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Prostatolithotomy
What is
Prostatolithotomy?
Prostatolithotomy involves the incision of the
prostate for removal of a calculus.
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Effects
of Prostatolithotomy
In
some men, infected prostate stones may cause
recurrent urinary tract infections (UTIs) and
make it difficult to cure bacterial prostatitis.
The stones may have to be removed with surgery
before UTIs or chronic prostatitis can be
resolved.
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Candidates for Prostatolithotomy
Prostatic calculi are extremely common in men
over 50 years of age but infrequent in patients
below 40 years and rare in children.
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Your Consultation
Prostatic calculi rarely present as a clinical
problem and their diagnosis is usually obtained
by plain radiology or transrectal
ultrasonography. Treatment of the calculi is
often not required, but usually involves
transurethral resection although ESWL with
suprapubic percutaneous extraction has been
described.
Large prostatic calculi detected pre-operatively
in the presence of small amounts of resectable
prostatic tissue should be treated and extracted
as aggressively and completely as possible at
the first intervention to avoid the necessity of
repeat intervention.
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The
Prostatolithotomy Procedure
If a
Prostatolithotomy is done under local anesthesia
through the area between the anus and scrotum
(perineum), no other special preparation is
needed.
If the
biopsy is done through the rectum, you may need
to have an enema before the biopsy.
If the biopsy is done under general anesthesia,
do not eat or drink anything for 8 to 12 hours
before the biopsy. During preparation for the
biopsy, an intravenous line (IV) is inserted in
your arm, and a sedative medication is given
about an hour before the biopsy.
For a
Prostatolithotomy, a thin needle is inserted
through the rectum (transrectal biopsy), through
the urethra, or through the area between the
anus and scrotum (perineum). A transrectal
biopsy is the most common method used. The
tissue samples taken during the biopsy are
examined for cancer cells.
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Recovery
Hospital stays range from one day to one week,
depending upon the level of organ involvement
and type of urologic surgery (open versus
laparoscopic). Major urologic surgeries may
require stents (temporary diversion of urine or
feces) and catheters that are removed after
surgery. Some surgeries are staged in two parts
to accommodate the removal of diseased tissue,
and the augmentation or reconstruction to
replace function.
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Risks
The
risks of urologic surgery vary with the type of
surgical procedure and the extent of organ
involvement. Open surgery poses the standard
surgery and anesthetic risks associated with
strain on the heart and lungs. Risks of
infection at the wound site accompany all
surgeries, open and laparoscopic. The risk of
injury to adjacent organs is higher in
laparoscopic surgery.
Significant gains have been made in prostate
surgery. Urinary control issues following
prostate surgery, especially radical
prostatectomy, have improved. However,
postoperative urinary incontinence remains a
significant risk, with 27% of patients in one
study reporting the need for some kind of
leakage protection. In the same study, only
14.2% of previously potent men reported the
ability to achieve and maintain a postoperative
erection that is sufficient for sexual
intercourse.
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Frequently Asked Questions
Q:
What are prostatic calculi?
A:
Prostatic calculi are usually composed of
calcium phosphate stones formed either by simple
precipitation of prostatic secretions or
calcification of the corpora amylacea. They may
arise either spontaneously or as a result of
inflammation, infection or obstruction.
Q: What are the
signs and symptoms of prostatic calculi?
A:
Symptoms attributed to prostatic calculi are
rare and include reduction of the urinary
stream, lower back and leg pain, recurrent
passage of calculi after TURP and orchitis.
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The following list of Urology procedures are
performed at Beverly Hills Medical Group -
please click the links to find out more:
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