Recovery after prostate adenoma tour

• Transurethral resection is one of the most popular operations used for prostate diseases.
• After it there are no scars left, the risk of complications is minimal, and the probability of unsuccessful completion is almost maximum.
• Rehabilitation after a TUR of the prostate consists of several stages, during which it is important for the patient to adhere to the necessary rules in order to avoid complications.

Rehabilitation after TUR of prostate adenoma and bladder

The rehabilitation period is a fairly important part of recovery after any surgery.

In the case of transurethral resection, the rehabilitation period usually takes place in two stages:

1. 
   hospitalization . Its duration is approximately 7 days. When the patient is under the supervision of doctors, he is prescribed flushing of the urinary catheter, which was inserted before surgery, and after three days it is removed. Experts also prescribe the use of various antibacterial agents to eliminate possible inflammatory processes after resection of prostate adenoma. The patient must remain in a supine position for two days;
2. home . Its duration can vary from 1 to 2 months. This period is considered the most difficult for a man, since there are no specialists nearby who could monitor the recovery process. For many men, dieting is the hardest part of rehabilitation because it requires giving up many goodies, significantly reducing portion sizes, and eating only certain foods.

For the fastest recovery, you must adhere to certain rules:

• follow the diet prescribed by your doctor. Prohibited foods include: salty foods, sour and spicy foods, smoked foods. It is also necessary to completely stop drinking alcoholic beverages;
• mandatory intake of medications prescribed by a doctor;
• It is very important to reduce various physical stresses on the body. You should avoid playing sports and lifting heavy objects;
• drink liquid in sufficiently large quantities in the morning and afternoon. It is also recommended to consume diuretic drinks;
• suspend sexual activity during recovery.

In case of resection of the bladder, a system is installed that ensures its irrigation with medications. This treatment usually continues for three days.

After the operation, specialists pay attention primarily to the patient’s condition. If he does not have vomiting, headache, or nausea, then he is allowed to drink up to 1.5 liters of water within 24 hours after the operation. For the next 10 days, it is very important to eat properly and drink plenty of fluids.

In the postoperative period, specialists prescribe antibacterial therapy aimed at preventing the patient’s body from becoming infected with various infections. After removing the catheter, it is necessary to control the quality of urine; it should be of a natural color without containing blood.

For approximately 14 days, the patient will experience various problems with urination, namely:

If such manifestations continue for more than two weeks, you must immediately inform your doctor about your condition. The presence of blood clots in the urine can be observed up to three weeks after the operation.

What medications should I take after surgery?

After surgery, the doctor may prescribe the following medications:

• To prevent the development of various infections, the patient should undergo a course of antibiotic therapy. These drugs suppress the activity of pathogenic microflora, which prevents infection;
• anti-inflammatory drugs are necessary to reduce inflammation and swelling of the affected prostate tissue. For example, you can use Prostatilen-zinc, it is quite effective and safe.

What to do to heal wounds?

Despite the fact that externally the wounds after TUR are invisible, they still require time to heal.

To avoid any injuries, the patient should avoid any physical activity, especially heavy lifting.

It is also advisable to avoid excessive strain during bowel movements and sudden movements. Walking at a slow or medium pace will have a beneficial effect on tissue regeneration.

The best solution would be to spend the rehabilitation period in one of the sanatoriums.

Diet for recovery after surgery

It can increase the concentration of sugar, which will lead to poor circulation and the formation of plaque in the lumen of blood vessels.

Healthy fats should come from lean meats, dairy products, and olive oil. To saturate the body with protein during remission, your diet should include chicken, lentils, lean beef, eggs, fatty fish, and beans.

Also, the diet after surgery should be rich in vegetables and fruits.

What you need to include in your diet:

• eating garlic and onions will reduce inflammation in the prostate gland and prevent the development of bacterial complications;
• Regular consumption of tomatoes, celery and potatoes prevents the occurrence and development of cancer;
• after surgery, it is recommended to eat foods that contain a large amount of fiber; they help improve metabolic processes (cucumbers, cauliflower, pumpkin, oatmeal, apples);
• Strawberries, citrus fruits, dried fruits and raspberries help ease the symptoms of the disease.

Kegel exercises for urinary incontinence in men

A common postoperative complication is urinary incontinence. To combat this disease, it is recommended to use Kegel exercises.

The method is considered one of the most effective among non-drug methods. The main advantage of Kegel exercises is the onset of positive results after a small number of sessions.

Types of Kegel exercises:

• To perform the first exercise, you must alternately tense and relax the pelvic floor muscles. 10 repetitions several times a day will be enough;
• the second exercise involves the same actions as in the first case, but the tension should be maintained for about 5 seconds.

Kegel exercises can be done not only by men; they are also recommended for women who suffer from urinary incontinence.

How to restore potency?

After removal of the prostate, in most cases, men are faced with a lack of potency.

To restore potency, various methods are used:

• physiotherapeutic procedures (shock wave therapy);
• maintaining a healthy lifestyle. Involves giving up bad habits, walking in the fresh air, regular exercise, and a balanced diet;
• taking medications (Cialis, Vimax, Viagra, Levitra, Avanafil);
• injection therapy (Papaverine). It is rarely used because it poses a danger to a man’s health if used incorrectly;
• vacuum devices (pumps). When using them, the penis is placed in a flask, from which air is pumped out using a pump. This process promotes blood flow to the organ, thereby stimulating an erection;
• ethnoscience. Herbal decoctions made from Chinese lemongrass, nettle, St. John's wort, clover, yarrow, ginseng and other plants are popular;
• inclusion of certain foods in the diet (airan, ginger, honey, cilantro, figs, pomegranate, asparagus, etc.).

When can you have sex after prostate surgery?

As you know, after removal of the prostate gland, sexual activity is prohibited for a certain period. The minimum period of abstinence is one month .

However, depending on the patient’s immunity, the possibility of sexual intercourse may appear only after 6-12 months.

So, in the event of a complication in the form of erectile dysfunction, sex becomes simply impossible. However, it is extremely rare and is usually treated with conservative methods.

Contraindications in the postoperative period

To avoid various complications, during rehabilitation the patient should stop engaging in active sports and physical labor, and should not lift objects that are heavy.

It is necessary to avoid hypothermia, and also to lead a calm lifestyle for at least 14 days - rest a lot, work little.

It is prohibited to drive any vehicle (including a bicycle). Excessive strain is contraindicated during bowel movements.

Video on the topic

About rehabilitation after TURP surgery for prostate adenoma in the video:

The rehabilitation period after transurethral resection of the prostate gland is a very important component for a successful recovery. To avoid complications, the patient must strictly follow the doctor’s recommendations.

The main points are: adherence to diet, lack of physical and emotional stress, sexual intercourse, and taking prescribed medications.

Source: https://prostata.guru/prostata/reabilitaciya-posle-tur.html

What you need to know about TUR operation for prostate adenoma

Transurethral resection of the prostate is a minimally invasive operation to remove pathologically overgrown prostate tissue through access through the urethra . Despite the apparent simplicity of the technique, the operation requires high professionalism of the doctor. The likelihood of developing complications after a TUR of the prostate largely depends on the type of instrument and the patient’s health status.

Indications and contraindications for TOUR

The main indication for TUR is hyperplasia (prostate adenoma). The prostate gland hugs the part of the urethra just below the opening of the bladder. As prostate tissue grows, the lumen of the urethra decreases, as a result of which the neck of the bladder suffers from oxygen starvation.

As a result, the man begins to suffer from urinary retention or leakage. TUR involves the removal of excess tissue that interferes with normal urination . The prostate itself (the capsule with tissue remains) remains in place.

It cannot be removed using the TUR method due to the extensive venous network (important venous plexuses will inevitably be damaged).

When is a TURP of the prostate gland recommended?

1. Patients for whom maintaining sexual function is important.
2. For obesity and the presence of cardiovascular pathologies.
3. In case of relapse of adenoma.
4. Localized prostate cancer (which can be completely removed from the gland).

TUR is carried out in cases where previous methods (conservative, hyperthermia) were ineffective.

The operation is performed using a resectoscope - a hollow tube through which instruments are brought into the surgical area.

Resectoscope with loop General scheme of TUR

Contraindications for TOUR:

• Arthrosis and other pathologies of the hip joints that prevent the legs from spreading to the sides (this is the position the patient is in during TUR);
• Urethral strictures (impossible to insert the device);
• Bladder capacity less than 100 ml;
• Tumors and defects of the bladder walls;
• Varicose veins of the urethra and bladder neck;
• Severe concomitant diseases.

Advantages of the TOUR:

1. There are no cuts or scars.
2. Short recovery period.
3. The bladder is not injured.

After a TUR, the tissue can be examined for the presence of malignant cells, and after the laser it is completely evaporated.

Types of TOUR

Depending on the type of cutting element (loop), the following types of TUR are distinguished:

• Monopolar : one pole is the knife, the other is the body. To conduct impulses, liquid must constantly circulate between them. An outdated but still used method. It is fraught with severe bleeding, the development of TUR syndrome, and is dangerous for those suffering from cardiovascular diseases. Used only for TUR of the prostate with a volume of no more than 80 cm3 - to quickly remove tissue, otherwise too much electrically conductive solution will be absorbed into the blood.

Urologist, surgeon Maxim Aleksandrovich Ryabov talks about the indications, the course of the operation, and the consequences of transurethral resection of the prostate

• Bipolar : both poles are at the ends of the loop, resulting in a high temperature, effectively sealing the vessels. Saline solution is used as an auxiliary fluid, which is not dangerous to the body. You can spend more time on the operation and remove the nodes better. The method is suitable for excision of formations with a volume of up to 150 cm3, as well as for patients with cardiovascular diseases.
• Plasmokinetic : a “super pulse” is formed around the loop - a plasma corona, which compacts and seals the cut tissue, but does not overheat the surrounding tissue.

Plasmokinetic transurethral resection of prostate adenoma is recognized by most urologists as the least traumatic and most effective method of treating hyperplasia.

Preparation

List of preliminary tests (valid for 30 days):

Be sure to tell your doctor about all the injuries you have suffered to the brain and spinal cord, and about the medications you are taking. Antibiotics are prescribed before and after TUR. You should not eat food 8 hours before; on the day of surgery you must cleanse your intestines.

Operation technique

For TUR, spinal anesthesia is usually used as pain relief - an injection into the spine. During the operation, the patient may feel pressure and touch, but not pain. If there are contraindications, endotracheal anesthesia is used, in which the respiratory function is performed by a special apparatus.

Spinal anesthesia before TOUR

The patient is placed on a urological chair or operating table with his legs spread apart, the groin area is treated with an antiseptic solution and covered with sterile sheets. The groin must first be shaved or hair removed using hair removal cream.

Urethral zones

A lubricating antiseptic gel is first injected into the urethra, and then the resectoscope itself. The place to which the device is inserted is indicated in the figure below by number 5 (prostatic part of the urethra):

First, the bladder is examined, the condition of the closing sphincter is assessed, and then the hyperplasia is removed (layer-by-layer excision with a loop). Bleeding vessels are immediately coagulated (cauterized) with a loop.

Cutting tissue during TUR

The doctor monitors all actions on the monitor. In a number of clinics there are two of them, one of which is turned towards the patient if he is under spinal anesthesia and wants to see the progress of the operation.

The process of cutting tissue (real operation) with detailed instructions from the doctor. Schematic video of the TUR prostate operation.

The goal of TUR is to restore the patient’s ability to urinate normally. To do this, it is necessary to clear the urethra of growths. This is done in several ways (depending on the direction of growth of education):

1. Removal of a small amount of tissue (10-20%) from the bladder neck or middle lobe of the prostate. This method is called “pseudo-TUR”.
2. Excision of 30 to 80% of the tissue (partial TUR), in which a cone-shaped passage is formed.

The removed tissue is pushed into the bladder, and then these remains are washed out and removed through a special channel of the resectoscope. Some of them are sent to the laboratory for histology to rule out cancer through cellular analysis.

With hyperplasia, the PSA level increases. After TUR it will drop (but not to zero), since there will be much less tissue producing this antigen.

Monopolar TUR should last no longer than an hour, otherwise the risk of postoperative complications will significantly increase. It is important not to go beyond the spermatic tubercle (inferior landmark) and the neck of the bladder. Otherwise, the orifices of the ureters and the walls of the bladder will be damaged, which will also lead to serious postoperative complications.

To speed up the healing of the urethral walls after surgery, a catheter is inserted into the bladder - a thin flexible tube through which urine will be drained randomly within 2-3 days. The doctor regularly checks its quality. When the urine becomes light, the catheter is removed.

Postoperative period

After TUR, resuscitation is not required; the patient is immediately transferred to a regular ward. There should be no pain even after recovering from anesthesia. Your legs won't move for about two hours - this is normal. On the first day, it is advisable not to get out of bed to avoid headaches. After 3-4 days the patient is discharged home.

After the catheter is removed, urination will be painful. To relieve symptoms, antibacterial, anti-inflammatory and painkillers are prescribed for a week.

Early rehabilitation lasts about two weeks . During this time, it is recommended to drink at least 8 glasses of liquid per day to flush out the bladder.

You can have sex and start doing Kegel exercises after 3 weeks.

For 2-4 weeks after TUR, the patient will be bothered by frequent urination and dripping of urine caused by severe irritation of the receptors. There is no need to worry about this as it is a natural phenomenon. The problem of leakage can be solved with the help of urological pads.

Immunologist Ermakov Georgy Aleksandrovich talks about rehabilitation after TUR of prostate adenoma

After excision of hyperlasia, a fairly deep wound remains, covered with burnt tissue.

Subsequently, it will begin to be rejected, which may lead to intravesical bleeding. The patient may detect blood in the urine on days 7, 14 and 21 after TUR.

For the first 3-6 weeks, you should not lift anything heavier than 2.5 kg or drive. After a TOUR, it is generally advisable to sit less and not on a hard one (it is recommended to use a donut-shaped pillow with a hole for the perineum to avoid pressure). To activate blood flow, you definitely need to move.

It is important to follow nutritional recommendations. No special diet is required, but spicy, salty, smoked and fatty foods, as well as alcohol and coffee should be excluded from the diet to avoid urethral irritation. Eat less potatoes, rice and animal protein to prevent constipation.

Complications after surgery

Complications after TUR are due to the specifics of the technique.

Hyperplasia almost always occurs against the background of chronic prostatitis, therefore, after excision of part of the tissue, inflammation in the remaining tissue often worsens (in 13% of patients).

Damage to the excretory ducts of the gland also occurs, so the organ may become non-functional - the prostate will no longer enrich sperm with its secretion in the same volume, which will complicate natural conception.

Retrograde ejaculation diagram

An obstacle to conception is also retrograde ejaculation, which occurs in 75-93% of patients (when seminal fluid flows into the bladder instead of the urethra). The complication arises due to cutting of the muscle that closes the lumen of the bladder neck (this is necessary to expand the lumen).

The second common problem after TUR is the formation of the so-called pre-bladder. This is a cavity that remains in place of the removed prostate tissue, a widening of the area of ​​the urethra under the bladder.

Chronic inflammation often develops and is maintained in the prevesicle, stones are formed, which is why the patient periodically suffers from painful urination (dysuria).

In this regard, open adenomectomy is better.

Immunologist Ermakov Georgy Aleksandrovich on possible complications after TUR of prostate adenoma

A significant disadvantage of TUR: most clinics use resectoscopes with a large tube caliber (24 or 27), so patients have to bougienage (dilate) the urethra, which is traumatic. When the instrument is forcibly advanced, the mucous membrane is damaged, and scar tissue and strictures subsequently develop (in 18% of patients).

The most dangerous consequence of the operation is TUR syndrome. This is a severe violation of the body’s water and electrolyte balance, fraught with death in the absence of emergency measures. The reason is excessive absorption into the bloodstream of the irrigation fluid used during monopolar TUR.

Life after surgery

Many men are afraid of becoming impotent after a tour. According to doctors, this is possible if the operation is performed with a monopolar instrument in the hands of a not very competent surgeon. If TUR is done correctly, the erection will even improve due to increased blood flow. The quality of orgasm will also not be affected.

As for retrograde ejaculation after TUR, in this case it is necessary to strengthen the tone of the smooth muscles of the bladder neck. Kegel exercises combined with deep squats, as well as special medications, will help.

Urination will be completely restored within a maximum of 6 weeks. During this period, it is important not to fall into depression, otherwise not only erectile function, but also health in general will suffer.

You can drink alcohol (not strong and in small quantities) no earlier than six months later, but it’s better not to. Alcohol provokes inflammation, weakens the effect of medications, slows down the healing process, and weakens the immune system.

Prices and where the operation is performed

Below are approximate prices from clinic websites. The exact cost of the institution is not indicated, since it depends on the category of complexity of the operation, which is determined by the volume of the gland, the age of the patient, and the presence of concomitant diseases.

Examples of clinics and costs:

• GMS Hospital (Moscow): RUB 385,720;
• Network of “SM-clinics”: from 60 thousand rubles;
• Center for Endosurgery and Lithotripsy (Moscow): 105 thousand rubles.

In state clinics and city hospitals, the cost of a monopolar TOUR starts from 13 thousand rubles.

Patient reviews

Alexander, 47 years old: “I did a TOUR in Moscow City Clinical Hospital No. 50. My wife is 12 years younger, I thought that the end of my family life had come, but after a couple of months I fully recovered. To eliminate problems with urination, I took a course of Vesicare.”

Evgeniy, 44 years old: “My father had a rather large adenoma removed at the Pirogov clinic in St. Petersburg using a bipolar loop. There were no special complications. We struggled with the natural consequences of urine leakage for about 3 months.”

Conclusion

Doctors consider TUR the most precious operation of all transurethral endosurgery methods, since it requires talent and specific knowledge from the specialist. The effectiveness of the manipulation and the patient’s condition after it depend on this. When choosing a clinic, be sure to clarify what method and who performs the removal (reviews of doctors are on the forums).

Sources:

Source: https://muzhchina.info/prostata/adenoma/tur

Consequences after surgery TUR prostate adenoma: features of recovery and contraindications

• September 13, 2018
• Prostate
• Oksana Skripchenko

There are many treatments for prostate adenoma. Each of them has its own advantages and disadvantages. One of the treatment methods is TURP of the prostate gland. With any treatment, not only the effectiveness of the method is important, but also the likelihood of possible complications. Before you understand the consequences after TURBT surgery for prostate adenoma, you need to understand what it is. Having an understanding of the method can reduce the risk of negative results.

What is TUR of prostate adenoma?

Medical terms are often complex and long, so abbreviations are used for convenience. Transurethral resection of prostate adenoma (TURP) is the removal of part of the prostate gland through the urethra using an endoscope. Surgery is a fairly popular treatment method in the field of andrology. Excision of the prostate is performed using special endoscopic equipment - a resectoscope, which is inserted through the lumen of the urethra. A resectoscope is a medical optical instrument in the form of a hollow tube through which a loop or curette is applied to the prostate gland to remove the affected tissue.

In what cases is the operation performed?

Conservative treatment of the proliferation of glandular tissue is effective only in the early stages of the disease.

Therapy helps to reduce the severity of clinical signs, and not to reduce the pathological growth of prostate tissue. Surgery is considered the most effective method of treatment.

Transurethral resection is a minimally invasive, highly effective and most preferred treatment method in surgical andrology.

Indications for TURP surgery for prostate adenoma:

• Tumors with a prostate volume of 60-80 cm³.
• The need to remove adenoma in elderly patients.
• The presence of cardiovascular diseases and respiratory pathologies in patients.
• Prostate cancer.
• An obstructive blockage of the urinary tract that makes urination difficult.
• Frequent infections on the skin of the genital organs.

Contraindications

To avoid severe consequences of treatment, removal of prostate adenoma is carried out only in the complete absence of contraindications. Features in which the use of transurethral resection is impossible include:

• Large adenomas. The tumor size is assessed individually, taking into account the doctor’s level of preparedness.
• Pathological narrowing of the lumen of the urethra.
• Deformation of the urethra.
• Acute inflammatory processes of the genitourinary organs.
• Disruption of the normal functioning of the organ due to diseases of the cardiovascular and respiratory systems.
• Chronic renal failure.
• Myocardial infarction - acute and subacute periods.
• Common infectious diseases.
• Local purulent processes.
• Disturbance of the hemostasis system.

Saline or calcified stones in the bladder cavity and suprapubic fistula are not contraindications. The hollow channel is used for visual control of the process.

Methodology

The operation is performed under general or spinal anesthesia. The patient lies on his back with his legs raised and spread.

A resectoscope is brought through the urethra to the bladder, urine is drained and the bladder is filled with furatsilin.

The approximate locations of the upcoming transurethral resection are determined on the seminal mound and the upper part of the tumor. Then one in the middle or two lateral canals are made to remove hyperplastic gland tissue.

When performing resection, the condition of the tissue is constantly assessed, the bladder is continuously washed, and bleeding is eliminated by coagulation of blood vessels. After the excision is completed, the gland bed is examined. The resectoscope is removed and a urethral catheter is inserted into the canal. The duration of the surgical intervention is 45-60 minutes.

Intraoperative complications

Any operation, even a minimally invasive one, is a surgical intervention carried out using various techniques for separating and connecting tissues. Such manipulations do not go unnoticed.

One of the common complications during surgery is damage to the wall of the bladder, the round cord located in the inguinal canal, and the capsule of the gland. All organs are located very close to each other and with any inaccurate movement, their structure is disrupted.

Bleeding during surgery is a natural process, the intensity of which is controlled using an irrigation system. In case of severe bleeding, the system may not be able to cope, and there is a need for another suction, which means an additional puncture and tissue damage.

The risk of such complications is usually due to the low qualifications of doctors and the patient’s concealment of various facts about his state of health. Therefore, preparation for surgery should be taken very seriously by both the patient and the medical specialist.

Recovery period after prostate tour

Rehabilitation is an important component of the therapeutic process. Failure to comply with medical prescriptions and non-compliance with recommendations are most often the causes of various types of complications.

The recovery period can be divided into two stages: hospitalization and outpatient treatment.

While in a hospital, you need not just blindly go through all the procedures and carry out drug therapy, you should ask your doctor how the recovery process is going.

It is immediately necessary to find out what the consequences may be after TURBT surgery for prostate adenoma, how great the risk of their occurrence is and how to prevent them.

After discharge, you should not relax, much less celebrate the successful surgical intervention performed by specialists.

While at home, you should take or complete a course of medication (if prescribed by a doctor), adhere to a diet, and refrain from heavy physical activity, sports and sexual activity.

The latter is especially difficult, but in order for the healing process to proceed intensively, you need to be patient a little.

Prostate tour: postoperative period

After the operation, the patient is transferred to a regular ward and observed there. A catheter is inserted into the patient's urethra to control the filling of the bladder and flush the canals. The duration of the catheter in the urethra is individual for each person and can range from 12 hours to 3 days.

Complications after TUR surgery for prostate adenoma begin to appear almost immediately:

• Severe pain in the groin area. To eliminate physical suffering, the patient is prescribed painkillers.
• Painful deurination with accompanying frequent false urges. Doctors do not consider such manifestations to be a complication, provided that they go away within a week.
• Bleeding from the urethra and cloudy urine are associated with the removal of dead tissue (eschar) from the body.
• The increase in temperature is due to the development of the inflammatory process. To prevent complications of the pathological process, antibacterial therapy is prescribed. In most clinics, antibiotics should be taken 5 days before transurethral resection and another 7 days after. This helps prevent inflammatory changes in organs.

What is TUR syndrome?

During transurethral excision, an irrigation system is used to flush the bladder to better visualize the area where surgery is performed.

After TUR operation for prostate adenoma, the consequences of using the irrigation system manifest themselves in the form of water intoxication. The liquid used during manipulation is absorbed into the bloodstream and can cause “water poisoning.” Intoxication is called TUR syndrome and is a rather dangerous complication.

Sodium chloride (NaCl) is used as an isotonic solution. The saline solution does not contain potassium salts, which contributes to disturbances in the electrolyte composition of the blood plasma. An imbalance of electrolytes negatively affects the hemostasis system, cellular excitability, and thrombus formation.

According to statistics, TUR syndrome occurs in 0.3% of operated patients. Despite this, postoperative intoxication is a reason to refuse transurethral resection.

Bleeding

Serious early complications after removal of prostate adenoma include severe bleeding. They occur within the first 30 days after discharge. If, at the time of discharge from the hospital, blood discharge from the urethra appears, you must inform your doctor about this. He will prescribe additional examination and administration of coagulants. In such cases, it is better to hold off on discharge.

If blood appears on your underwear or during urination some time after discharge, you should call the doctor who provided the treatment. In case of severe bleeding, seek emergency outpatient medical care.

Bleeding usually occurs due to non-compliance with the postoperative regimen: heavy physical activity, early return to sports and sexual activity.

Urinary disorders

Disturbances in the deurination process are common complications after TUR of prostate adenoma. Typically, disorders manifest themselves in the form of a decrease in stream, difficulty urinating, or urinary incontinence.

Tumor resection is carried out through the urethral canal. When inserting a resectoscope and suctioning urine, the thick circular muscle located at the internal opening of the urethra can be injured. The internal sphincter prevents involuntary deurination. Urinary incontinence in most cases occurs when a monopolar resectoscope is used during surgery.

After any operation, the inflammatory process cannot be avoided. Difficulty urinating and a decrease in stream are usually associated with a slight increase in the size of the tissues of the urethral canal. After the inflammation subsides, deurination returns to normal, usually everything goes away within 10-14 days.

Infectious and inflammatory diseases

The consequences after surgery TUR prostate adenoma are not always directly related to manipulation. Transurethral resection is performed using an endoscopic instrument; the risk of infection is reduced to zero. Infectious and inflammatory diseases that occur a week after the intervention are usually a relapse of existing chronic pathologies.

The infection can be caused by the patient neglecting the hygiene of the inflamed area. After excision of the adenoma, you need to wash your genitals more often, wear loose underwear and change it more often.

Erection and ejaculation disorders

The most severe consequences for the male body after TUR operation are erectile dysfunction and ejaculation. Disorders are considered one of the most common and account for 4-10% of all complications.

The disease itself contributes to the occurrence of erectile dysfunction. An increase in the size of the penis occurs due to reflex mechanisms and psychogenic reactions. Every third man experiences psychological discomfort after surgery. Full recovery occurs within a year.

Retrograde ejaculation – failure to release sperm from the urethra often occurs after prostate surgery. This type of ejaculation disorder is considered a pathology and requires treatment.

Prevention of complications

Recurrence of adenoma after transurethral resection occurs in less than 1% of patients. The incidence of postoperative complications is 8-10%.

After a TURP of the prostate, a man’s lifestyle is of no small importance in the occurrence of complications. The operation itself is one of the stages of the therapeutic process. To prevent negative consequences, you should follow all the doctor’s recommendations, abstain from sexual activity for a while, in case of uncharacteristic manifestations, avoid self-medication and seek help from doctors.

Source: https://cureprostate.ru/419758a-posledstviya-posle-operatsii-tur-adenomyi-prostatyi-osobennosti-vosstanovleniya-i-protivopokazaniya

Rules for rehabilitation after transurethral resection

Despite the fact that transurethral resection (tour) of prostate adenoma is carried out without damaging the external tissues (the resectoscope is inserted into the pathological lesion through the urethra), there is still the possibility of postoperative complications.

The main one is related to the fact that during the intervention, for the purpose of better visibility of the operating area, a large amount of rinsing fluid enters the bladder cavity. This fluid, along with blood and already removed structures, is sucked out through another tube, but there is a risk that “water intoxication” will occur.

This complication is associated with the penetration of the irrigating solution into the patient’s circulatory system. This is not the only undesirable aspect of the operation, but they will be discussed below. The article will also describe rehabilitation after prostate adenoma, because such knowledge will help you go through the recovery period quickly and without consequences.

Recovery after TUR of prostate adenoma

1. How the patient underwent the operation.
2. From the individual characteristics of the body.
3. From age and much more.

After surgery, the man is not allowed to go home immediately. For some time, rehabilitation after surgery for prostate adenoma is carried out in a hospital setting. At this time, the patient is prescribed a course of conservative (drug) therapy and is under round-the-clock supervision of the treating staff. In the first days after TUR, the patient must take antibiotics. This measure is associated with minimizing the risks of secondary infection or the development of inflammatory phenomena.

To avoid secondary infection, all tissue particles that got there during the resection of the adenoma must be removed from the bladder cavity. To do this, active irrigation is carried out using an antiseptic solution through a urinary catheter. The bladder cavity is freed not only from affected, excised tissue, but also from residual urine and blood clots.

The urinary catheter is retained for some time, because Usually, after surgery, representatives of the stronger half cannot empty the bladder on their own.

The surgeon decides how long to leave the catheter in the bladder. The period can last several hours, but more often than not, days.

When making a decision, the doctor is based on the individual characteristics of the man’s body, the nature of the discharge and the characteristics of the surgical intervention.

After hospitalization, the man is discharged home, but the rehabilitation period after the prostate adenoma surgery does not end there. At home, you need to follow all the doctor’s recommendations.

All movements must be smooth and careful. Sharpness can damage post-operative wounds and cause complications.

Possible complications and risks after surgery

Complication	Cause of development and clinical manifestations
Internal bleeding	This complication occurs immediately after surgery. It is quickly diagnosed and stopped, because... the patient is under round-the-clock attention of medical personnel. The cause of the pathology is incomplete cauterization (coagulation) of blood vessels. Sometimes the causative factor is that the patient did not inform the surgeon that he was undergoing a course of drug therapy at the same time. Some medications can interfere with blood clotting (anticoagulants, aspirin). With such a complication, doctors take urgent measures. Aminocaproic acid is usually administered intravenously.
Secondary focus of infection	This complication occurs if the rules of asepsis and antisepsis are violated during the operation, or when the patient himself does not follow the doctor’s prescriptions and recommendations.
Urinary dysfunction	This complication is characterized by false urges, pain during urination, and minor blood inclusions. Urologists classify these consequences as normal if they disappear on their own after the rehabilitation period. If the symptoms have not disappeared after 3 months, then you need to seek specialized help. Temporary problems with urination occur due to the fact that immediately after the TUR a wound remains on the body of the gland. At the same time, spasms of muscle fibers are observed. When a man goes to the toilet “smallly”, a stream of urine affects the area of ​​the gland affected by the operation, which leads to a painful attack. The appearance of blood in the urine is associated with the rejection of dead cells. After the tissue of the operated prostate gland is restored, the blood in the urine will disappear. When the amount of blood in the urine does not decrease, but on the contrary, the urine turns redder every day, this indicates postoperative bleeding. In this case, a man should definitely seek specialized help.
Incontinence	This condition after surgery can also be called normal, physiological. One of the symptoms of prostate adenoma is problems with emptying the bladder due to compression of the urethra. In advanced cases of adenoma, spontaneous, drip-like leakage of urine often develops due to irritation of the walls of an overfilled bladder. This explains the fact that even after surgery, urinary incontinence may continue for some time, but the symptom usually disappears on its own.
Sexual dysfunction	Impaired sexual function is mainly associated with retrograde ejaculation. The retrograde type of ejaculation is characterized by the outpouring of seminal fluid not outward, but into the cavity of the bladder. In young men for whom fertility is important, additional treatment is required. For representatives of the stronger half after 40–45 years, this complication does not bring significant discomfort.

Source: https://prostatitaid.ru/adenoma-prostaty/o-zabolevanii-adenomy/reabilitatsiya-posle-tur.html

Recovery after surgery for prostate adenoma

When deciding whether to undergo prostate surgery, the urologist evaluates many aspects. First of all, attention is paid to the clinical manifestations of the disease, because it is discomfort and a decrease in quality of life that forces men to consult a doctor with the problem.

• Surgery is necessary if there is a high probability of the adenoma turning into prostate cancer
• Before sending the patient to the operating table, the doctor conducts a full examination and finds out the following details:

• tumor size;
• how much the tumor has increased during observation;
• is there a tendency towards malignancy (degeneration into a malignant tumor);
• whether the prostate secretion contains atypical impurities (erythrocytes, leukocytes, pathogenic microflora).

Typically, reviews from patients say that after the operation they felt excellent, but after discharge from the hospital, rehabilitation is necessary in any case, since at this time various problems can occur such as:

1. Problems urinating, which results in a stronger flow of urine and painful sensations. These nuances, as a rule, disappear on their own, but if there are difficulties, they must be reported to the doctor.
2. Urinary incontinence. To prevent frequent urination and incontinence from aggravating the situation, it is necessary to increase muscle tone using special means.
3. Problematic urination. Sometimes, when a transurethral type of operation is performed, technical errors occur. In this case, not a single conservative method will help, and you can improve your health only by performing a repeat TUR of the prostate.
4. Retrograde ejaculation. After resection of the prostate has taken place, some patients experience retrograde ejaculation, and this consists in the fact that instead of getting out, sperm penetrates into the cavity of the bladder during ejaculation.

Many patients are interested in whether removal of the prostate gland can affect potency.

Type of operation
How is it carried out?
Advantages
Flaws

Adenomectomy	The intervention is performed under general anesthesia. Manipulations are performed through an incision in the lower abdomen. The tumor is removed virtually manually. The prostate gland is preserved if possible.	The ability to visually examine the affected organ, adjacent blood vessels and other organs for concomitant pathologies.	Highly traumatic, long recovery (up to 90 days). Risk of damage to healthy tissue.
Operation TUR (transurethral resection)	All manipulations are performed through the urethra under local or general anesthesia. A special instrument equipped with a camera, a light source and a special surgical loop is inserted into the canal. The tumor is carefully scraped out of the gland, and the remaining biological material is removed by rinsing the bladder with saline solution.	The recovery period is shorter than that of resection. Men after TUR of prostate adenoma are less likely to have problems with erectile function. Full recovery does not exceed 60 days.	After TUR of prostate adenoma, the postoperative period may be complicated by bleeding or the formation of large clots that “clog” the catheter.
Removal of adenoma with laser	The procedure is performed under local anesthesia (sometimes an epidural is used) and is performed without any incisions. A liquid is injected into the tumor using a thin needle, which is heated by a laser beam. When heated, the liquid leads to the destruction of the tumor and simultaneous sealing of the blood vessels.	Minimal risk of bleeding and postoperative impotence, short recovery period.	High cost of the procedure.

Regardless of how traumatic the method was chosen to remove the tumor, recovery and rehabilitation after surgery is based on the same principle. It ensures healing of wound surfaces on the prostate gland and serves to restore the functioning of internal organs affected by the procedure.

Postoperative period during hospitalization

The main goal of postoperative rehabilitation is to prevent complications and restore the functions of the prostate gland and the genitourinary system as a whole. The first stage of recovery takes place in a hospital under the supervision of specialists.

The course of the postoperative period depends on how long the preparation for the operation lasted, as well as on the chosen method of removing the tumor.

For example, with the classic removal of prostate adenoma, the postoperative period is the most difficult and lengthy in time, because the body is forced to restore the integrity of the anterior abdominal wall and fatty tissue, and not just the walls of the bladder and gland. Complete healing can take up to six months.

At the hospitalization stage, that is, during the first day after surgery to remove prostate adenoma, men need careful observation and rest.

You can move independently during this period only if the tumor was removed using laser technology.

If a transurethral or abdominal method was used to remove prostate adenoma, it is recommended not to get out of bed on the first day after surgery.

At this time, the bladder is emptied forcibly using a catheter, which, in addition to urinary diversion, performs drainage functions.

It supplies a saline solution into the hollow organ, which can be used to partially dissolve blood clots or fragments of a tumor removed by TUR. When using a catheter, discomfort may occur due to spasm of the bladder walls.

Symptomatic therapy is undesirable, since the walls of the organ adapt to the presence of a foreign object within 24 hours.

Catheterization is used for several days until the swelling of the prostate gland decreases.

In the absence of symptoms indicating the presence of infection in the body, it is removed after 3-6 days, depending on the type of intervention used.

Before this, the operated man is recommended to fill the MP to check his functional status. If problems arise again with urination, the final removal of the catheter is postponed, and additional diagnostics are also carried out.

In some cases, if blood loss occurred during surgery, iron is prescribed in combination with vitamin B12, B6 and ascorbic acid.

If the temperature rises, the doctor may decide to prescribe anti-inflammatory drugs and other symptomatic drugs (antispasmodics and analgesics).

Types of postoperative complications

The recovery period is difficult, and during this time a man cannot lead his usual sex life. The main task after such an operation to remove the prostate is to restore the flow of urine and sexual function as much as possible. Some patients will need to consult a sexologist.

If the operation does not bring the desired result, then rehabilitation after prostate adenoma boils down to installing a prostatic stent in the penis, which will expand the lumen of the urethra. This is an absolutely safe procedure, since the product is small in size and does not cause discomfort.

:09 Feb 2015, 12:56

Source: https://infernal-cs.ru/vosstanovlenie-posle-operacii-tur-ad/