Prostate problems are extremely common among men, especially as they age, and are often due to prostatic enlargement (or prostatic hyperplasia). In some cases, patients might need to seek treatment for prostatitis (an infection of the prostate). An enlarged prostate is often referred to as benign prostatic hyperplasia (BPH) and may not require surgical intervention (such as a prostatectomy) to treat.
Transurethral resection of the prostate
A transurethral resection of the prostrate (TURP) procedure is surgery undertaken to treat male urinary problems caused by benign prostatic enlargement. TURP is an effective step for males who have not responded to medication aimed at treating a symptomatic enlarged prostate.
During the TURP, which is done under spinal or general anaesthetic, Dr. Choonara will insert a resectoscope via the urethra, and use this combination visual/surgical instrument to remove the section of excess tissue from the prostate that is blocking urine flow.
Transurethral incision and/or resection of the bladder neck
A bladder neck incision (BNI) with or without resection of the bladder neck is used for treating obstructive urinating symptoms due to bladder neck dysfunction more commonly found in younger men. A transurethral resection of the bladder neck may also be necessary for treating bladder neck contracture, which can occur at the junction of the bladder and the prostate (especially if the patient has had prostate surgery).
Retropubic /transvesical prostatectomy for BPH
In cases where benign prostatic hyperplasia (BPH) is causing urinary tract problems, or where prostate cancer is present, Dr. Hayden may recommend either the partial (simple prostatectomy) or total (radical prostatectomy) – removal of the patient’s prostate gland. A retropubic or transvesical prostatectomy is done for BPH.
These forms of open prostatectomy are distinguished by where Dr. Choonara makes a single incision in the prostate capsule in order to remove the affected area of the prostate: either in the patient’s pelvis (retropubic prostatectomy) or through the bladder wall (suprapubic or transvesical prostatectomy).
If a patient requires a radical prostatectomy, Dr. Choonara will consult with each patient and discuss the different options available to them during the prostatectomy procedure, including a nerve sparing prostatectomy, which endeavours to leave behind the nerves required for penile erection after the prostate has been removed.
Transrectal ultrasound guided biopsy of the prostate for suspected prostate cancer
In cases of suspected prostate cancer – if the patient has been showing prostate cancer signs and symptoms, if the blood prostate specific antigen level is high or if there is a strong genetic predisposition towards it – then Dr. Choonara may order a transrectal ultrasound guided biopsy as an effective first stage of prostate cancer diagnosis. A transrectal ultrasound guided prostate biopsy is a procedure where a special needle is inserted into the patient’s rectum through a guide attached to the ultrasound probe, in order to collect tissue samples for later investigation in the laboratory.
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