Treatment and Surgery Restoration of Prostate Diseases

• Cystoscopy
  Cystostopy is an endoscopic technique which is considered one of the most important “diagnostic urological tests”, for the examination of the lower urinary system. The test takes a short time, is carried out with local anaesthesia and can be performed in the urologist’s private office, provided it is equipped with the proper endoscopic equipment. The test uses a flexible cystoscope with a diameter of a few millimeters, and can check the urethra for damage in the sphincter or narrowing, the urinary bladder walls, the ureter mouths, the prostate size in men, or whether there are stones, a tumor or growth in the urinary bladder. During the cystoscopy, tissue samples can be collected for biopsy, and some pathological damages can be cauterized. After cystoscopy, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 2-4 hours and are treated with common pain killers. video

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• Urethroscopy
  Urethroscopy is an endoscopic technique which is considered one of the most important “diagnostic urological tests”. The test takes a short time, is carried out with local anaesthesia and can be performed in the urologist’s private office, provided it is equipped with the proper endoscopic equipment. The test uses a flexible cystoscope with a diameter of a few millimeters, and can check the urethra for damage in the sphincter or narrowing, inflammation or exophytic lesion. During the urethroscopy, tissue samples can be collected for biopsy, and some pathological damages can be cauterized. After urethroscopy, the patient may experience mild nuisance (burning sensation) during urination, as well as frequent urge to urinate. These problems do not last more than 2-4 hours and are treated with common painkillers. video

   

  Prostate T.R.U.S. Guided Biopsy
  The Transrectal Ultrasound Guided Biopsy of the Prostate (T.R.U.S. – BIOPSY) is a diagnostic test which can achieve timely and reliable diagnosis of prostate cancer. With a thin ultrasound transducer we can have a reliable and complete image of the prostatic gland. Also with the transducer’s guidance small tissue samples are collected with a special biopsy needle. The operation takes approximately 20 minutes and is carried out with topical anaesthesia or sedation. The test is safe and the nuisance that may be experienced by the patient during and after the operation is minimal and can be treated with common painkillers. video

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• Transurethral Resection of the Prostate (TURP)
  This operation uses a special instrument, the resectoscope, which consists of a cold light lense system, faucets for the liquid flow control, and an electric loop which cuts or cauterizes the tissues performing haemostasis. We approach the prostate through the urethra. With the resectoscope the prostatic tissue is cut in small pieces. The liquid which is infused carries the pieces along into the bladder, from where they are removed. The operation is carried out with general or spinal anaesthesia, does not last longer than 1 hour and the patient remains in hospital for 2 days. video

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• Transurethral Photoselective Vaporization of the Prostate – Green Light Laser
  This method is used in cases of benign prostatic hyperplasia. This is because it performs vaporization of the removed part of the prostate and there is no sample for biopsy. The operation is carried out through the urethra with an instrument similar to resectoscope, with which we insert a flexible optic fibre, the Green Light PV, which vaporizes the specific part of the prostate that we want to remove. Also, this instrument performs suction of the remaining parts of the prostate, and at the same time the tissues are cauterized and haemostasis is achieved. The operation is carried out with general or spinal anaesthesia, does not last longer than 1 hour and the patient remains 24 hours in hospital for observation. video

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  Bladder Neck Stenosis (Marion Disease)
  This condition is rare and is caused by the development of fibrous tissue on the urinary bladder neck. It is more commonly observed in boys. The surgical restoration of the condition is similar to that used in cases of benign prostatic hyperplasia. The operation is carried out through the urethra with a special instrument, with which we insert a flexible optic fibre, the Green Light PV, which vaporizes the specific fibrous tissue that we want to remove. Also, this instrument performs suction of the remaining parts of the tissue, and at the same time the tissues are cauterized and haemostasis is achieved. The operation is carried out with general or spinal anaesthesia, does not last longer than 1 hour and the patient remains 24 hours in hospital for observation. video   

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• Prostate Tumor – Total (Radical) Prostatectomy
  During this operation there is removal of the entire prostatic gland, the seminal vesicles, the nearby lymph nodes and the periprostatic adipose tissue. This operation can be performed in three ways:

  • Retropubic Prostatectomy: an incision is made in the abdomen, just under the navel to the pubic symphysis. The layers of the abdominal walls and the urinary bladder are opened, the lymph nodes in the lateral sides of the pelvis are excised and then the prostatic gland, the seminal vesicles and the periprostatic adipose tissue are removed. The operation is carried out with general anaesthesia and lasts 3 hours approximately. video

    

  • Perineal Prostatectomy: the prostatic gland is removed through an incision in the perineum between the scrotum and the anus. In this case, however, the pre-operative tests must have clearly shown that there is no possible metastasis of the cancer cells to the lymph nodes, because this operation does not allow access to, and therefore excision of, the lymph nodes. video
  • Laparoscopic – Robotic Prostatectomy: 5 or 6 1-1,5cm incisions are made in the abdomen, through which the laparoscopic instruments are inserted. This methods enables the surgeon to have a more direct access to the pathological tissues due to the better resolution of the images during the operation, it limits, however, the surgeon’s control and range of vision. video

  The operation is carried out with general anaesthesia and the duration of the patient’s hospitalization ranges from 5 to 9 days, depending on the surgical method selected and the post-operative condition of the patient.