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Prostate Problems

Prostatic hyperplasia or benign prostate growth is related to androgens and the age of the patient. There is also a certain degree of heritability in prostate growth.

Common
symptoms

The most frequent symptoms are:

  1. Difficulty initiating urination
  2. Very prolonged urination
  3. Shortness of micturition
  4. Low force urinary stream
  5. Dribbling at the end of urination.

In addition, other symptoms may appear due to bladder irritation caused by prostate enlargement, such as frequent urination, urinary urgency and nocturia or increased urination at night.

All these symptoms alter the quality of life of patients.

Complications such as the formation of bladder lithiasis, diverticula, hematuria and even renal failure and repeated urinary tract infections can occur.

TREATMENT

Treatment can be divided into several stages:

1. Medical treatment:

When the patient presents mild or moderate symptoms, drugs are usually administered that allow the patient to urinate better and may delay the progression of hyperplasia.

2. Surgical treatment:

When drugs are not effective, the patient does not want to take medication, or there are complications. There are different treatment options:

Rezum

It consists of the injection of water vapor into the prostate, which produces a progressive reduction in size and improves the patient’s symptoms. It is a minimally invasive treatment with no impact on sexual function or ejaculation. Indicated in prostates smaller than 80 cc.

Prostate laser vaporization

It consists of vaporizing the prostate tissue with laser to create a sufficiently wide channel in the prostatic urethra to allow the patient to improve his symptoms and urinate without difficulty. It is also minimally invasive, and the catheter can be removed the day after surgery in most cases. It is associated in many cases with retrograde ejaculation. Indicated mainly in prostates smaller than 80 cc.

Prostate laser enucleation

It consists of performing an endoscopic adenomectomy, i.e. removing the entire prostate adenoma and then morceling it (destroying it) inside the bladder in order to aspirate it. It can be performed on any type of prostate regardless of its size.

Bipolar prostate resection

It is a classic endoscopic treatment that consists of cutting prostate tissue until a good orifice is left to allow the patient to urinate correctly. Indicated in prostates smaller than 80 cc.

Prostate adenomectomy

Classic open abdominal surgery for complete removal of the adenoma. Currently indicated for very large prostates.

Results and
life quality

The availability of laser technology allows minimally invasive vaporization and enucleation techniques with excellent results, as well as Rezum in prostates smaller than 80 cc.

Minimally invasive surgical techniques such as Rezum, Vaporization, Enucleation and Prostate Resection have the following advantages:

  1. Minimize the effects of surgery
  2. Decrease complications
  3. They have no repercussion on the patient’s ejaculation.
  4. They allow a quick incorporation of the patient to his work and personal life.

FAQ

Usually yes, enucleation and vaporization techniques at least 24 h of bladder catheterization. Rezum at least 7 days of bladder catheterization. Regarding TUR and Adenomectomy, catheterization is usually necessary for 5 to 7 days depending on the case.

It is not usual, nor does it have to occur, but it may happen that stress incontinence occurs temporarily and for a few weeks, which usually recovers progressively and with pelvic floor training.

Normally the bleeding that occurs with endoscopic techniques is minimal and the risk of major bleeding is very low, not being necessary in most cases to perform transfusions or other hematological treatments.

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