Where and what is the Prostate Gland?
The Prostate gland is at the base of the Bladder and surrounds the urinary passage (urethra). The normal function of the gland is to produce some of the seminal fluid, which is expressed with ejaculation.
How does the gland cause trouble?
With increasing age, the prostate gland enlarges slowly due to the stimulation by the male sex hormone (testosterone). Testosterone is produced by the testicles and therefore the first enlargement of the prostate gland begins at puberty. Slow growth continues in most men as they get older but only causes trouble if it narrows the urinary passage.
What does a prostate operation do?
The latest technique is the removal of the Prostate Gland is with Bi Polar resection and vapourisation in saline. The operation removes the gland and thus allows free passage of urine from the bladder.
The operation is done under anesthesia using a special instrument called a Resectoscope and the Bi Polar button and loop electrode which is passed down the urinary passage. Because there is no cut in the skin, healing after the operation is quicker. It may still be necessary however, to leave a catheter to drain the bladder for 1-2 days. The procedure is done as a Day Case or overnight stay in Hospital unless other concomitant ailments dictate a longer stay.
If the prostate gland is very large, it may be necessary to remove the gland by a cutting operation in the lower abdomen. If this method is preferred, our surgeon will explain the details.
What is TURIS?
The word TURIS emanates from Trans Urethral Resection in Saline. Here the resection of the obstructing part of the prostate gland is removed by Bi-Polar current using cutting and vapourisation in Saline.
What are the advantages of Laser over Standard TURP Operation?
TURIS affords the following advantages:
- Greatly reduced bleeding in most cases resulting in less strain physiologically on your body, reduction in transfusion rate and early discharge from the hospital.
- The irrigation fluid used is Normal Saline and not Glycine which is 10 times more expensive volume for volume.
- This in turn results in diminishing the complication of the TUR Syndrome or Water intoxication and a reduction in cost.
- Post-operative irrigation is not required.
- Retrograde Ejaculation, which is very common after a standard TURP, is almost non-existent in TURIS.
- All the above factors result in cost savings without any compromise whatsoever in the results of surgery!
Further, the cost savings are transmitted to you as we are not charging you more for this procedure. It is estimated that you will on average save Ksh. 40,000 – 60,000.
What are the disadvantages of TURIS?
The disadvantage is that it takes slightly longer to perform the surgery.
After the operation
There is usually some bleeding from the prostate cavity and this causes a red discoloration of the fluid coming from the catheter. This usually stops after a day or two. It helps to drink plenty of fluids after the operation to get a good wash-through of the bladder.
A common fear is that there will be leakage of urine after the operation, but serious leakage is rare. There may be minor leakage for a day or two after the catheter is removed, but this soon stops. There may also be feeling of urgency resulting in the need to pass urine frequently. Both the minor leakage and the urgency occur because there is a raw area inside which has to heal up. If there has been long-standing blockage of the bladder, the bladder itself may be damaged and the need to pass urine frequently may continue for several weeks.
Sometimes blood may appear again in the urine some 10-14 days after the operation. This is caused by the internal healing process and may be aggravated by constipation. This bleeding usually clears up quickly and it helps to drink plenty. In order to minimize this bleeding, we recommend that constipation should be avoided, and it may be necessary to take a mild laxative.
How soon will the urinary stream Improve?
Following the operation there is usually an immediate improvement in the urinary stream and further improvement may continue for up to 6 months. You may find that the frequency of urination does not completely settle down for 2-3 months.
Will the operation affect my sex life?
Sexual intercourse often becomes less frequent with increasing age but there is no reason for the prostate operation to end sex life. Removing the prostate gland does not alter erections of the penis or the sensation of orgasm. Once the operation has healed having sex will not cause damage, but it is best to wait 3-4 weeks.
How long before I can go back to work and become fully active?
This depends on how fit you were before the operation. However most of our patients are advised to go back to work even for half days in a couple of days.
Credit: Laserstone Surgery