Hypertrophy of the prostate, so ejaculation is saved
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It is the most frequent side effect and the greatest fear of all those men who have to undergo surgery for the enlargement of the prostate gland: retrograde ejaculation, directed towards the bladder and not towards the outside. However, this fear can also be addressed due to the evolution of surgical and endoscopic techniques capable of intervening on prostate hypertrophy, albeit in selected cases, preserving this function and ensuring the patient a better quality of life. And with flattering results, which approach 85%.
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In selected cases, however. The application of specific techniques naturally depends on the type of patient, the size of the prostate and his age. Hypertrophy is a very common condition, affecting over 6 million Italians over 50, with ever higher incidence rates as they age. And retrograde ejaculation is a consequence that can affect up to 65% of cases. Thanks to new modifications introduced in the most common surgical techniques (Turp, enucleation and vaporization), the ejaculatory function was already spared, also improving normal urinary function.
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Alternatives that today are enriched with minimally invasive techniques that aim to preserve sexual function and improve urinary disorders, thus preserving the quality of male life in its entirety. Among these are Urolift and, although still experimental, Aquabeam, Rezum, ‘iTind. All news that will be discussed at the 95th National Congress of the Italian Society of Urology (SIU) which opens tomorrow in Riccione.
How it works
“Prostatic hypertrophy – he explains Giuseppe Carrieri, SIU Secretary General and Professor of Urology at the University of Foggia – is treated with surgery or endoscopy, such as prostatic adenomectomy, transurethral resection of the prostate (Turp) and various types of laser enucleation. But most of the interventions, up to 65% of cases, cause the appearance of retrograde ejaculation with the emission of seminal fluid towards the inside, that is towards the bladder, and not towards the outside. It also has an erectile deficit rate of 6.5%, regardless of the amount of tissue removed. The consequence is profound psychological distress, especially in younger patients. Today, thanks to new techniques it is possible to minimize these risks “.
The novelties in use
“The Urolift – he adds Vincenzo Ficarra, head of the SIU scientific office and professor of Urology at the University of Messina – is a procedure that can be performed in an outpatient or day hospital, which involves the implantation of devices (similar to clothespins) of very small dimensions capable of keeping the urethral canal open exerting traction on the obstructing prostatic lobes. The iTind is a kind of intraprostatic stent, placed endoscopically in the prostatic urethra and left in place for about 5-7 days, before being removed on an outpatient basis. Once positioned, the device expands itself causing ischemic pressure on the prostatic urethra and the neck of the bladder thus favoring the formation of a channel that allows the passage of urine.
Thermal energy and water vapor
Rezum is a minimally invasive procedure that uses water vapor. This is injected through a very thin needle into the hypertrophic prostate tissue. The thermal energy diffused into the interstitium of the prostate tissue by convection causes rupture of the cell membranes with consequent progressive reduction of the volume of the prostate gland. The Acquabeam system uses a jet of water without using thermal energy. The pressure of the water destroys the prostate tissue without thermal or mechanical consequences for the neighboring tissues “.
Who suffers from prostate
Benign prostatic hypertrophy is the enlargement of the prostate, the male gland that secretes seminal fluid and affects ejaculation, erection and urination. It is a disease that affects over 6 million Italians over 50 years old: half of those aged between 51 and 60, 70% of 61-70, even 90% of those in their eighties. This does not mean, however, that the youngest are excluded: it also affects 8% of males under 40 years of age. Given its high incidence, it is essential not to overlook the symptoms that present themselves in the form of urinary disorders such as difficulty in urination, frequency in urinating, burning and the need to empty the bladder.
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