الفهرس | Only 14 pages are availabe for public view |
Abstract The senile prostatic enlargement represents one of the main problems in old age, and it is estimated that every man over the age of forty years, has some degree of senile prostatic enlargement. The symptoms of senile prostatic enlargement are either obstructive or irritative. They may be severe enough to interfere with patient’s life and activities. Various modalities of treatment of S.P.E. are UJW available: 1- Medical treatment, including Hormonal and non-Hormonal treatment. The medical treatment is mainly indicated in poor risk patients that can not tolerate any type of anaesthesia, in patients waiting for operation to give symptomatic relief, in catheter wearer to allow removal of the catheter, and may be given pre-and post. Operatively to prevent post operative retention. Medical treatment is not supposed to replace an indicated operation or to reduce the prostatic size. It’s main use is in the early cases, with mild symptoms and no complications. 2- The endoscopic manipulation, including transurethral resection and prostatic incision. The transurethral resection depend mainly on the availability of instruments and the experience of the surgeon. It IS mainly indicated in a patient with definite, persistent, and progressive symptoms, and gland that can be resected to the surgical capsule in a reasonable lenght of time, and can not be adequately enucleated by open morbidity, and mortality, and the results of T.U.R. can never be achieved by open surgery in many pathological conditions of the prostate and the bladder neck. Surgical treatment, including the different approaches to the prostate, the retropubic, the suprapubic and the perineal routes. The retropubic approach affords direct exposure and better haemostasis. It is indicated in very large glands and can be resorted to when serious complications arise during T.U.R. The Madigan prostatectomy is a type of retropubic prostatectomy in which the prostatic urethra remain intact. Suprapubic approach is especially indicated when vesical pathology is accompanying huge prostatic enlargement. The different modalities of treatment are tailored according to the patient’s general and urological condition, the. size. and configurations of prostatic enlargement, the accompanying vesical or urethral pathology, the availability of instruments, and the experience of the surgeon. In this work evaluation of the different methods of treatment had been made. |