The operation of adenoma and prostate cancer
Prostate adenoma is an increase in volume of the prostate that occurs in older men and causes complications of bladder and urinary flow behaving as an obstacle. This is a benign condition (not a cancerous growth of the prostate) for comparison with prostatic adenocarcinoma (which is prostate cancer).
Endoscopic surgery is indicated in cases where prostate adenoma weighs less than 60 grams. At an adenoma greater than 100 grams open surgery remains the indication. Prostate cancer surgery plays a palliative role (relieve of symptoms) and is accompanied by castration and hormone treatment with either female hormones, either male hormone blockers.
1. The classic operation consists of a classic abdominal incision and opening the bladder until it reaches the prostate which will be enucleated. It will be placed two drain holes, one by urethral and one through bladder wall. Hospitalization is usually for 10-14 days because is required medical supervision of possible complications as: bleeding, urinary infection. Late eventrations may occur or sclerosis of the bladder neck (the bladder evacuation area through which the adenoma was resected and where is done a suture to prevent bleeding).
2. Modern Endoscopic Surgery
The approach is transurethral (urethral orifice) and with a special tool resectoscope is made a small incision through the wall of the bladder neck to the prostate that slices it into fragments which are evacuated through the device sheath. Cutting is done using loops with small voltage electric current replacing the scalpel and hemostatic ligatures of open surgery. The same system is connected to a mini video camera that provides optical control of the operation and a continuous lavage system with sterile water that maintains clarity of the operator field.
The operation is usually executed under spinal anesthesia and hospitalization lasts 3-4 days to 4-5 days in which the patient is bearer of a bladder drain.
Successes of the intervention are similar to conventional surgery , but complications are significantly reduced.