Prostate Restored
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How much of the prostate is removed during TURP?

While enlargement of the prostate happens to most men, fewer than 10% will require surgery. The TURP procedure cannot be used to cure prostate cancer because it removes only the parts of the prostate closest to the urethra, while leaving the majority of the gland intact.

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Once you are asleep, Dr Swindle will start the operation by inserting a fine telescope down the penis into the urethra. The urethra is the tube that drains urine from the bladder to the penis. This instrument allows Dr Swindle to examine the urethra, prostate and bladder. After the prostate has been inspected an instrument called a resectoscope is then used to cut away the enlarged prostate tissue. The tissue is cut by a wire loop at the end of the resectoscope that has an electrical current running through it. The wire loop both cuts the prostate tissue and seals blood vessels. The procedure usually takes about 1 hour and at the end of the procedure you will be transferred to the recovery ward where nurses keep a close eye on you for about an hour or so before transferring you back to the ward. At the end of the operation a urinary catheter, which is a soft plastic tube, is placed inside the urethra to drain the urine from the bladder. The catheter is then connected to bags of fluid (saline or salty water) that wash out any blood that may accumulate in the bladder. It is normal for your urine to appear red or blood stained. This should not cause alarm and the irrigation into your bladder will continue until your urine is a clear color.

The following diagram demonstrates the procedure:

During transurethral resection of the prostate (TURP), Dr Swindle inserts a thin tube called a resectoscope into the urethra and threads it up into the enlarged prostate. The resectoscope contains a tiny camera allowing the surgeon to view the gland throughout the operation, as well as an electrical loop. Dr Swindle uses the loop to chip away at overgrown prostate tissue blocking the urethra.

After the procedure, the enlarged passageway allows urine to flow more easily.

The tissue that is removed from your prostate will be sent to the pathologist for assessment to ensure there is no prostate cancer present. If you have a spinal anaesthetic you will be awake but drowsy and it is important that you remain still whilst Dr Swindle is operating. You will not feel any pain during the operation. There will be a feeling of numbness or heaviness in your legs for several hours after the operation and this is quite normal.

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Why do I have a hard on all day?

The medical name for having an erection that will not go down is priapism. It happens when the blood that fills the penis to make it erect gets trapped and cannot flow back out again. Priapism can cause severe pain. A prolonged erection can damage the penis and could cause permanent problems in getting an erection.

If you've had an erection for more than 4 hours, go to your nearest accident and emergency (A&E) department. If it's been less than 4 hours, the following tips may help: gentle exercise, such as jogging or using an exercise bike, may help your erection go down having a warm bath may also benefit, as can having a pee. Having had a warm bath may make it easier for you to pee use paracetamol or ibuprofen to relieve the discomfort However, if these steps do not help and you've had an erection for more than 4 hours, go to A&E, as this is an emergency. Why won’t my erection go down? The medical name for having an erection that will not go down is priapism. It happens when the blood that fills the penis to make it erect gets trapped and cannot flow back out again. Priapism can cause severe pain. A prolonged erection can damage the penis and could cause permanent problems in getting an erection. Therefore, it's important that priapism is treated quickly. What causes priapism? The cause of priapism is often unknown. It can be due to nerve damage or a side effect of some medicines, such as those for erectile dysfunction (impotence). It can also be caused by conditions that affect the blood, such as sickle cell disease or leukaemia, or by an injury to the penis or genital area. Alcohol and some illegal drugs can also cause priapism. Will I need treatment? Treatment for priapism may involve taking medicine or draining blood from the penis. If the priapism is caused by an underlying condition, this will need to be treated. Surgery may be necessary to prevent permanent damage.

Further information Why can I not get and keep an erection?

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