Less than a year after transurethral resection of benign prostatic hyperplasia, how did urinary symptoms appear recently?

Prostatic hyperplasia is a common disease in elderly men. When prostate hyperplasia develops to a certain extent, surgery is needed. At present, the main surgical method is transurethral resection of prostate.

Subjects asked why there was a waiting time for urination one year after transurethral resection of prostate. If the factors such as urinary tract infection, urinary calculi, drunk stimulation and diabetic bladder injury are excluded, let's start with the common long-term complications after transurethral resection of prostate!

Common long-term complications after transurethral resection of prostate

1, urethral stricture

After the operation, the hyperplastic prostate tissue is removed, the urinary tract obstruction is relieved, and urination will suddenly become extremely easy. However, some patients will have dysuria again soon after discharge. At this time, the possibility of urethral stricture is great!

According to the literature, the probability of urethral stricture after transurethral resection is about 3.5%.

Causes of urethral stricture;

① During the operation, the urethral orifice is narrow, and the electrosurgical endoscope forcibly passes through the urethral orifice, resulting in urethral injury. Scar stenosis was formed at the injured site after operation.

② Contraction of bladder neck. Most of them are related to scar contracture of bladder neck after resection of bladder neck tissue. Urethral cystoscopy showed that the mucosa of bladder neck was stiff and edema, with poor toughness and raised posterior lip.

③ Repeated urethral infection can lead to urethral adhesion and stricture.

Once dysuria occurs shortly after discharge, you should go to the hospital in time to check whether there is urethral stricture!

Most urethral strictures can be relieved by regular urethral dilatation, and some serious strictures need incision/resection.

2. Prostatic hyperplasia recurred.

The recurrence of benign prostatic hyperplasia is mostly related to the residual benign prostatic hyperplasia tissue during operation. The more residual tissue, the easier it is to relapse! Literature reports that the recurrence rate can reach 65438 07% within 5 years after transurethral resection of prostate.

① In transurethral resection of prostate, if the resection is too deep, it may cut the capsule and cause urine extravasation; If the resection is too shallow, it will lead to prostatic hyperplasia gland residue. If you want to completely remove hyperplastic glands without causing additional damage, just like a watermelon, it is very difficult to eat red soil completely without eating a little bit of white clay. In fact, even the "best" electrotomy experts in the world can only remove it almost completely, and some benign prostatic hyperplasia tissues will remain.

② For the prostate with large hyperplasia volume, the resection time is longer. Patients with benign prostatic hyperplasia are all elderly people, and the longer the time, the greater the risk. In order to ensure the safety of patients during surgery, sometimes only a part of the prostate is removed, and the urinary tract is opened without affecting urination. If it recurs in the future, you can have another operation.

There is a patient with prostatic hyperplasia in the author's hospital bed. More than a year ago, he received transurethral resection of prostate in a 3A hospital in Beijing. One year after operation, dysuria occurred again. A few days ago, I suffered from acute urinary retention (completely unable to urinate) and inserted a catheter. Color Doppler ultrasound showed that the prostate was 52mm 52mm 57mm, the calculated volume was about 80 grams, and it grew very big. He was going to have another operation.

3, urinary incontinence.

Urinary incontinence after transurethral resection of prostate is mostly temporary incontinence, and only a few are permanent incontinence.

Urinary incontinence often occurs a few days after catheter removal. Before the operation, the prostate urethra was squeezed and narrowed, and after the operation, it suddenly became unusually spacious. Before running to the toilet, it would happen that you peed your pants!

Temporary urinary incontinence is related to local edema, slight injury of external sphincter and dysfunction of external sphincter. Most patients recovered within 265438 02 weeks after operation. If urinary incontinence does not improve after 6 months, there is a greater possibility of permanent urinary incontinence, which is related to the injury of external sphincter caused by excessive incision during operation.

After urinary incontinence, you can temporarily use a urine pad for pelvic floor muscle training (levator ani exercise). When urinary incontinence still exists after 6 months, surgical treatment should be considered.

4. Sexual dysfunction.

It is reported that the most common complication after transurethral resection of benign prostatic hyperplasia is retrograde ejaculation, the incidence rate is over 50%, and penile erectile dysfunction accounts for about 10%.

Retrograde ejaculation has little effect on elderly men, and semen injected into bladder will be discharged with urine.

Penile erectile dysfunction can be treated with drugs.

According to the 20 19 annual meeting of American urology society, from 200 1 to 20 16, ***2304 patients underwent transurethral resection of prostate, with an average of 19.5 months after operation, 148 patients (6.4%)

Conclusion: Less than one year after transurethral resection of benign prostatic hyperplasia, there is waiting for urination, so whether there are postoperative complications, such as urethral stricture or recurrence of benign prostatic hyperplasia, should be considered. Mild urethral stricture requires urethral dilatation, and benign prostatic hyperplasia needs drug treatment in the early stage of recurrence. When the situation is serious, another operation is needed. Of course, there may also be factors unrelated to surgery, such as urinary tract infection, urinary calculi, drunken irritation, diabetes and so on. , can cause temporary urination waiting.

There are many reasons why the urinary period is less than one year after transurethral resection of prostate, but they can be roughly divided into two categories: one is related to surgery; Second, it has nothing to do with surgery.

How to solve the problem of operation-related factors and operation-unrelated factors?

Generally speaking, the symptoms caused by prostate are closely related to sedentary, holding urine, spicy diet and drinking. You need to take some after you have been diagnosed by urine routine, urine culture and prostate fluid routine. Chinese patent medicines for clearing away heat and promoting diuresis, relieving stranguria and promoting diuresis were treated symptomatically for four to eight weeks, and the symptoms were obviously relieved. Usually, you can take a hot bath every time before going to bed to promote the blood circulation of the prostate.

Prostatic hyperplasia will bring obvious urination problems to patients. Glandular hyperplasia changes from small to large, which makes the patient's urination problem more and more serious. Some patients will have early symptoms such as frequent micturition, urgent micturition, increased nocturia, delayed micturition, dysuria, urinary drip and urinary incontinence, and patients will have frequent micturition and increased nocturia times; With the aggravation of the course of disease, patients will have problems such as waiting for urine and dysuria. This is because the mechanical obstruction to urethra is aggravated after gland enlargement, which leads to the aggravation of dysuria in patients, and some patients will also have the phenomena of thin urinary line, bifurcated urine and endless urine flow. Patients with severe hyperplasia have urinary incontinence, which may lead to acute urinary retention.

Urinary symptoms are common in prostate diseases, and then with the accumulation of urine, the pressure is getting higher and higher, and finally discharged through the urethra. Suffering from prostatitis leads to a decrease in the ability of the posterior urethra to store urine, that is, urine is more sensitive to the urethra, so when the pressure drops, it will lead to a decrease in the pressure of the posterior urethra, thus reducing the power of urination, so there will be urinary symptoms.

Now there are symptoms of urination, and there are three main possibilities for analysis:

1. Inattention to living and eating habits after operation led to recurrence of symptoms. For example, frequent masturbation, staying up late, sedentary, urinating, drinking, frequent sexual life and so on. , will induce repeated attacks of prostatitis, prostatic hyperplasia is also developed on the basis of prostatitis.

2, prostatectomy, in fact, is mainly to remove some hyperplastic glands, not all, so it does not mean that surgery will be cured. Then, under the influence of the external environment, it is still possible to continue to increase, so pressing the posterior urethra at this time will cause abnormal urination.

3. It is not only a problem of prostatic hyperplasia, but also accompanied by prostatic calcification. It is known that early prostatic calcification is asymptomatic, and when it develops gradually, abnormal urination and sexual dysfunction will occur.

At present, the best way is to do a B-ultrasound of prostate to see what gland it is.

What causes the urgency of urination? There are two main categories:

First, the contraction function of bladder and urinary system is insufficient.

Second, the sphincter function is too full, that is, there is urinary tract obstruction caused by lower urinary tract obstruction, urethral stricture or prostatic hyperplasia, which leads to poor urination and waiting for urine. In other words, the bladder and urinary system must undergo intense contraction, so that urine can enter the sphincter of prostate valve, relax, and then be excreted through urethra.

Patients with severe symptoms, obvious obstruction or complications should choose surgery. If there is urinary tract infection, residual urine, hydronephrosis and renal insufficiency, it is advisable to indwelling catheter or cystostomy to drain urine first, and treat it with anti-infection, and then choose surgery after the above situation is obviously improved or recovered. The effect of the operation is positive, but there are some pains and complications. Transurethral resection of prostate is suitable for most patients with benign prostatic hyperplasia and is the most commonly used surgical method at present.

All the tests are normal, which can only be explained by Chinese medicine. Traditional Chinese medicine believes that there are symptoms such as damp-heat betting, small intestine heat accumulation, urinary incontinence, dysuria, waiting for urination, frequent urination, urgency and dysuria. Suggestion: It is necessary to use some heat-clearing and dehumidification granules properly, and some Relinqing granules or Sanjin tablets can also be used for treatment. Drink more water, avoid fatigue, eat more fruits and vegetables and avoid drinking alcohol, which is conducive to the recovery of the disease.

Treatment of bleeding after transurethral resection of benign prostatic hyperplasia includes:

1. Hemorrhage during hospitalization: The main reasons are bleeding caused by poor hemostasis, diabetes, hypertension or anticoagulant drugs. Conventional hemostasis adopts air bag compression, or hemostatic drugs are added to the washing liquid. If the hemostasis effect is not good, it needs to be operated again to stop bleeding;

2. Delayed bleeding: The main reasons are poor wound growth, excessive activity or urinary tract infection. If hematuria occurs at the beginning or end of urination, anti-infection treatment can be strengthened, and patients are advised to drink more water and pay attention to rest; The whole process of hematuria requires timely medical treatment.

Long-term adherence to eating food with the function of "warming kidney and strengthening yang" can bid farewell to the troubles of "sub-health and chronic diseases"; Say goodbye to the trouble of "men's health and prostate" and let men be happy with Yang Yang from now on! Strong body! Women are full of blood, no spots, no fat and beautiful! Healthy all your life!

Go to the hospital for a check-up. No problem. The following methods help to improve. Eat some rape pollen, exercise more at ordinary times, eat less greasy things, eat as little meat and salt as possible, not to mention alcohol and tobacco. Going to bed early should gradually improve. Many people like to stay up late, including me. In fact, staying up late will cause underground immunity, not only hurting other organs.