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Minimally Invasive Surgery For Enlarged Prostate

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What Is The Role Of Minimally Invasive Surgical Treatments For Benign Prostatic Enlargement

Minimally Invasive Outpatient Procedure Eases Prostate Enlargement
  • Juan Victor Ariel Franco1 2,
  • Jae Hung Jung3,
  • 1Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
  • 2Research Department, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina
  • 3Department of Urology, Yonsei University Wonju College of Medicine, Wonju, South Korea
  • 4Central Library, Instituto Universitario Hospital Italiano de Buenos Aires, Argentina
  • 5Minneapolis VAMC, Urology Section and Department of Urology, University of Minnesota, Minneapolis, USA
  • Correspondence to JVA Franco juan.francomed.uni-duesseldorf.de
  • How Does Enlarged Prostate Affect Quality Of Life

    The symptoms of enlarged prostate including difficulty urinating, urgency with leaking, dribbling urine, and waking at night with the urge to urinatecan have a negative effect on quality of life. Side effects of some treatments may result in sexual dysfunction.

    Fortunately, effective treatment can manage BPH symptoms, along with lifestyle changes, such as diet, exercise and stress reduction. The earlier doctors can diagnose an enlarged prostate, the more effective treatment can be, lowering the risk for complications and preserving quality of life.

    Its important to have an honest conversation with your doctor about all symptoms you may be experiencing and how they affect your daily activities and sexual health. You and your doctor can tailor a treatment plan specifically for your conditions, symptoms and concerns.

    What Is Enlarged Prostate

    An enlarged prostate is the slow growth of the prostate gland, which is involved in the production of seminal fluid and reproductive function in men. An enlarged prostate is also known as benign prostatic hyperplasia . BPH is generally not caused by infection or cancer. It is very common for the prostate gland to become enlarged as a man ages.

    As a man matures, the prostate grows. At puberty, the prostate doubles in size. At about age 25, the prostate gland grows again, and this can lead to an enlarged prostate as a man enters his 40s, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

    An enlarged prostate may not cause any symptoms or noticeable problems in some men. However, as men age, an enlarged prostate may grow to the point where it presses on the bladder and urethra, causing urine flow to be slower and less forceful. Symptoms of enlarged prostate are very common in men in their 60s and extremely common in men over 70.

    If an enlarged prostate prevents complete emptying of the bladder, it may lead to a urinary tract infection or permanent damage to the bladder. This can include the inability to control urination . The earlier doctors can diagnose an enlarged prostate, the more effective treatment can be, lowering the risk for complications.

    A healthcare provider must determine whether your symptoms are due to an enlarged prostate or are the result of other prostate diseases and disorders, such as an infection or cancer.

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    When Is Bph Treatment Necessary

    The course of BPH in any individual is not predictable. Symptoms, as well as objective measurements of urethral obstruction, can remain stable for many years and may even improve over time for as many as one-third of men, according to some studies. In a study from the Mayo Clinic, urinary symptoms did not worsen over a 3.5-year period in 73% of men with mild BPH. A progressive decrease in the size and force of the urinary stream and the feeling of incomplete bladder emptying are the symptoms most correlated with the eventual need for treatment. Although nocturia is one of the most annoying BPH symptoms, it does not predict the need for future intervention.

    If worsening urethral obstruction is left untreated, possible complications are a thickened, irritable bladder with reduced capacity for urine infected residual urine or bladder stones and a backup of pressure that damages the kidneys.

    • Inadequate bladder emptying resulting in damage to the kidneys
    • Complete inability to urinate after acute urinary retention
    • Incontinence due to overfilling or increased sensitivity of the bladder
    • Bladder stones
    • Symptoms that trouble the patient enough to diminish his quality of life

    Find a Location

    Currently, the main options to address BPH are:

    • Watchful waiting
    • Surgery

    Invasive Vs Minimally Invasive Prostate Surgery

    Greeneville Urologist Offering New, Minimally Invasive BPH Treatment ...

    There are many approaches for treating prostate conditions, and not all of them involve a significant trauma to the body. This option is vital for men who are concerned about the side effects of surgical treatment.

    When using surgery to treat a prostate condition, invasive methods use a larger incision on the abdomen to access the pelvic region and operate on the prostate gland.

    In contrast, minimally invasive approaches use various techniques to operate on the prostate with minor damage to the body. Typically, doctors can complete these procedures through tiny cuts or tube-style instruments inserted into you.

    Common invasive prostate surgeries include transurethral resection of the prostate, open prostatectomy, and robotic prostatectomy. They are the current gold standard surgical intervention for troublesome benign prostatic hyperplasia or localized prostate cancer.

    However, these methods are also associated with considerable side effects, such as urinary incontinence and erectile dysfunction, all of which reduce the patients quality of life. Because of these adverse effects, scientists have developed a range of minimally invasive techniques to help reduce the risk of adverse side effects.

    With these newer techniques, the body does not have to heal from large wounds, reducing the risk of adverse treatment effects.

    The following sections will discuss what these procedures involve and provide some details about their efficacy.

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    Common Side Effects Often Observed After Surgeries

    The type and severity of these adverse effects will depend on the exact intervention you receive.

    Typically, minimally invasive techniques have fewer and less severe side effects compared to their invasive counterparts.

    Some side effects are short-lived, while others persist for many years after surgery. Discuss with your doctor to help you identify the best treatment for your specific prostate condition.

    What You Need To Know About The Prostate Minimally Invasive Prostate Surgery

    The main purpose of the prostate is to produce semen, a milky fluid that sperm swims in. During puberty, the body produces semen in a large number of cases, including enlarged prostate. This fluid causes the prostate to swell and cause a number of bladder-related symptoms. This is why the prostate is important to the body. It can be caused by many factors, including infection and inflammation.

    A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

    While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

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    Minimally Invasive Surgery For Bph

    The last fifteen years have seen remarkable advances in the treatment of benign prostatic hyperplasia. new medications continue to be developed along with high-tech procedures to relieve urinary problems this condition causes.

    By the age of sixty, about 50 percent of American men will have developed benign prostatic hyperplasia . This enlargement of the prostate is a natural part of aging. Some men will not experience any notable symptoms from BPH, while others will have urinary problems of varying severity. As the prostate enlarges, the gland begins to press against the urethrathe tube that transports urine out of the bodylike a clamp on a garden hose.

    As a result of the pressure, the bladder wall becomes thicker and irritable and, eventually, the bladder begins to contract even when it contains only small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to fully empty itself. Over time, severe BPH may cause additional problems, with urine retention and strain on the bladder leading to urinary tract infections, bladder or kidney damage, bladder stones, and incontinence.

    The goal and the approach

    Most patient are able to return to work in two to three days after the procedure and they experience few side effects. There is no incontinence associated with the TUNA procedure and erectile difficulties are rare.

    What Are The Benefits Risks And Side Effects Of Minimally Invasive Surgeries

    Minimally Invasive Aquablation for Enlarged Prostate Symptoms | Jackson North Medical Center

    Symptom relief is the biggest benefit of minimally invasive surgery. Some men have fewer problems controlling their urine after they have one of these procedures. However, having minimally invasive surgery may increase the risk that you will need to have another surgery in the future.

    Side effects from minimally invasive surgery may include:

    • Needing to urinate more often
    • Sudden urges to urinate
    • Semen flowing backward into the bladder instead of out of the penis

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    Convective Water Vapor Ablation

    This treatment is also known as Rezum. This treatment uses the stored thermal energy in water vapor to kill excess prostate tissue. Inside a handheld device, sterile water is heated to just above the boiling point, when it turns into steam. A precise dose of thermal energy from the steam is then injected into the prostate with a small needle. The release of this thermal energy causes rapid cell death. The bodys natural healing response then breaks down and removes the dead tissue, causing the prostate to shrink.

    Improved Quality Of Life After Successful Prostate Artery Embolization Procedure

    Zlotchenko carefully explained the details of the PAE procedure to the McDougals and gave them literature to review. He went into great depth, said Dennis, who decided on PAE and its minimally invasive approach. He had it at UCHealth University of Colorado Hospital on the Anschutz Medical Campus in September 2021.

    McDougals Parkinsons disease made his case unusual, and Zlotchenko and his team took extra precautions to address it. For example, McDougals tremors had to be well-controlled before Zlotchenko could painstakingly guide the catheter through his blood vessels.

    The strategy included putting McDougal under general anesthesia to keep him paralyzed, Zlotchenko said. In addition, I worked with my anesthesia colleagues to make sure the patient got his medications as close to his scheduled doses as possible.

    The procedure went well and has helped improve McDougals symptoms. He keeps a bedside commode as a precaution but is no longer making multiple and often unproductive trips to the bathroom every night. With that, his fall risk has decreased, which is especially important as his Parkinsons disease continues to progress.

    He also has a new measure of stability in his daily life. Before the procedure, the problems caused by his enlarged prostate meant that it was nearly impossible for him to go anywhere that he didnt have constant bathroom access.

    Its given us a much better quality of life, even enabling us to take short walks together, Candace said.

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    What Are The Diet And Nutrition Tips For Enlarged Prostate

    There is no specific diet that can prevent or treat enlarged prostate. However, healthy nutrition habits can benefit prostate health, including:

    • Avoiding alcohol and caffeine, which can increase urine production

    • Focusing on fresh fruits, vegetables and whole grains

    • Following a low-sodium diet by avoiding processed foods and not adding salt to your meals

    • Including healthy fats, such as those found in avocado, chia seeds, olive oil, and fatty fish like salmon

    • Limiting red meat in favor of lean poultry, fish, and plant-based proteins

    • Reducing dairy, especially whole-fat varieties of milk, cheese, and butter

    Ask your healthcare provider for guidance before making significant changes to your diet.

    Questions To Ask Before Surgery

    Transurethral Microwave therapy of the Prostate (TUMT)

    As you think over the options for surgery, ask your doctor these questions:

    • Is there a good chance my condition will get better?
    • How much will it improve?
    • What are the chances of side effects from a treatment?
    • How long will the effects last?
    • Will I need to have this treatment repeated?

    With newer technologies, doctors can do some minimally invasive procedures with tiny cuts or use tube-style instruments that they insert into you. These procedures may not treat the symptoms to the same degree or durability as more invasive surgical options, they do have faster recoveries, less pain afterward and have reduced risks.

    Other times, the traditional and more invasive surgery may be needed. It all depends on your case and what you and your doctor decide is best for you.

    Doctors can choose from these minimally invasive procedures, endoscopic, or open surgeries to treat moderate to severe symptoms. These procedures are also used if tests show that your ability to pee is seriously affected.

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    Minimally Invasive Prostate Surgery

    The problem with almost all of procedures is that they damage the prostate and therefore cause short or even long-term consequences euphemistically referred to as side effects.

    The only difference between them is that they use different technologies but it doesnt matter how you damage the prostate, it is damage. Exceptions to this are uro lift since it just relieves pressure on the urethra but even that is still invasive.

    Of all the procedures that cause damage to the prostate probably rezum causes the least amount of damage.

    The only truly minimally invasive procedure which does not damage the prostate is prostate artery embolization.

    Holep Rezum And Urolift

    Surgical treatments for benign enlargement of the prostate are an option for men with troublesome symptoms who have not had satisfactory results after trying prostate medication, or who do not wish to remain on longterm medication for their prostate condition. Surgery is also used to treat men suffering from urinary retention who are unable to pass urine and are dependent on a catheter to empty their bladder, and for men who have repeated urine infections or bleeding due to their enlarged prostate.

    REZUM is the new minimally invasive treatment that uses steam vapour to shrink the prostate and improve urinary symptoms. It is carried as day case and patients are able to return normal daily activity within a few days.

    Uro Lift is a new minimally invasive treatment for men with urinary symptoms due to minimal- moderate enlargement of the prostate. It is performed from within the urethra and involves pinning back rather than removing the obstructive prostate tissue. It is not suitable for all men with urinary symptoms and is as yet unproven in the treatment of men with urinary retention. Advice from a specialist urologist, such as those in the Cambridge Urology Partnership, is advised in order to determine whether UroLift might be suitable for you.

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    Innovative Minimally Invasive Options In Treatment Of Urinary Problems Related To Prostate Enlargement In Men

    The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
    Recruitment Status : Withdrawn First Posted : February 3, 2017Last Update Posted : March 20, 2018
    • Study Details

    For ageing men, Health related quality of life is challenged by two common issues: the onset of bothersome urinary symptoms attributable to prostate enlargement and diminishing ability to maintain normal sexual activity and function both issues are important to men, yet often the treatment of the former has adverse effects on the latter. Current medical and surgical treatments offer symptomatic improvement of urinary symptoms. However long recovery times, degradation of sexual function and incontinence may negatively affect a patient’s QoL.

    Condition or disease

    Phase
    Lower Urinary Tract SymptomsBenign Prostatic HyperplasiaUrinary Frequency/UrgencyUrinary Incontinence, UrgeIncontinence, UrinaryNocturiaDevice: UroLift as artifical device for prostatic urethral lift.Device: Embospheres Microspheres as embolic agents for prostate artery embolizationNot Applicable
  • Recovery experience Recovery experience based on Quality of life Visual Analog Scale
  • Known upper tract renal disease
  • Cystolithiasis
  • New Minimally Invasive Treatment For Enlarged Prostate Shows Promise

    Minimally-Invasive BPH Therapies

    University of Arizona interventional radiologists and urologists at Banner University Medical Center Tucson have been working to improve the quality of life in men with benign prostatic hyperplasia .

    BPH, also known as an enlarged prostate, affects as many as half of men by age 60. Symptoms include urinary frequency, urgency, urination at night that disrupts sleep and incomplete bladder emptying.

    Now, for the first time in Southern Arizona, physicians at Banner UMC are offering a new, non-surgical outpatient procedure — prostate arterial embolization — for this common condition.

    Historically, patients who have suffered from urinary problems stemming from an enlarged prostate have only had the option of surgery, said Hugh McGregor, MD, assistant professor in the UA Department of Medical Imaging. PAE utilizes the newest technology and achieves relief of symptoms in 85 percent of men, with minimal side effects and a quick recovery, he said.

    PAE is performed as an outpatient procedure with a local anesthetic. Doctors work through an incision the size of a pinhole to decrease the size of the enlarged prostate gland, Dr. McGregor said, adding that recovery time with PAE is minimal compared to the six weeks commonly required after the traditional surgical option known as TURP .

    Dr. McGregor added that sexual side effects, a risk in traditional TURP surgery, are minimal in PAE.

    About Banner University Medical Center Tucson and South

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