Treatment for Benign Prostatic Hypertrophy

Article by peter parker

When the patient is deemed fit for definitive treatment, the surgical procedure consists of the removal of the enlarged gland. Two operations are well-liked. Every carries its own merits and disadvantages.it's essential for the

treatment of Benign Prostatic Hypertrophy.

Millin's retropubic prostatectomy (1947) is completed by approaching the prostate via the space between the prostate and the pubic bone by way of a suprapubic incision. Given that the bladder is not opened, it ought to be preceded by cystoscopic examination to detect any concomitant lesions in the bladder. Soon after enucleation of the enlarged lobe, the prostatic capsule is sutured back. Modified Freyer'stransvesical prostatectomy is a welltried alternative.

The bladder is opened and the prostate enucleated following breaking by way of the prostatic urethral mucosa. Overhanging mucosa is excised. Haemostasis is secured by diathermy coagulation and/or suture. The bladder can be closed with a perivesical drain. Transvesical prostatectomy has the advantage of being able to deal with any other concomitant lesion in the bladder. Emergency prostatectomy (Wilson Hey, 1945) advocated by Wells (1952) takes little account of renal insufficiency and carries with it a greater mortality in average hands. (Lane, 1949).

Complications of Prostatectomy.

1. Haemorrhage.

2. Postoperative vesical fistula is not uncommon, but it is generally temporary. This occurs only in Freyer's Prostatectomy.

three. Urethral stricture with further obstruction. This is due to the overhanging mucosa at the internal sphincter. Its occurrence is prevented by trimming the mucosa and performing sphincterotomy at the time of surgery.

four. Epididymitis. Incidence decreased by vasectomy.

five. Osteitis pubis. This rare complication is encountered in Retropubic sort of Prostatectomy. This has not occurred in our series.

Transurethral Resection is an operation that is especially well-liked in North America. A McCarthy or Nesbit resectoscope is the instrument commonly used. The prostatic adenoma is removed piecemeal.

In the presence of infection or renal insufficiency, it is contraindicated. Bacteraemia, septicaemia and intravascular haemolysis are complications.. In unfamiliar hands, rupture of the bladder or prostatic capsule is frequent.Nevertheless, in the hands of experienced surgeons trained in this technique, it is an appealing operation with a short and comfortable postoperative convalescence. It is eminently suitable for the tiny and fibrous prostate.


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