and embraces the urethra like a sleeve and when it grows exuberantly it compresses as if it were a ring the urethra, preventing the normal passage of urine from the bladder to the outside.
Africandoctor's herbal tea for prostate enlargement
We have plants suitable and ideal for the healing of prostate adenoma, which has been made availabe in a tea form. They are used to slow the growth of the prostate, reducing the "fuel" of the prostate cells: the cells of the enlarged prostate and the prostate work with the same factors and use the same "fuel".
These plants are also effective when the volume of the prostate is visible, above 40 m. Obtaining their relaxation and favoring the opening of the funnel of the bladder neck and the prostatic urethra. They thus improve emptying of the bladder. These plants are the first phytotherapeutic approach to reduce the frequency of urination and improve spraying.
Advantage of this natural remedy :
- relieves inflammation and pain
- normalizes urination and erection
- fixes the result reliably and for a long time
- valid at any age and at any stage
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SURGICAL INTERVENTION FOR PROSTATE ADENOMA
Surgical intervention for the treatment of benign prostatic hypertrophy is evaluated when the conservative and / or pharmacological treatment is not sufficient to allow an acceptable quality of life for the patient, in order therefore to improve symptoms such as:
- difficulty starting urination,
- weak flow,
- frequent and urgent need to urinate ,
- need to get up at night to urinate (nocturia),
- inability to completely empty the bladder.
It is necessary for the patient to face the intervention on an empty stomach (for at least 6-8 hours), while during the anesthetic visit preceding the surgery, indications will be provided on any drugs in use (replacing any anticoagulants with the heparin to be administered subcutaneously).
Interventions with minimally invasive surgery
Among the minimally invasive interventions: “Transurethral resection of prostate adenoma (TURP) is still considered the gold standard intervention.
It consists in the removal of the prostate adenoma, tissue present in the central area of the prostate and responsible for the difficulty in urinating, which through surgical techniques can allow a faster recovery for the patient ".
Numerous other techniques have been proposed, but have very limited indications, among these we mention:
- Transurethral Microwave Thermo Therapy (TUMT);
- Transurethral Needle Ablation of the Prostate (TUNA).
On the other hand, the procedures that allow the removal of the adenoma using the laser are recently introduced: the most used are the Tullio laser (TULEP) and Holmium laser (HOLEP).
At the end of the operation, a bladder catheter will be positioned which will remain in place for at least 2 days, in order to allow a correct washing of the bladder from any residues.
The patient is then transferred to the ward where he will remain lying down all day.
The possible symptoms that you will experience will initially be linked to anesthesia (which lasts up to 6 hours) and mainly consist of headache , but already the day after the surgery it is possible to walk and eat normally. Discharge, if there are no problems, takes place 2 days after surgery, after evaluation of the urine emitted and the urination residue by means of suprapubic ultrasound.
The two days of hospitalization are linked to the need to evaluate the recovery of the patient, as well as the need to carry out frequent irrigation of the bladder and urethra with physiological solution through the bladder catheter.
Depending on age and general state of health, it is normal to feel a little post-intervention tiredness, which could last from a few weeks to a couple of months.
What are the complications of the intervention?
Anesthesia allows the patient to avoid any form of pain during surgery, while in the post-operative period it is possible to feel a little discomfort due to the presence of the catheter (and to irrigations, which can cause an unpleasant sensation of full bladder) .
Due to the swelling of the prostate following the resection procedure, which is the cause of inflammation, it is initially not possible for the patient to urinate normally; the same catheter used for irrigation will therefore also be useful at the same time to allow emptying of the bladder as long as necessary.
Following discharge, it is normal for the patient to experience some difficulties during urination for a few days, as well as to find traces of blood in the urine , but these are symptoms destined to resolve quickly; more rarely, however, it may be necessary to leave the catheter in place longer, a few days or a few weeks, in cases where it is not possible to urinate normally.
The intervention is considered reasonably safe and rare complications; among these we remember:
- Intraoperative complications
- TUR syndrome (2% of cases) with
- nausea and vomiting ,
- high blood pressure .
- Complications after surgery
- Urinary tract infections
- Urinary retention : may require maintenance of the bladder catheter for a longer period.
- Complications common to all interventions :
- Long-term complications :
- urinary incontinence and erectile dysfunction (these first two complications are typical of prostate surgery),
- retrograde ejaculation with consequent sterility (but the perception of the associated pleasure does not diminish),
- bladder neck sclerosis,
- urethral stricture,
- regrowth of prostate tissue (risk of recurrence).
What will I have to do at home?
Antibiotic therapy may be prescribed to be continued at home. There may be some disorders during urination such as burning and incontinence. Among the indications provided at discharge, it is advisable to drink in sufficient quantities and not to keep the urge to urinate .
- It will be possible to return to driving quickly, in most cases in about a week (the discriminating factor is the ability to brake quickly in an emergency).
- The return to work is strictly dependent on the type of activity carried out.
- Sexual abstinence of about 3-4 weeks will be recommended.
It is recommended to contact your doctor in case of:
- fever (above 38 °),
- severe pain when urinating,
- inability to urinate,
- persistence of blood in the urine.
Based on experience, what are the patient's fears when he has to undergo surgery for benign prostatic hypertrophy? What are the "false myths" to dispel?
Unfortunately, misinformation on the subject has generated two main fears in the patient: incontinence and impotence . To dispel these two false myths it is necessary to clarify and distinguish the intervention for benign prostatic hypertrophy from that for prostate cancer. In the case of a tumor, the prostate is completely removed, the disease can affect the nerves of the erection and can therefore cause urinary incontinence and disorders of the sexual sphere.
On the contrary, the intervention for benign prostatic hypertrophy does not create any damage from the point of view of the sexual sphere because the nerves of the erection are far from our working point and the prostate is only reduced in size, not removed in bulk. It is important to specify that some patients accuse problems of the sexual sphere after the surgery that are not attributable to the technique. Having a certain age, they often have pre-existing erectile deficit conditions that are only exacerbated by prostate problems. Even the possible drop in desire, is not to be attributed to the intervention, but only to the strong psychological impact it has on the patient. Ultimately, if the surgical technique is performed correctly, sexual activity can start physiologically with the exception of retrograde ejaculation which in this case becomes a persistent phenomenon.
As far as incontinence is concerned, it is a completely transitory condition . Many patients in the early stages after surgery complain of urgent urinary leakage because the bladder must readjust to a normal contraction condition after removal of the prostate. Then it is possible to return to normal urination, with a little patience because it usually takes three to six months to resume the urination routine .
What advice can be given to patients who have an enlarged prostate and who are considering having surgery?
Definitely talk about it with a urologist , exposing all doubts related to any problems. Benign prostatic hypertrophy does not jeopardize the survival of the individual but severely limits daily life, leading in some cases to infections and complications.
Giving up the quality of one's life for the unfounded fear of routine intervention, which could definitively solve the problem, would be senseless.
It is also important to contact the doctor at the onset of symptoms because patients usually neglect the problem and come to this intervention when the conditions are not optimal, but the more complicated the clinical picture the more it takes to recover after the intervention .
In conclusion, I strongly believe in the surgical technique, clearly practiced in moderation: today we are able to make good prostate resections with excellent results and without major complications.
I find it indicated in the patient who does not want or cannot bear the therapy but also in the case in which the drugs are not effective and finally in the cases of complications such as infections and urinary retention and diabetes, which make it necessary.
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