Item Number: 37203
This is the procedure used to resect the inside (enlarged, obstructive part) of the prostate. Known generally as the “Re-Bore”. Glycine is used as an irrigant.
Why is it done?
- This procedure is performed when the prostate gland is enlarged to such an extent that medication cannot relieve the urinary symptoms.
- Symptoms include a weak stream, nightly urination, frequent urination, inability to urinate, (LUTS) kidney failure due to the obstruction, bladder stones, recurrent bladder infections.
- Medication such as Flomaxtra, Urorec Minipress etc. should always be given as a first resort.
- Step-up therapy should have been used for prostates larger than 35-50cc with either Duodart, Avodart or Proscar
- Prostate cancer first needs to be ruled out by doing a PSA, and when indicated, with a 3T MRI scan of the prostate with an abnormal PSA with a possible prostate biopsy of any suspicious lesions.
- A TURP can also be performed to dis-obstruct severe prostate cancer, to allow a normal urination process.
How is it done?
- Patients will receive a general anaesthesia, unless contra-indicated.
- A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant jelly and an irrigant fluid.
- The inside of the bladder is viewed for pathology. If any suspicious lesions are seen, a biopsy will be taken.
- A resection of the prostate is then started and should take 60-90 minutes.
- Prophylactic antibiotics will be given to prevent any infections.
Complications
Side–effects
- Retrograde ejaculation in more than 90% of patients. Therefore if you have not completed your family, this procedure is not for you unless absolutely necessary.
- Infertility as a result of the retrograde ejaculation.
- Stress incontinence especially in the elderly and diabetic patients
- Patients with Multiple Sclerosis, Strokes and Parkinsons have a higher risk of incontinence and risks should be discussed and accepted prior to surgery.
- Urethral structuring in 2-3% of patients, requiring intermittent self-dilatation.
- Regrowth of prostate lobes within 3-5 years requiring a second procedure.
NB! Each person is unique and for this reason, symptoms vary.
Copyright 2019 Dr Jo Schoeman