PROSTATE SURGERY

Laparoscopic Surgery

Benign Prostatic Hyperplasia (BPH) refers to the benign growing of the prostatic tissue (information about prostate cancer is available here).  When the urethra leaves the bladder, it crosses part of the prostate. For this reason, when the prostate enlarges, it ends up squeezing the intraprostatic urethra, causing some urinary difficulties.  This process is very common in men, starting at the age of 40, and as they get older, it tends to progress, obstructing the urinary flow and complicating the urine stocking.

Initially, this pathology is usually treated clinically, through medications that relax the intraprostatic musculature (alpha-blockers) or that make the hyperplasiated tissue (finasteride e dutasteride) recede.  When the use of such medications does not offer the desired result, or when the patient already presents severe alterations of the bladder or the kidneys, it is up to the physician to surgically remove this tissue which blocks the urethra.  In the past, this procedure was made, above all, through open techniques, however, today, in the minimally invasive surgery era; it can be done through a transurethral or laparoscopic technic.

The laparoscopic technique is indicated for the voluminous prostates (above 80g).  The urethral techniques can be used in practically all the patients who need this surgery.  The most common are: Transurethral Resection (TUR), Holmium Laser Enucleation (HoLEP) and Prostatic Vaporization (Plasma Button), which is the main innovation in this field.

Main advantages: better safety against hydric intoxication, because of the usage of physiological saline solution, very little bleeding, reduced vesical probe time postoperatively, less hospitalization time, and it can be used safely in cardiac patients who take medications to reduce the blood coagulation or who make use of electronic devices like a pacemaker and a defibrillator, since it uses bipolar current, which is ideal in these cases.

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