From middle age onwards, the man’s prostate slowly but surely changes from ally to opponent. Initially you do not realize that the prostate is growing, because urinating once a night is barely noticeable. And you won’t immediately notice having to urinate more often during the day with a slightly weaker stream. But if you end up having to urinate almost every hour, and having to go out three times a night, the diagnosis is quickly made, namely “benign prostate enlargement”. Then the choice is to first use medication against the symptoms for the time being, or to undergo a sufficient operation. You can choose between the TURP or UroLift operation.
Prostate exclusively male organ
The prostate is an organ that both men, women and future offspring can enjoy. Because this gland produces the fluid in the semen in which the sperm cells can move freely and easily find their way to the female egg. Unfortunately, this prostate not only wants to provide pleasure and reproduction in old age, but often also causes discomfort when urinating.
Enlarged prostate
It seems very efficient and clever on Mother Nature’s part that the male urethra passes through the core of the prostate, much like a bell house in an apple. But if you judge objectively, you can still call it a design flaw. The problem with every prostate is that it starts to grow as a man ages, due to a reduced level of the sex hormone testosterone.The enlarged prostate becomes a nuisance for many men over the age of 50 due to problems with urination. As they grow, the prostate dimensions change from chestnut (if you are still young) to mandarin or even larger. But not only the outside grows, the inside also expands, slowly but surely closing and squeezing the urethra. As a result, the bladder also has to exert more effort. The medical term for such a benign prostate enlargement is: Benign prostatic hyperplasia, BPH.
Urinary complaints
This pinching of the urethra means that urination becomes increasingly difficult, difficult and incomplete. This manifests itself, among other things, in the following symptoms:
- more frequent urges,
- weaker beam,
- drip,
- difficult to get started,
- bladder that does not empty completely,
- After half an hour I have to go again.
Total pee blockage
At some point you may be at risk of a complete urinary blockage, which will require an emergency trip to the hospital. So if you have serious urinary complaints, it may be better not to go to a country where a hospital is not easily found. In some respects, you can compare prostate complaints with the phenomenon of hair loss: Almost every man will suffer from it sooner or later, but not everyone becomes completely bald. And you may also be lucky enough to live with that enlarged prostate until you die.
Adjusted lifestyle
That frequent unexpected urge to urinate due to small urine discharges can sometimes take over your daily schedule, because the ultimate result is:
- Waking up to an average of 4 times a night to go to the toilet. Not good for your productivity during the day, this tiring night-time sleep-destroying symptom also called nocturia.
- You should only do long car rides, bus trips, etc. if you have deliberately consumed little alcohol.
- At some point in your hometown you know every department store or hardware store that has a toilet.
- When you leave the house, think in advance about where you can pee.
- When flying, first go to the last toilet before you board, and you want a seat close to the walkway.
- When visiting the cinema, concert or theater, pee before entering the theater and also during the break.
- Every time before you leave home, don’t forget to go to the toilet.
- And so we can continue.
Medicines
Symptom-fighting medications that relax or even shrink the prostate may provide relief for a few years, but it may be a stay of execution. In the long run, surgery is often the only solution, which also gives the reassuring feeling that you can no longer suffer a total urinary blockage.Moreover, no one can predict the future, so there is no rock-solid guarantee that the necessary medicines will remain available undisturbed at all times. Strikes, war or flooding are small risks that cannot be completely eliminated, but they can endanger the supply of medicines. You don’t want to think about what could happen to the prostate if years of drug use are forced to stop for a longer period of time.
Postponing surgery also offers advantages
On the other hand, the benefits of prostate surgery are unfortunately not eternal. Even after the operation, the prostate will grow again, which means that complaints can arise again over the years. The first 15 years are generally guaranteed to be free of complaints. But still an argument not to rush into surgery, lest you have to go under the knife twice in your life.
Prostate surgery
In most cases, a surgical intervention by the urologist takes place via a so-called TURP operation. A proven, successful standard procedure, in which a cutting/burning device is inserted through the urethra via the penis, complete with lamp and camera. The urologist then hollows out the prostate. The approximately 60-minute operation is often performed under spinal anesthesia and you can watch on a TV screen. Afterwards, the urologist may show you all those pieces of cut-off prostate meat that he has collected in a jar, so that you can be sure that you have a urine passage in the prostate that is wider than ever before. In at least 80% of cases, the TURP operation appears to be a sufficient solution. With the understanding that the prostate tissue can regrow. But you can usually make progress during the first 15 to 20 years. If you have postponed the operation for a very long time, it is again an advantage in that respect.
Recovery phase
When you return to the ward you will notice that you have been given a catheter with a bladder flushing function. And you probably have a temporary IV in your arm. That IV will probably disappear the next day, making you mobile again, although walking with that catheter is not exactly fun. Moreover, the catheter remains in place by means of an inflated balloon in the bladder, which gives you a constant feeling of urgency. But about 48 hours after the operation, the catheter may also be removed from the bladder via the penis (not a pleasant feeling when pulling out the catheter), after which you can urinate on your own for the first time. That is not really pleasant those first times, because urination gives a burning sensation and at the same time blood and clots appear. After urinating a few times, the nurse will use an ultrasound machine to check whether the bladder is emptying sufficiently, and with a bit of luck you will be back home two or three days after the operation. Duringthe first few days, you will probably still urinate blood and clots regularly and that burning sensation will continue for a while. There may even be temporary incontinence because the urge to urinate can be intense and unexpected. Moreover, you will probably still have to urinate very frequently in the first weeks (months) and you will also have to go out often at night. But these are temporary inconveniences that will diminish and hopefully disappear over time.
UroLift treatment
Since around 2013, in addition to the TURP operation, the UroLift method has been available. It is a day treatment, in consultation with the patient under local anesthesia or general anesthesia. With this procedure, the excess prostate tissue is not removed, but the prostate tissue is pushed aside via anchors in order to keep the urethra open. After treatment, 95% of men no longer experience urinary complaints for years. Since the method has been applied for a relatively short time, it cannot yet be said with certainty how many years people will remain free of complaints. An advantage is that the erection and ejaculation remain intact, which is less certain with the TURP method.