Prostate removal, also known as prostatectomy, is a common surgical procedure used to treat prostate cancer, benign prostatic hyperplasia (BPH), and other prostate-related conditions.

Over the years, there have been significant advancements in prostate removal techniques, leading to improved outcomes and reduced side effects for patients. One such technique is Transurethral Resection of the Prostate with Integrated System (TURIS), which has revolutionized the field of prostate surgery.

This article discusses the advancements brought about by TURIS and its impact on the treatment of prostate-related conditions.

The Basics of Prostate Removal

Prostate removal involves the surgical removal of the prostate gland, which is located just below the bladder and surrounds the urethra.

The procedure is typically recommended for patients with prostate cancer that is confined to the prostate gland or for those with severe urinary symptoms caused by an enlarged prostate. Traditionally, prostatectomy was performed through open surgery, requiring large incisions and longer recovery periods. However, with advancements in technology and surgical techniques, minimally invasive approaches have become increasingly popular.

The Emergence of TURIS

TURIS, or Transurethral Resection of the Prostate with Integrated System, is a minimally invasive surgical technique that has significantly advanced prostate removal procedures.

It involves the use of specialized instruments and advanced visualization systems to remove the prostate gland, while minimizing damage to surrounding tissues. TURIS is primarily performed using endoscopic equipment through the urethra, without the need for external incisions.

Advantages of TURIS

TURIS offers several advantages over traditional open surgery and other minimally invasive techniques for prostate removal. Some of the key benefits include:.

Reduced blood loss: TURIS utilizes cauterization techniques, reducing the risk of bleeding during surgery.
Shorter hospital stays: The minimally invasive nature of TURIS often allows for shorter hospital stays, reducing healthcare costs and improving patient comfort.
Quicker recovery: Patients undergoing TURIS generally experience less pain, have smaller incisions, and recover faster compared to those who undergo open surgery.
Preservation of sexual function: TURIS aims to preserve the nerves responsible for sexual function, leading to improved outcomes in terms of erectile function.
Improved urinary outcomes: TURIS can effectively relieve symptoms related to urinary flow obstruction caused by an enlarged prostate.

How TURIS Works

TURIS involves the use of various instruments and techniques to remove the prostate gland. The procedure is typically performed under general anesthesia, and the surgeon accesses the prostate through the urethra using a cystoscope.

Here are the steps involved in a TURIS procedure:.

Step 1: Preparation

Prior to the surgery, patients may be required to undergo certain medical tests and evaluations. This is done to ensure that they are fit for the procedure and to determine the size and condition of their prostate gland.

Step 2: Visualization and Instrument Insertion

Once the patient is under anesthesia, a cystoscope is inserted into the urethra to provide visualization of the prostate gland. Specialized instruments are then inserted through the cystoscope to begin the removal process.

Step 3: Tissue Removal

The surgeon carefully removes tissue from the prostate gland using specialized instruments such as a resectoscope or laser. The goal is to remove as much of the prostate gland as necessary while minimizing damage to surrounding tissues.

Step 4: Hemostasis and Closure

During the tissue removal process, cauterization techniques are used to control bleeding.

Once the entire procedure is completed, the surgeon ensures that bleeding is under control and may place a catheter to assist with urine drainage during the initial recovery period.

Step 5: Recovery and Follow-up

After the procedure, patients are closely monitored in the recovery area to ensure they wake up from anesthesia smoothly and experience no immediate complications.

Depending on the patient’s condition, they may be discharged from the hospital within a day or two. Regular follow-ups with the surgeon are scheduled to monitor the patient’s progress.

Advancements in TURIS Technology

Over the years, there have been significant advancements in the technology used for TURIS procedures. These advancements have further improved outcomes and patient experiences. Some notable advancements include:.

1. Integrated Visualization Systems

Newer integrated visualization systems provide surgeons with high-definition, three-dimensional views of the surgical field. This enhanced visualization allows for better precision and accuracy during the tissue removal process.

2. Advanced Energy Sources

TURIS now utilizes advanced energy sources such as lasers and bipolar technology. These energy sources improve cutting and cauterization capabilities, reducing the risk of bleeding and promoting faster tissue healing.

3. Robotic Assistance

Robotic-assisted TURIS procedures are gaining popularity, as they offer improved dexterity and precision for surgeons. Robotic systems allow for better access to hard-to-reach areas and enhanced instrument maneuverability.

4. Real-time Imaging and Navigation

Newer systems incorporate real-time imaging and navigation capabilities, enabling surgeons to better visualize the prostate gland and surrounding structures during the procedure.

This helps in accurate tissue targeting and reduces the risk of damage to critical structures.

Risks and Considerations

While TURIS offers several advantages, it is essential to understand the potential risks and considerations associated with the procedure. Some common risks and considerations include:.

Bleeding: Though minimized compared to open surgery, bleeding is still a potential risk with TURIS.
Infection: There is a small risk of infection, which can be managed with proper hygiene and preventive measures.
Urinary disturbances: Temporary urinary disturbances such as urgency, frequency, or difficulty in urination may be experienced during the recovery period.
Erectile dysfunction: While efforts are made to preserve sexual function, there is still a risk of temporary or permanent erectile dysfunction.
Side effects: Patients may experience side effects such as retrograde ejaculation (semen flowing back into the bladder) and urinary incontinence, although these are generally temporary.

Conclusion

The advancement of prostate removal techniques through TURIS has revolutionized the field of prostate surgery.

It offers several advantages over traditional open surgery, including reduced blood loss, shorter hospital stays, quicker recovery, and improved urinary and sexual outcomes. With the continuous development of TURIS technology, patients can benefit from enhanced visualization, advanced energy sources, robotic assistance, and real-time imaging and navigation.

While considering the risks and considerations, TURIS remains a highly effective and minimally invasive option for prostate removal, providing improved patient outcomes and quality of life.