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Enlarged prostrate
Discussion in 'All Categories' started by Suneel Khanna - Feb 12th, 2012 10:58 am.
Suneel Khanna
Suneel Khanna
In an ultra sound done recently, my prostarte median lobe has been found to be enlarged and this is obstructing the urethra leading to retention of urine - around 200 ml.
Pl inform what kind of treatment is advisable and is safest and if available in Gurgaon which doctor is performing that procedure? What is the cost of treatment and how many days will it take - for hospitalisation and post surgery recovery etc.......
re: Enlarged prostrate by Dr M.K. Gupta - Feb 18th, 2012 10:16 pm
#1
Dr M.K. Gupta
Dr M.K. Gupta
Dear Suneel Khanna

You can go for TURP at World Laparoscopy Hospital, Gurgaon. This factsheet is for men that are experiencing a kind of prostate surgery called transurethral resection from the prostate (TURP), or who wish details about it.

TURP is a very common operation for males who've an enlarged prostate gland (benign prostatic hyperplasia).

You'll satisfy the surgeon carrying out your procedure to discuss your care. It might vary from what's described because it will be made to meet your own needs.

About TURP
What are the options to TURP?
Preparing for the operation
What happens during TURP
What to expect afterwards
Recovering from TURP
What are the risks?

About TURP

For those who have an enlarged prostate, you may find it difficult to pass urine, as the prostate can obstruct the flow of urine from your bladder. Your surgeon may suggest that you have a procedure known as TURP to remove a section of your prostate gland and reduce pressure on your bladder.

Illustration showing the prostate and surrounding structures
Do you know the alternatives to TURP?

You can expect to simply be advised to have surgery in case your symptoms haven’t improved after taking medicines. There are different sorts of surgery to TURP, such as the following. The kind you are advised to have is determined by the severity of your condition.

Transurethral incision from the prostate - this is a similar operation to TURP, but involves making a couple of small cuts in the neck of the bladder and prostate rather than removing area of the prostate. It is usually only suitable for males whose prostate is just moderately enlarged.
Open prostatectomy - a cut is going to be made in your abdomen (tummy) and the outer part of your prostate will be removed. Normally, this is only carried out in men that have a very large, benign (non-cancerous) prostate and it is rarely done.
Minimally invasive surgery (such as electrovaporisation and laser prostatectomy) - during these kinds of operation, laser or electrical power is going to be used to burn off excess tissue.

Your surgeon will talk about which procedure is most suitable for you personally.

Get yourself ready for your operation

Your surgeon will explain how to get ready for your operation. For example, should you smoke you'll be asked to stop, as smoking increases your chance of obtaining a chest and wound infection, which could slow your recovery.

Your surgeon will discuss along with you what's going to happen before, during and after your operation, and any pain you may have. Here's your opportunity to know very well what may happen, and you can feel free by preparing questions you should ask about the risks, benefits and any other options to a procedure. This should help you to be informed, to help you give your consent for that operation to go forward, which you may be asked to do by signing a consent form.

The procedure is usually done under general anaesthesia. Which means you is going to be asleep during the operation. Alternatively, you might have the surgery under spinal or epidural anaesthesia. This completely blocks feeling from the waist down and you will stay awake throughout the operation. You may be offered a sedative having a spinal anaesthetic - this relieves anxiety and helps you to relax.

Your surgeon or anaesthetist will advise which kind of anaesthesia is most suitable for you personally.

If you’re having a general anaesthetic, you'll be asked to follow fasting instructions. What this means is not eating or drinking, typically for about 6 hours beforehand. However, it’s vital that you follow your anaesthetist’s or surgeon’s advice.

You might be asked to wear compression stockings to help prevent blood clots forming in the veins inside your legs. You may want to have an injection of the anticlotting medicine called heparin as well as, or rather than, wearing compression stockings.
What happens during TURP

The operation will take around an hour.

Your surgeon will insert a narrow, rigid, metallic, tube-like telescopic camera called an endoscope to your urethra. She or he will then eliminate and remove the center of your enlarged prostate using specially adapted surgical instruments that use heat energy to get rid of tissue.
What to expect afterwards

You will need to rest until the results of the anaesthetic have passed. You might not be able to feel or move your legs for several hours after a spinal or epidural anaesthetic.

You may need pain relief to assist with any discomfort as the anaesthetic wears off.

You will have a catheter to drain urine from your bladder into a bag. The catheter will also be used to wash your bladder having a sterile solution. This will help to flush out any thrombus in your bladder. The catheter is going to be removed when your urine begins to run clear. Normally, this is within 24 to Two days. Occasionally, you may want to keep your catheter set for a while once you go back home - if that's the case, your nurse will highlight how you can look after it.

You may have a drip in your arm to stop you getting dehydrated - this is removed once you’re drinking enough fluids. You'll be asked to wake up and move about as this helps prevent chest infections and thrombus in your legs.

You may be capable of going home after about 1 to 3 days. You will have to arrange for someone to drive you home. General anaesthesia temporarily affects your co-ordination and reasoning skills, so you mustn't drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you’re in almost any doubt about driving, speak to your motor insurer to ensure that you’re aware of their recommendations, and try to follow your surgeon’s advice.
Dealing with TURP

If you need pain alleviation, you are able to take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and when you've any queries, ask your pharmacist for advice.

You may be advised to improve your fluid intake. This is to purge out your bladder and help you to recover.

It will take up to a month to recuperate fully from TURP. After 2 to 3 weeks you can resume your normal activities. Don’t do any strenuous activity for about a month following the operation. You can have sex once you are comfortable - this can apt to be at least 3 to 4 weeks after your operation.
Do you know the risks?

As with all procedure, there are some risks related to TURP. We have not included the risk of these happening because they are specific to you and differ for everyone. Ask your surgeon to explain how these risks affect you.
Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after you have the operation.

Some specific side-effects of TURP range from the following.

Blood in your urine - this should clean up fully within about fourteen days. Whether it continues for over this, see your GP.
An urgent need to pass urine sometimes accompanied by a burning sensation whenever you do pass urine - this usually clears up after a couple of weeks.
Incontinence (urine leakage) - talk to your GP if this happens, however it nearly always clears track of time.
Impotence - this isn’t often a problem and many men aren’t affected when they had normal erections before surgery.

Complications

Complications are when problems occur during or after the operation. The possible complications associated with a operation have an unexpected response to the anaesthetic, excessive bleeding or developing a blood clot, usually inside a vein within the leg (deep vein thrombosis, DVT). Specific complications of TURP range from the following.

Retrograde ejaculation - this is when semen passes to your bladder throughout an orgasm instead of out of your penis. You will then pass the semen combined with urine the next time you urinate. Although retrograde ejaculation is permanent and can affect your fertility, it isn’t usually a problem for many men.
Infection. You might be given antibiotics prior to the operation to prevent infection.
TURP syndrome. This is where the fluid used to flush your bladder throughout the operation is made available to the body. This can cause alterations in your blood pressure and you may feel sick or vomit. However, this is becoming less frequent nowadays as surgeons can use a different type of fluid to flush your bladder, that is less likely to result in TURP syndrome.
Your prostate may grow again and you may need to have another operation - you may also need another operation if too little was removed throughout the first operation.

With regards
M.K. Gupta
re: Enlarged prostrate by Mill - Mar 13th, 2012 7:15 am
#2
Mill
Mill
Ovarian cysts during pagcnrney .much worried ?I'm 47 days pregnant yesterday 2 ovarian cysts were found through scan. one is 44mm the other is 59mm. too big I think. Doctor told not to worry asked me to take Duphaston tab 2 times a day I'm scared to take medicine. won't it affect my baby? I've slight pain also. Will these cysts cause problem to my baby? pls help
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