ʻO ka Prostate resection - minimally invasive

ʻO ka hoʻokiwikā prostate invasive liʻiliʻi kahi ʻoki e wehe i kahi ʻāpana o ka gland prostate. Hana ʻia e mālama i kahi prostate hoʻonui ʻia. E hoʻomaikaʻi ka ʻoki ʻana i ke kahe o ka mimi ma o ka urethra, ka paipu e lawe ana i ka mimi mai ka pūpū ma waho o kou kino. Hiki ke hana i nā ʻano ʻokoʻa. ʻAʻohe ʻoki (ʻoki) i kou ʻili.

Hana pinepine ʻia kēia mau kaʻina hana i ke keʻena o kāu lawelawe mālama ola a i ʻole i kahi keʻena hōʻoki kino.

Hiki ke hana i ke ʻoki ma nā ʻano he nui. E pili ana ke ʻano o ke kaha ʻana i ka nui o kāu prostate a me ke kumu o ka ulu ʻana. E noʻonoʻo kāu kauka i ka nui o kāu prostate, pehea kou olakino, a he aha ke ʻano o ke ʻoki āu e makemake ai.

Hana ʻia kēia mau kaʻina hana āpau e ka hele ʻana i kahi mea kani ma o ka wehe ʻana i kāu penis (meatus). Hāʻawi ʻia ʻoe i ka anesthesia laulā (hiamoe a ʻaʻohe ʻeha), anesthesia spinal or epidural (ala akā ʻaʻohe ʻeha), a i ʻole anesthesia kūloko a me ka sedation ʻO nā koho i hoʻokumu paʻa ʻia:

• ʻO ka prostatectomy laser. Lawe kēia kaʻina hana ma kahi o 1 a 2 mau hola. Luku ka laser i nāʻiʻo prostate i ālai i ka wehe o ka urethra. E hoʻi paha ʻoe i ka hale i ka lā like. Pono ʻoe i kahi catole Foley i kau ʻia i loko o kāu pēke e kōkua ai i ka hemo ʻana i ka mimi no kekahi mau lā ma hope o ke kaha ʻana.
• ʻO ka hoʻopau ʻana o ka nila kuʻuna (TUNA). Hāʻawi ke kauka i nā nila i loko o ka prostate. ʻO nā nalu kani pinepine (ultrasound) hoʻonā i nā nila a me nāʻiʻo prostate. Pono ʻoe i kahi catole Foley i kau ʻia i loko o kāu pēpē e kōkua ai i ka hemo ʻana o ka mimi ma hope o ke kaha ʻana no 3 a 5 mau lā.
• ʻO ka thermotherapy transurethral microwave (TUMT). Hāʻawi ʻo TUMT i ka wela me ka hoʻohana ʻana i nā pulses microwave e hoʻopau i kaʻiʻo prostate. E hoʻokomo kāu kauka i ka antenna microwave ma o kāu urethra. Pono ʻoe i kahi catole Foley i kau ʻia i loko o kāu pēpē e kōkua ai i ka hemo ʻana o ka mimi ma hope o ke kaha ʻana no 3 a 5 mau lā.
• Transurethral electrovaporization (TUVP). Hāʻawi kahi mea hana a mea hana paha i kahi uila uila ikaika e luku i nāʻiʻo prostate. E kau ʻoe i kahi catheter i loko o kāu ʻōpū. Hiki ke hoʻoneʻe ʻia i loko o nā hola ma hope o ke kaʻina hana a i ʻole hoʻi ʻoe e hoʻi me ʻoe i ka home.
• ʻOkiʻoki Transurethral (TUIP). Lawe kāu kauka lāʻau i nā ʻokiʻoki liʻiliʻi kahi e hui ai ka prostate i kāu ʻōpū. Hoʻonui kēia i ka urethra. Lawe kēia hana i 20 a 30 mau minuke. Hiki i nā kāne he nui ke hoʻi i ka hale i ka lā like. Hiki ke hoʻopau piha i 2 a 3 mau pule. Hiki paha iā ʻoe ke hoʻi i ka hale me ka catheter i loko o kāu ʻōpū.

Hiki i kahi prostate nui ke paʻakikī iā ʻoe e mimi. Hiki paha iā ʻoe ke loaʻa nā maʻi maʻi urinary. ʻO ka wehe ʻana i nā mea āpau, a ʻāpana paha, o ka gland prostate hiki ke hoʻomaikaʻi i kēia mau ʻōuli. Ma mua o kou ʻoki ʻana, e haʻi paha kāu kauka iā ʻoe i nā loli i hiki iā ʻoe ke hana i kāu ʻai ʻana a i ʻole inu ai. Hiki paha iā ʻoe ke hoʻāʻo i kekahi mau lāʻau.

Paipai ʻia ka hemo ʻana o ka prostate inā ʻoe:

• ʻAʻole hiki ke hoʻonele loa i kāu pēpē (hoʻopaʻa urinary)
• Loaʻa hou i nā maʻi maʻi urinary
• Loaʻa i ke kahe o kāu prostate
• Loaʻa i nā pōhaku bladder me kāu prostate hoʻonui ʻia
• Mimi lohi loa
• Lawe i nā lāʻau, a ʻaʻole lākou i kōkua i kāu ʻōuli a i ʻole makemake hou ʻoe e lawe

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• Lilo ke koko
• Nā pilikia hanu
• Ka hōʻeha puʻuwai a i ʻole hahau i ka wā o ke ʻoki
• ʻO ka maʻi, e komo pū ana me ka ʻeha ʻoki, paru (pulumonia), pūpū, a me nā puʻupaʻa
• Nā hopena i nā lāʻau

ʻO nā pilikia ʻē aʻe no kēia ʻoki kino:

• Nā pilikia kūkulu hale (impotence)
• ʻAʻohe hoʻomaikaʻi hou ʻia
• Ke hoʻi nei i ka semen i loko o kāu pēke ma kahi o ka urethra (e hoʻoneʻe retrograde)
• Nā pilikia me ka mimi kaohi (incontinence)
• ʻO ke koʻikoʻi urethral (ke hoʻopaʻa nei i ka puka urinary mai nā maʻi makaʻu)

E kipa nui ana ʻoe me kāu mea hoʻolako a me nā hoʻokolohua ma mua o ke kahakaha ʻana.

• Piha hōʻike kino
• ʻO nā kipa me kāu kauka e hōʻoia ai e mālama maikaʻi ʻia nā pilikia olakino, e like me ka maʻi diabetes, ke koko kiʻekiʻe, a me nā pilikia puʻuwai a i ʻole māmā
• ʻO ka hoʻāʻo ʻana e hōʻoia iā ʻoe he anatomy bladder maʻamau a me kāu hana

Inā ʻoe he puhipaka, pono ʻoe e hooki i kekahi mau pule ma mua o ke kaha. Hiki i kāu mea hāʻawi ke kōkua.

E haʻi mau i kāu mea hāʻawi i nā lāʻau, nā wikamina, a me nā mea hoʻopili ʻē aʻe āu e lawe nei, ʻo nā mea āu i kūʻai ai me ka ʻole o ka lāʻau.

I loko o nā pule ma mua o kou ʻoki kino:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i ka aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamini E, clopidogrel (Plavix), warfarin (Coumadin), a me nā lāʻau e like me kēia.
• E nīnau i nā lāʻau āu e lawe ai i ka lā o kou ʻoki ʻana.

I ka lā o kou ʻoki kino:

• Mai ʻai a inu paha i kekahi mea ma hope o ke aumoe i ka pō ma mua o kou ʻoki ʻana.
• Lawe i nā lāʻau i kauoha ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila a i ʻole ka haukapila.

Hiki i ka hapa nui o ka poʻe ke hoʻi i ka home i ka lā o ke ʻoki, a i ʻole ka lā ma hope. Loaʻa paha iā ʻoe kahi catheter i loko o kāu pēpē ke haʻalele ʻoe i ka haukapila a i ʻole ke keʻena maʻi.

ʻO ka hapa nui o ka manawa, hiki i kēia mau kaʻina hana ke hoʻokuʻu i kāu mau ʻōuli. Akā loaʻa iā ʻoe kahi manawa kiʻekiʻe e pono ai kahi ʻoki ʻelua ma 5 a 10 mau makahiki ma mua o ka loaʻa ʻana o transurethral resection o ka prostate (TURP).

ʻO kekahi o kēia mau hana ʻokiʻoki liʻiliʻi hiki i ka liʻiliʻi o nā pilikia me ka kaohi ʻana i kou mimi a i ʻole hiki ke moe kolohe ma mua o ka TURP maʻamau. E kamaʻilio me kāu kauka.

Loaʻa paha iā ʻoe nā pilikia aʻe no kekahi manawa ma hope o ke kahakaha ʻana:

• Koko i kou mimi
• Puhi me ka urination
• Pono e mimi pinepine hou aku
• Hoʻoikaika koke e urino

Greenlight kukuna prostatectomy; ʻO ka hoʻopau ʻana o ka nila kele; TUNA; ʻOkiʻoki Transurethral; TUIP; Hoʻolahi Holmium kukuna o ka prostate; HoLep; Coagulation kukuna interstitial; ILC; Vaporization Photoselective o ka prostate; PVP; Transurethral electrovaporization; TUVP; Therurapy Therwraper transurethral; TUMT; Urolift; BPH - resection; ʻO Benpl prostatic hyperplasia (hypertrophy) - resection; Prostate - hoʻonui ʻia - resection; ʻO ka wai mahu wai (Rezum)

• Hoʻonui prostate - he aha e nīnau aku ai i kāu kauka
• ʻO ka Prostate resection - minimally invasive - hoʻokuʻu
• Transurethral resection o ka prostate - hoʻokuʻu

ʻO Djavan B, Teimoori M. Hoʻokele ʻoki lāʻau o LUTS / BPH: TURP vs. open prostatectomy. I: Morgia G, ed. Nā Hōʻailona Urinary Tract Low a me Benign Prostatic Hyperplasia. Cambridge, MA: Elsevier Academic Press; 2018: chap 12.

Hanai HE, Barry MJ, Dahm P, et al. Hoʻoponopono ʻoki lāʻau o nā ʻōuli urinary haʻahaʻa i hāʻawi ʻia i ka hyperplasia prostatic maikaʻi: AUA Alakaʻi. J Urol. 2018; 200 (3): 612-619. PMID: 29775639 www.ncbi.nlm.nih.gov/pubmed/29775639.

Han M, Partin AW. ʻO prostatectomy maʻalahi: hāmama a me nā robot-kōkua laparoscopic hoʻokokoke. I: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th hua. Piladelapia, PA: Elsevier; 2016: chap 106.

ʻO Welliver C, McVary KT. Ka hoʻokele minimally invasive a endoscopic o benign prostatic hyperplasia. I: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th hua. Piladelapia, PA: Elsevier; 2016: chap 105.