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What Is The Prostate and What Are Its Functions?

It is a walnut-sized (10-20 gr) gland tissue through which the outer urinary tract, which is located just below the urinary bladder (bladder) in men, passes. The prostate gland secretes the necessary fluids for sperm cells in the semen.

What Are The Most Common Prostate Diseases?

Prostatitis (Inflammation of the Prostate Gland)
Inflammatory disease of the prostate tissue, the most common findings of which are fever, weakness, pain, burning when urinating, difficulty urinating, sudden tightness, painful ejaculation and erectile dysfunction. It usually heals with medical treatments.
Benign Prostatic Hyperplasia (BPH)

What Is Benign Prostate Enlargement?

With the enlargement of the prostate gland with age, it compresses the urinary canal passing through it and as a result, it creates urinary problems. Problems increase in the 50s and 60s. The incidence increases with age.
Benign prostate enlargement protects from kidney failure, urinary incontinence, bladder stone formation, and bladder cancer due to chronic irritation with early diagnosis and treatment.
In addition, it seriously improves the life comfort of patients.

What Are The Symptoms?

Frequent urination, frequent urination at night (more than 2)
Sudden urge to urinate, urinary incontinence
Burning or bleeding in the urine
Weakening of urine flow
Difficulty with urinating
Intermittent urination
Feeling of not being able to empty the bladder completely and dripping at the end of urine

What Diseases Are Most Commonly Confused About Prostate Growth?

External urinary tract stenoses and stones
Bladder tumor
Urinary Tract Infection
Overactive bladder
Neurogenic Bladder
Pelvic pain syndrome
Bladder stone

How Is Benign Prostate Growth Diagnosed?

The first evaluation is made with the medical history and complaints of the incoming patient. Physical examination and, where necessary;
PSA (prostate specific antigen) test,
Uroflowmetry (urine flow rate),
Cystoscopy (examination of the external urinary tract and bladder with a special instrument) is used.

How Is Benign Prostate Growth Treated?

Treatments to be applied in benign prostate enlargement;
Close monitoring
Drug therapy
Focal treatments (REZUM)
Surgical methods (TUR-P, Prostate Vaporization, HOLEP )

Drug Therapy

Alpha blocker (channel expanders)
Alpha reductase inhibitor (prostate reducer)
Muscarinic receptor antagonists (to reduce frequent urination)
Pd5 inhibitor (with difficulty urinating and erectile dysfunction)
Phytotherapy (herbal treatment)
Combination therapies

Focal treatments (REZUM)

What Is Rezum?

In patients with benign prostatic enlargement, the prostate tissue is reduced with water vapor formed as a result of thermal energy and the part that obstructs the urinary tract is opened.
Under resum local or sedoanalgesia, the part of the prostate tissue that obstructs the canal is opened by destroying the tissue by injecting water vapor into the prostate tissue (closed) with a needle by entering the urinary tract with a camera.

What Is The Difference In The Reserve?

Rezum is the ideal choice for elderly patients who have health problems or do not want to risk anesthesia.
The procedure takes 10 minutes and there is no need to stay in the hospital after the procedure. Recovery after the procedure and return to daily life are faster than in surgeries.
In young patients, the risk of recurrence (retrograde ejaculation), which is common after surgeries, is almost nonexistent.
The effect of Rezum is usually evident in 2-3 weeks, but this period can be extended up to 6 weeks.
Rezum has protective properties on the external urinary tract.
Since 2017, Rezum has been applied to over 35,000 patients in developed countries.

Surgical Methods

Transurethral Prostate Resection (TUR-P)

It is an endoscopic (closed) surgical method that is accepted as the most commonly used gold standard technique in the surgical treatment of benign prostate enlargement (BPH).

How Is Transurethral Prostate Resection (TUR-P) Surgery Performed?

With general or spinal anesthesia, the prostate tissue is separated into small pieces by entering the external urinary tract with a special device accompanied by a camera and taken out.
It can be done with two energy sources, monopolar and bipolar. Bipolar energy can also be used safely in patients with pacemakers because no electrical current passes through the patient's body.
Today, the most commonly used energy source in TUR-P methods is bipolar energy. After the operation, a catheter is placed in the urinary tract for 2-3 days. Since the surgery is performed by endoscopic (closed) method, no incision is made. This is why healing is so fast.
Patients start eating and drinking 6 hours after the surgery and are usually discharged on the 2nd day.

Prostate Surgery with Holep

What Is Holep? (Prostate Enucleation with Holmium Laser)

It is a surgical method in which advanced laser technology is used in the treatment of benign prostate enlargement (BPH). It is a closed procedure that can clean and remove the entire part of the prostate tissue that closes the urinary canal. Prostate surgery with holep is a comfortable method.

What Are The Benefits of Holep Surgery?

Even in very large prostates, the procedure is performed without making any incisions in the body.
It is an alternative method to open surgery.
There is almost no chance of having surgery again.
It does not harm sexual functions.
He doesn't need a blood transfusion in surgery.
In mandatory cases, the procedure can be performed even in those who use blood thinners.
Since it is applied with the principle of laser separation in patients whose catheter is withdrawn after surgery, the patient who is withdrawn does not experience a burning sensation while urinating.
Since Holep surgery offers advantages such as low risk of bleeding, short hospitalization time and rapid recovery process, patients can return to their normal lives after a short time.

The nerves that regulate sexual functions are not damaged. Therefore, postoperative erection problems are not expected in patients.
Since there is no burning defect in the tissues removed after surgery, pathologists examine the tissue more comfortably and possible malignant formations are less likely to be overlooked.

For Whom Is Holep Surgery Suitable?

Most patients with prostate disease who are considering surgical surgery are suitable for Holep.
Holep is a suitable surgical method for anyone who needs prostate surgery. Holep technique is applied safely.
In the presence of bladder stones accompanying prostate size, it is successfully applied in the same session and simultaneous stones can be broken with a laser in a closed way. Again, in patients with stenosis in the urinary tract, this stenosis can also be opened with laser during the procedure.
It can also be applied more safely than other techniques in patients with cardiovascular diseases, who have a stent in the heart, who have undergone bypass, and who use blood thinners due to vascular occlusion.

How Is HOLEP Surgery Performed?

General anesthesia or spinal anesthesia (by numbing from the waist down) is performed. It is performed by entering the urinary canal with an endoscope.
Since no incision is made, the patient can return to daily life very quickly. The enlarged prostate tissue is carefully separated from the capsule by laser and thrown into the bladder. The prostate tissue thrown into the bladder is broken down with another instrument (morselator) and vacuumed out of the body. The procedure is terminated by inserting a catheter.
The removed prostate tissue is sent to pathology to evaluate the possibility of possible cancer.
Patients start eating and drinking 6 hours after the surgery and are usually discharged on the 2nd day.

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