In terms of surgical procedures for the treatment of benign prostate enlargement, various options are currently available, with TUR-P (transurethral prostate resection) being the most common method in Germany. It is one of the most frequently performed operations of all and leads to good results if the indication is correct and the surgeon has the appropriate experience.
The surgeon can control and safely perform the procedure through optics. The enlarged and obstructing prostate tissue is removed, but the so-called prostate capsule remains. The excised tissue fragments, the so-called resection chips, are flushed out of the bladder and are sent to a pathological institute for examination. Here, the presence of malignant prostate cells can be ruled out. Since the capsule remains intact, patients who have undergone TURP must also continue to undergo screening examinations after the operation for the timely detection of prostate carcinoma.
Possible complications
The risks of this surgical technique are divided into early and late complications. In the case of early complications, post-operative bleeding is observed in particular, which usually resolves itself without the need for further surgery. In rare cases, a so-called post-coagulation, i.e. hemostasis in the course of a second short operation, is necessary. Late complications are rarely urinary incontinence due to injury of the sphincter muscle and scarring narrowing (so-called strictures) of the urethra. Frequently, so-called retrograde (backward) ejaculation occurs after TUR-P. This means that the still produced seminal fluid is not expelled forward, but remains in the bladder until the next urination. As a rule, the patients do not find this disturbing, as libido, erection and orgasm remain intact.
Modern surgical techniques have made the so-called TUR syndrome extremely rare, which can occur when irrigation fluid enters the circulation through opened blood vessels. This can lead to a change in the composition of the blood and a severe strain on the circulation. Especially the further developed and improved techniques such as the more modern bipolar resection technique (TURiS) lead to a reduction in the complication rate, making it currently the standard method in Germany for the treatment of benign prostate enlargement.
Latest laser technology at the West German Prostate Center
Especially with regard to the still existing bleeding risks and the occasionally associated prolonged hospital stay, the particularly gentle laser therapy has been used for several years in addition to the classic peeling. In addition to Greenlight laser therapy and diode las ers, the West German Prostate Center also has the ultra-modern and very low-bleeding holmium laser enucleation (HoLEP).
