General Surgery

Prostate Surgeries

Prostate is a male reproductive gland which is responsible for the production of the sperms and the semen. It is developed around 12th week of intrauterine life. Any structural and functional changes can lead to the prostate disorders, which has to be corrected mainly by surgery.

Conditions of Prostate

BPH (Benign Prostate Hypertrophy) - It is very common in the older males above the age of 60 years. In BPH there is compression and obstruction of the urethra and bladder leading to the structural changes internally. The symptoms of BPH are increased frequency in urination with urgency even for the little quantities. There is also retention of urine leading to the painless enlargement of the urinary bladder.

Diagnostic test such as blood urea creatinine, urodynamaic study, USG of prostate gland and cystoscopy can help in ruling out the BPH. Medical management with the help of drugs are done as the first line of the treatment. If the symptoms do not subside or affecting the quality of life then surgical procedure is adopted. The procedures performed are Transvesical suprapubic prostatectomy, Retropubic prostatectomy and the most common method followed nowadays is Transurethral resection of prostate where the resectoscope is passed through the urethra and under vision with constant irrigation with water or glycine, prostate is resected into pieces and removed.

Carcinoma of Prostate - this usually occurs above the age 65 years, it is also a very common condition in India. The spread of the carcinoma may be through the blood, lymphatics and involves the other parts of the body if not diagnosed and treated early. Clinical symptoms include multiple bone pain, acute retention of urine difficulty in passing the urine with blood in the urine. There can also be hard nodule present at the rectum. Biopsy of the transrectal truecut which shows adenocarcinoma marks the prostate cancer. Other tests also involve X-ray of bones, serum acid phosphatase, serum alkaline phosphatase, abdominal and transrectal USG and prostate specific antigen test can help in staging the cancer.

Management of the carcinoma can be done depending upon the staging of prostate cancer. If there is early prostatic malignancy then radical prostatectomy where there is complete removal of prostate and seminal vesicles along with pelvic lymphadenectomy is done. In case of late prostatic malignancy then Radiotherapy is administered and also low orchidectomy, removal of entire testis is done.

Prostatitis - This is the inflammation of the prostate gland. This can be both acute and chronic type. In prostatitis, in addition to the prostate, seminal vesicles and the posterior urethra are also involved. Causes of prostatitis may be bacterial infections such as Staphylococcus aureus, E.coli and Staphylococcus albus. The instrumental and the invasive urological procedures can also lead to the prostatitis.

Symptoms include high grade fever with chills and rigors, muscular pain, pain in the anal region, irritation, urethral discharge, pain during urination. In acute conditions, hospitalization of the patient is done. It is usually treated by the medical line of treatment by giving intravenous fluids, antibiotics and antipyretics. And in chronic prostatitis, prolonged antibiotic therapy is advised.


Plastic Surgery
prostate surgeries
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