"Enlarged Prostate" is a disease of the elderly. After the age of fifty, the prostate gland starts increasing in size. But all men do not have problems.

The Prostate Gland :

Shape     :  Like a chestnut (Supari)

Position:  It is located at the Junction of the bladder and the urethra

Function: The gland produces a part of the seminal fluid. After the age of 50, it hardly has got any utility. It grows and causes blockage to the urethra. As a result urine cannot pass freely

Symptoms:

1. Urinary Flow or speed becomes slow
2. Hesitancy-Finds it difficult to begin
3. Passes urine several times at night
4. Daytime frequency also increased
5. Delay in passing urine-takes a long time to complete
6. Finally Retention of urine
7. Completely unable to pass urine

MICROSURGERY of PROSTATE (TURP)

Pre-op Check List :

1. Blood -Hb,
2. TC/DC Urea,
3. Creatinine
4. Urine-C/S
5. E.C.G.
6. USG of KUB

Preparation :

1. Patient should be admitted to the hospital the day before the operation.
2. Patient can have normal diet on admission.

Anesthesia:

1. Spinal - This means an injection would be given in the spine.
2. There would be no pain sensation from Umbilicus and below.
3. Patient would be conscious.
   
   Is the procedure Painful ? Ans : NO

Steps of TURP or MICROSURGERY

• The Resectoscope is introduced through the Urethra.
• The instrument is then connected to the Diathermy
• The Prostate gland is then cut into small chips
• The chips are then sucked out through a special instrument
• The instrument is then removed and a Catheter is then introduced

Procedure in the WARD

• Patient can eat and drink after two hours.
• Irrigation is continued—Fluid flows from a bottle through the catheter into the bladder and then out into an Urobag. The purpose of irrigation is to wash the blood and rubbish from the bladder  to the outside.
• Irrigation stops after 24 hours.
• Patient can walk on the Ward with the Catheter and Urobag.
• Catheter is removed Three days after the Operation.

DISCHARGE

Can go home after the day after the Catheter is removed.

Home Protocall

1. Patient should be taking rest but can walk
   normally
   Can go to the toilet for passing Urine & Stool
   Can have bath normally
   Can climb stairs but may be tiring
2. Diet: Plenty of fluids orally (3 Lts)
   Normal food as before operations
3. Medicine : Antibiotics to continue for 15 days
4. Weakness: Expected for first 2 to 4 weeks Adequate rest is enough
5. Blood in Urine :
   There will blood stained urine - drink more fluids
   If blood increases - Tab dicynene 500 mg three times daily
   If more blood - Contact doctor
6. Blockage - Passage may be blocked by blood clot or rubbish. Will need to be washed in Hospital.

FOLLOW UP SCHEDULE

1) 2 Weeks later

1. Consultation with Surgeon.
2. Check Biopsy Report.

2)   1 Month later
- See Consultant with report of Urine C/S.