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.

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Copyright 2019 Dr Jo Schoeman