How is transurethral resection of the prostate done?

The indications for transurethral resection of the prostate depend on a number of different factors. The choice of transurethral prostatectomy depends on the specific condition of the patient, and the surgeon masters the basic skills and skills of prostate resection.

1. Benign prostatic hyperplasia

The size of the prostate is not an absolute indication for surgery, the normal prostate size is about 2.0x3.0x4.0cm, some people have a large prostate, but there are no symptoms of dysuria in clinical practice, and there is no residual urine in the examination, so it can be observed. When patients have dysuria, residual urine, hematuria, bladder stones, hydronephrosis, renal insufficiency, renal failure, and bladder tumors, they should be actively treated.

Prostate tissue location

1.1: In the past, when the weight of prostate tissue needs to be removed exceeds 60.0g, clinically because of the long time of electroresection and a lot of bleeding, the chance of complications increases significantly, and open prostatectomy is the best choice, which can remove the hypertrophic gland quickly and completely. But 60.0 g is not an absolute contraindication to prostate resection surgery. In recent years, the author has completed dozens of cases of more than 150.0g patients (including 1 case of 220.0g, with an operation time of 5.0 hours). 240.0 g1 case, operation time 3.5 hours, preoperative anemia, hemoglobin 91.1g, intraoperative blood transfusion 200.0ml)

240.0g of hyperplastic prostate tissue was removed

1.2: Open prostatectomy and transurethral resection of the prostate can be used for adenoma of medium prostate. Frail patients tolerate the latter procedure better and get up and move faster after surgery. The choice of the two methods depends mainly on the urologist's personal habits and his proficiency in transurethral resection techniques. Transurethral resection should not be continued for more than 1 hour. Either way, complete resection of the entire hyperplastic gland in the surgical capsule of the prostate (hyperplastic glandular tissue typically accounts for 80% of the total glandular tissue) is required.

1.3: Small prostate adenomas should be removed through the urethra because the prostate is deep in the pelvis.

2. Prostate stones

Prostate stones are mostly located between the gland and the capsule, and transurethral resection removes the hypertrophic gland, and the stone can be removed to remove the coexisting fibrous tissue.

3、prostatitisand prostate cancer

troubleprostatitisThe course of the disease is prolonged, the effect of drug treatment is poor, the difficulty of urination is obvious, there is residual urine, and the prostate cyst or abscess or prostatic fluid can not be discharged smoothly in B ultrasound, combined with fever, pain and other symptoms, transurethral resection of the prostate can be performed with the consent of the patient. Prostate cancer or glands clinically diagnosed with fibrosis can be resected through the urethra to relieve dysuria, and cooperate with other treatments to prolong the patient's life and improve the quality of life.

Transurethral resection of the prostate is a successful model of minimally invasive surgery in the past 80 years, and the technology has become more mature and standardized, which has derived laparoscopy, hysteroscopy, nasal endoscopy, thoracoscopy, gastroscopy, and colonoscopy, which has relieved the pain of many patients.There are a wide range of surgical indications, and patients have less bleeding and faster recovery. Elderly patients with comorbidities such as cerebrovascular diseases, cardiovascular diseases, respiratory diseases, diabetes mellitus, and neurological diseases can tolerate transurethral resection of the prostate after adjusting treatment and achieving relative stability.