How to perform transvesical prostatectomy

My husband recently underwent an operation, which was a transvesical prostatectomy. So what is transvesical prostatectomy like? Because my husband's daily living habits are not good, he often smokes and drinks, so he needs timely treatment when he suffers from diseases. Fortunately, we sent him to the hospital in time, but his condition was not very good after the operation, so we want to understand the specific situation of this operation. In this way, we can also understand his problem and find a doctor to learn about it. In terms of surgical care, we can pay attention to many things.

What is transvesical prostatectomy?

1. Lie on your back with your head slightly lowered and your legs slightly apart.

2. Make a midline incision in the lower abdomen, about 10 to 12 cm long. Pull open the rectus abdominis muscle in the middle. Use the index finger wrapped in wet gauze to push the peritoneum upward to expose the bladder.

3. Open the bladder and expose the prostate. Open the bladder on the pubic bone, suck out the flushing solution in the bladder with an aspirator, and extend the incision downward until the bladder neck and prostate are exposed.

4. Removal of the prostate Use a deep abdominal hook to open the bladder incision, and you will see the enlarged prostate. At this time, you should first explore whether there are other complications in the bladder (such as stones or diverticula, etc.). If stones are found, use lithotripsy to remove the stones. Then, use a long-handled knife or long curved scissors to make a horizontal incision at the most obvious point where the prostate protrudes into the bladder (usually the middle lobe of the prostate), cut the bladder mucosa and the prostate capsule, and separate them slightly with long curved scissors. Insert your fingers and separate the posterior side of the prostate first, then the left and right sides in the capsule. Finally, pinch the urethra at the front end of the gland to completely remove it.

If there is adhesion tissue deep in the prostate, it can be clamped with a tissue clamp and lifted up, and then cut off with long curved scissors. After the gland is completely removed, the glandular fossa is immediately blocked with a hot salt water gauze strip to control bleeding. The gauze strip must be blocked exactly in the glandular fossa. The removed gland needs to be checked for integrity.

5. After 10 minutes of suturing to stop bleeding, remove the gauze plug and check the glandular crypt. If there is a lot of bleeding at the edge of the glandular crypt, use chromium intestinal thread to suture the bladder mucosa and the posterior edge of the prostate capsule at 5 to 7 o'clock to stop bleeding. When suturing, the needle should not be inserted too deep to avoid piercing the rectum or damaging the ureteral orifice. Generally, the bleeding can be stopped.

6. The incision is sutured and cigarettes are placed in the space behind the pubic bone for drainage, which is then led out from below the incision. The abdominal wall is sutured layer by layer with silk sutures. The balloon catheter is fixed to the anterior inner side of the left thigh with tape under a certain tension.

The above content is about the specific situation of transvesical prostatectomy. Patients are under anesthesia during surgery and cannot understand the situation of the surgery. After understanding the above content, we can find out what problems the patient will have after the surgery, and understand what is normal and what is abnormal. Abnormal problems must be solved by doctors in time.