Prostate ablation is an operation to destroy the part of the prostate affected by the tumor. It is carried out transurethrally, which avoids infection and bleeding using laser, plasma or high-frequency radiation. The method differs from classical excision of the prostate in that it has fewer contraindications, safety and quick recovery.
The essence of the procedure
Prostate ablation involves removing the top layer using various methods to remove the tumor. It is an alternative to transurethral resection, but is more modern, has fewer contraindications, the recovery period is shorter and complications are less likely, however, the cost of its implementation is 2-3 times higher.
The duration of hospitalization for ablation does not exceed 2 days, rehabilitation - no more than 7 days, catheterization - no more than 24 hours. The procedure is performed under local or general anesthesia and lasts about one and a half hours.
The operation is performed transurethrally by inserting an endoscope into the urinary canal. The impact is carried out only on those tissues that need to be removed; the nearest vessels are cauterized, which avoids bleeding. After this, the affected tissue dies and is excreted in the urine.
Indications for testing
The procedure is prescribed when signs of acute renal failure appear due to urinary retention, severe pain, the development of an acute infection, or poor effectiveness of drug therapy.
Kinds
There are several types of ablation, depending on the technology used:
- Laser.
- Plasma.
- Needle-shaped.
The choice of method depends on the size of the tumor, individual parameters and contraindications.
Laser
Laser ablation of the prostate gland is the most commonly used method. Used for relatively small tumors, it allows you to reduce its size to insignificant or completely remove it.
Laser ablation of prostate adenoma can be carried out in 2 modes:
- Low energy. The beam penetrates deeper, forming necrotic cavities along the contour of the tumor, after which this area gradually dies and is removed by urination.
- High energy. With it, the beam acts superficially, gradually burning out the affected area.
Laser ablation is contraindicated for cardiovascular diseases, as well as for people with metabolic disorders, diabetes, hypertension and cardiac ischemia.
Plasma
Plasma ablation of prostate adenoma is practically no different from laser ablation, except for the method of exposure. During the operation, targeted plasma is used, which does not have a thermal effect on healthy tissue.
Unlike laser, it can be prescribed to patients with cardiovascular diseases, however, it is contraindicated in cases of impaired renal function. After it is carried out for 2-3 days, general intoxication is observed; small amounts of dying tissue may enter the blood.
Needle
The method was originally invented at the beginning of the 20th century, but has now been refined due to the development of medical technologies.
Transurethral needle ablation of the prostate (TUIA) is performed as follows. Needles with bipolar electrodes are passed through the urethra to the prostate gland, after which it is exposed to high-frequency waves. The affected tissue is briefly heated to a temperature of 110 °C, nearby vessels are cauterized, which prevents bleeding.
The method is contraindicated for acute urinary tract infections, bleeding disorders, and prostate cancer. It is also not recommended for people with a pacemaker installed.
The full rehabilitation period is 2-3 months. During the first 2-6 weeks, symptoms of adenoma may continue to be observed.
Possible complications
Destruction of the affected tissue is performed using a relatively gentle method, however, in some cases, postoperative complications may still occur. First of all, this happens due to the fact that the excised tissue is not removed from the body, which causes intoxication of the body. Minor bleeding may also occur, which will be observed at first when urinating, but this symptom goes away within 2 days. The most dangerous complication occurs in 10-15% of cases – recurrence of tumor development within several years after surgery.
Postoperative period
Complete rehabilitation after surgery occurs within a week, but the bulk of the tissues and functions are restored in the next 2 days. After the rehabilitation period, in 80% of cases, complete remission is observed, sexual function is restored and the process of urination is normalized.
After the operation there are no visible traces or scars.
In terms of safety and effectiveness, the method is somewhat inferior to laser vaporization, but superior to classical transurethral resection.
