Surgical Treatment of Benign Prostatic Hypertrophy (BPH)
- Can be accomplished by suprapubic or retropúpica.
- Is used in large prostates> 60 grs.
- The highest rate of complications reached 45%, the most important 40% impotence, incontinence and erectile dysfunction 20 to 30%.
- Several days of hospitalization, risk of bleeding with blood transfusions.
Transurethral resection (TURP) is the gold standard of interventions.
- In general is a short surgery. They are 1 or 2 days boarding.
- 90% significant improvement in symptoms.
- Low morbidity of 0.2%.
- 20% must reoperation at 10 years or so.
- Complications: 10% impotence, retrograde ejaculation 50%,
- incontinence 4%.
Transurethral Incision (TURP):
- In small prostates <30grs, with obstruction of the neck and youth.
- Instead of removing tissue cut their hour 5 and 7 which enlarge the bladder neck and prostate.
- 80% improvement in symptoms. The re-operated <1% at 10 years.
- Complications: 15% retrograde ejaculation, impotence 2%.
In recent years, is most often used terms are listed below:
- Lower urinary tract symptoms (LUTS, LUTS - Lower Urinary Tract Symptoms). It is used to describe a group of symptoms characteristic of a large number of diseases of the lower segments of the urinary tract (bladder, urethra, prostate). Thus, LUTS are not specific to BPH. Earlier this syndrome called "prostatism.
- Benign prostatic hyperplasia (BPH) - histological diagnosis, as measured by hyperplasia of epithelial and stromal cells of cancer.
- Benign prostatic enlargement (BPE - Benign Prostatic Enlargement) - an increase in cancer determined with digital rectal examination (PRI), on ultrasound, with other imaging studies.
- Obstruction of the bladder outlet (BOO - Bladder Outlet Obstruction) - decrease in the current urine urethra by reducing the lumen of the bladder neck (functional diagnosis).
It is important to note that the above condition does not necessarily have to accompany each other. That is, there may be signs of hyperplasia at microscopic examination (biopsy, for example), it may not yet be macroscopic increase, obstruction of the bladder neck and symptoms. Perhaps an enlarged prostate without any symptoms (if not yet an enlarged prostate squeezes the urethra). Conversely, you may experience LUTS with no signs of prostate enlargement, the finger or ultrasound study. Moreover, there may be obstruction of the outlet without increasing the prostate - for example, bladder tumor or sclerosis of his neck.