PROSTATE DISEASES
You can find all your questions about prostate diseases in our content, and you can clear the question marks in your mind.
What is Prostate?
The prostate is located at the bottom of the bladder. It is a gland in the anterior part of the intestines that completely covers the outlet of the urinary bladder. It is one of the most basic parts of the male reproductive system. Its main task is to produce the fluid that protects the sperm. It also undertakes the task of keeping the sperm in this liquid in a healthy way. In addition, it tightens the mouth of the bladder and prevents you from incontinence.
Urologists in Turkey have a high experience in prostate diseases. State-of-the-art devices (Holep, Thulep, Prostate Fusion Biopsy, etc.) are used in the treatment of prostate diseases in Turkey and the treatment process is carried out by specialist doctors in this field.
What is the Function of the Prostate?
The prostate is a gland. It is located just below the bladder, through which the urethra (urinary canal) passes. In addition, the tubes that transmit the sperm from the testicles (vas deferens) open to this organ. The main task of the prostate gland is to secrete some of the fluid that makes up the sperm. It is about the size of a walnut in its ungrown form.
What are Prostate Diseases?
There are three most common types of prostate disease;
- Inflammation of the prostate (prostatitis)
- Non-cancerous prostate enlargement (benign prostate)
- Prostate cancer
A man may experience one of these diseases as well as others simultaneously.
What are the Prostate Symptoms?
The prostate grows slowly over the years and begins to squeeze the urinary channels in it. Urinary bladder provides urination and has a structure consisting of muscles. When the prostate compresses the urinary tract, the bladder muscles expand in response to this situation. Thus, the bladder contracts more strongly.
In these stages;
- The patient may not have any complaints.
- Frequent urination due to excessive use of the bladder.
- Waking up to urinate at night.
- Feeling the need to go to the toilet suddenly and quickly go to the toilet.
- Sometimes problems such as urinary incontinence may occur.
Over time, the prostate continues to enlarge. This causes fatigue in the bladder muscles. Thus, the urine flow of the patients slows down;
- Forked urination,
- Dripping while urinating,
- Intermittent urination,
- Feeling like there is still urine inside after urinating, etc. causes problems.
In untreated individuals, the urinary bladder muscles tend to melt. The high pressure in the bladder begins to disrupt the functions of the kidneys. Even if treatment is given after this stage, most of the functions of the bladder and kidney cannot be saved.
What is Prostate Enlargement?
Prostate enlargement generally occurs as a benign case. This growth begins from the late forties. In this way, it continues at varying speeds until the end of life. Benign prostatic enlargement (BPH) often occurs with aging. However, the exact cause is not completely clear.
The prostate gland, which grows more than normal, causes obstruction in the urinary tract and bladder outlet. Thus, it prevents the flow of urine. In addition, it harms both the urine storage and urine discharge function of the urinary bladder.
Although prostate enlargement is very common, it may not pose the same level of problem in every man. Although it occurs as a natural part of aging in some cases, it may not require treatment. However, in some cases, it can cause bothersome symptoms or impair voiding function. If it leads to such conditions that can harm the body, it should be treated.
What Causes Prostate Enlargement?
The exact cause of prostate enlargement is unknown, but the most common known cause is aging. According to studies, it has been determined that genetic factors are also effective in BPH. It has been determined that individuals with a family history of BPH have this disease more frequently. In addition, studies have been carried out on some environmental factors and their relationship with nutrition. However, satisfactory and precise results could not be obtained.
Especially in recent years, studies have been carried out to prove the relationship between obesity and BPH. Accordingly, it has been shown that increasing body weight, body mass index and belly circumference are associated with an increase in prostate size.
How is Prostate Enlargement Treated?
In cases of prostate enlargement, urine remains in the bladder because the bladder cannot be emptied completely. Cough urine inside can lead to chronic infections and permanent deterioration in kidney functions. For this reason, it is a disease that significantly reduces the quality of life of patients.
We can list the treatment ways in prostate enlargement (BPH) as follows;
- Medical (drug) Treatment
- Prostate SBA
- Prostate Surgery
- Classical Surgical Techniques
- Laser Surgical Techniques
Prostate drugs can be prescribed to patients in the treatment of BPH. These drugs have some side effects that all drugs have. It was stated that the majority of patients who were started on drug therapy underwent prostate surgery in the future.
It is possible to divide prostate enlargement surgery into two methods;
- Classical method surgery (TUR-P and Open Prostatectomy)
- It can be applied in the form of laser method prostate surgery (Greenlight laser and Holmium Laser- HOLEP etc.).
State-of-the-art treatment methods and applications are used in prostate enlargement treatments performed in health institutions in Turkey. Doctors who are experts in the field and experienced in the treatment of prostate enlargement achieve successful results in the treatment of the disease.
What is Prostatitis?
Prostatitis is the name given to the inflammation of the prostate gland. It is a painful and uncomfortable condition, but it can be treated. One type of prostatitis does not require treatment. In other types, it is aimed to relieve inflammation with drug treatment.
Prostatitis is the most common prostate disease in men under the age of 50. It is seen in the third place after prostate enlargement (BPH) and prostate cancer in men aged 50 and over. The incidence in this age range is around 10% on average.
Why Does the Prostate Enlarge?
In men, the prostate enlarges and approximately doubles in the early stages of puberty. After the age of 25, the prostate continues to grow in all men, but in different forms. This growth continues until the end of life. The causes of prostate enlargement are still not fully known today.
Male hormone (testosterone) and estrogen are thought to have a serious role in this growth. Approximately 50% of men over the age of 50 have an enlarged prostate. After the age of 60, this rate rises to 65%. With the age of 80, this amount of growth exceeds 90%.
What is Prostate Biopsy and How Is It Done?
In a standard prostate biopsy, the peripheral zone (capsular part of the prostate) is divided into 12 regions. A random sample is then taken from each region. The ultrasound device cannot distinguish between clean tissue and cancerous tissue. For this reason, potentially cancerous parts cannot be targeted for biopsy. Instead, random samples are taken from different areas of the prostate and cancerous tissue is expected to be encountered.
These random biopsies sometimes fail to detect cancers that have the potential to grow rapidly. For this reason, in new types of MR fusion biopsies, a special MRI is taken first. After that, suspicious areas for prostate cancer are detected in MRI and marked digitally. The marked images are transferred to special ultrasound devices. Thus, prostate biopsies are taken from the digitally marked areas.
MRI can successfully detect aggressive cancers larger than 0.5 cc in the prostate. For this reason, this method does not miss life-threatening cancers.
How Are Prostate Diseases Diagnosed?
As the prostate enlarges, it compresses the urethra and begins to reduce the flow of urine. Depending on the size of the obstruction, some complaints about urination begin in men. Early and accurate diagnosis is very important in individuals presenting with these complaints.
Because the same complaints can occur in prostatitis and prostate cancer. However, prostate cancer is also detected in patients who do not show any symptoms. In other words, only complaints are not sufficient in the diagnosis of prostate-related diseases.
For this reason, it is strongly recommended that all men over the age of 45 should have a prostate check. In some assays to be performed in this way, it is possible to make predictions about the prostate disease of the individual. The most frequently used and important of these assays is PSA. PSA stands for “Prostate Specific Antigen” sought in the blood. With this analysis, the relationship between the disease and cancer can be found and early diagnosis can be made.
How is Prostate Treatment Done?
Since the prostate is an organ that grows over time in the natural process, there is no way to prevent it. However, treatments that minimize the patient’s complaints and increase the quality of life can be applied. Methods are applied to eliminate the patient’s voiding problems. Surgery is not recommended for the patient immediately. Instead, a treatment method is followed according to the symptoms and their severity.
Generally, firstly, arrangements are made regarding the toilet habits and lifestyle of the patient. If necessary, drug therapy can be started for the second step. The drugs given today do not have an effect that treats prostate enlargement. Drug therapy is aimed at reducing patients’ symptoms and their severity. “Alpha blocker” is most commonly used as drug therapy. Alpha blockers quickly relieve the obstruction caused by the prostate. In recent years, there are varieties of these drugs with very low potential for side effects.
In addition, “5 alpha reductase inhibitors” are used in patients with prostate size over 35 grams. These drugs stop the growth of the prostate and reduce its size. The effect of these drugs begins 9 months after regular use. In cases where the patient goes to the toilet frequently and has an overactive bladder diagnosis, “anti-cholinergic group” drugs are used. It has been proven that the regular use of “Phosphodiesterase 5 inhibitor” drugs effective against erection relieves urination complaints.
The necessity of surgery may be mentioned in the following cases:
- If the patient's voiding problems persist despite drug treatments.
- If chronic urinary tract infections are seen.
- If the urine is accompanied by heavy bleeding.
- A catheter is inserted because the patient is unable to urinate.
Despite all these complaints, if the surgery is delayed, bladder and kidney problems will occur. In addition, the patient will face a serious problem such as kidney failure.
It is applied professionally by urology specialists who are experts in the field of prostate treatment in Turkey. Turkish doctors prefer healthy and safe treatment methods for prostate patients.
Prostate Surgery
Patients who do not respond to drug treatment in BPH can be treated with surgery. Some of these patients are those who first respond to drug treatment but then the drug is insufficient. In some cases, surgery is also applied to those who cannot use the drugs due to their side effects.
In addition, due to prostate enlargement;
- Those who have stones in their bladder,
- Those with chronic bleeding in the urinary tract,
- Persistent urinary tract inflammation,
- In patients who cannot urinate at all, surgical treatment should be planned.
In determining the technique of prostate surgery, the patient’s age, medications, other ailments and prostate size are taken into account.
Prostate surgeries are operations that require experience and attention. Urology specialists in Turkey achieve healthy and pleasing results with their experience in prostate surgeries. Therefore, many patients around the world visit the country to have prostate surgery in Turkey.
How is Prostate Surgery Performed?
Prostate surgery is generally performed by the following methods.
1. Transurethral Resection of the Prostate (TUR-P)
In transurethral resection of the prostate (TUR-P) surgery, the prostate tissue is burned from the inside with electrical energy. Then, small pieces are taken from the burned tissue. There is a high probability of bleeding in this surgery. For this reason, blood thinners (antiaggregant-coagulant) drugs, if the patient is using, are stopped 1 week in advance. It can be used again at the earliest 7 days after the operation.
After the surgery, the patient should stop with the probe for a minimum of 3-4 days. After this application;
- TUR-P syndrome,
- Urethral stricture,
- Infection,
- Urinary incontinence,
- Difficulty urinating,
- Sperm reflux (retrograde ejaculation),
- It has been stated in many studies that the need for reoperation is seen.
2. Open Prostatectomy
In patients with a prostate size of 100 grams or more, open prostate surgery can be performed. In this surgical operation, the patient’s skin and subcutaneous tissues are opened together with the urinary bladder. Then the prostate is taken with the help of fingers.
The probability of bleeding during this surgery is quite high. Therefore, blood support is often needed. After the operation, the patient needs to stay with the catheter for at least 7 days. In addition, the hospital stay is longer compared to other treatments.
3. Laser in Prostate Surgery
With the introduction of laser in urology, surgeries have started to be performed with laser in prostate surgery. We can list these methods as follows;
- Greenlight laser
- Photoselective vaporization of the prostate (PVP)
- nucleation of prostate with Thulium laser (Thulep)
- Prostate resection with Thulium laser (Tmlrp)
- Prostate eneculation with diode laser (Dilep)
- Prostate vaporization with diode laser (Dilvp)
- Prostate resection with Holmium laser (Holrp)
- Prostate enucleation (Holep) with holmium laser
HoLEP Device
When drugs are insufficient in the treatment of prostate, surgery becomes necessary. HoLEP is a laser method applied to patients who have BPH (benign prostate) and need surgical intervention. The HoLEP device has two different footswitches for enucleation and hemostasis.
How Long Does Prostate Surgery Take?
The duration of the prostate operation varies according to the size of the prostate and some characteristics depending on the patient. The surgical method applied for treatment is the most important factor affecting the duration of the operation.
In Turkey, you can have your prostate surgery done in a healthy and safe way with the successful work of our specialist doctors.