{"id":1424084,"date":"2024-11-12T00:00:00","date_gmt":"2024-11-11T21:00:00","guid":{"rendered":"https:\/\/analyse.optim.biz\/?p=1424084"},"modified":"2024-11-12T00:00:00","modified_gmt":"2024-11-11T21:00:00","slug":"tratamentul-chirurgical-al-adenomului-de-prostata-individualizat-pentru-fiecare-pacient","status":"publish","type":"post","link":"https:\/\/analyse.optim.biz\/?p=1424084","title":{"rendered":"Tratamentul chirurgical al adenomului de prostat\u0103, individualizat pentru fiecare pacient"},"content":{"rendered":"<div class=\"entry-content\">\n<div id=\"attachment_316494\" class=\"wp-caption alignright\"><img decoding=\"async\" aria-describedby=\"caption-attachment-316494\" loading=\"lazy\" class=\"size-medium wp-image-316494\" src=\"https:\/\/analyse.optim.biz\/wp-content\/uploads\/2026\/01\/constandache-catalin-1-300x197-1.png\" alt=\"Dr. C\u0103t\u0103lin Constandache, medic primar Urologie, Arcadia\" width=\"300\" height=\"197\" title=\"constandache-catalin-1-300x197-1\"><\/p>\n<p id=\"caption-attachment-316494\" class=\"wp-caption-text\"><a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/constandache-catalin\">Dr. C\u0103t\u0103lin Constandache<\/a>, medic primar Urologie, <a href=\"http:\/\/www.arcadiamedical.ro\">Arcadia<\/a><\/p>\n<\/div>\n<p>Adenomul de prostat\u0103 reprezint\u0103 <strong>m\u0103rirea de volum, de cauz\u0103 benign\u0103, a glandei prostatice,<\/strong> o gland\u0103 accesorie situat\u0103 sub vezica urinar\u0103, ce \u00eenconjoar\u0103 por\u021biunea ini\u021bial\u0103 a uretrei.<\/p>\n<p>\u00cen prezent, sunt considerate <strong>indica\u021bii absolute de interven\u021bie chirurgical\u0103 a prostatei:<\/strong> reten\u021bia complet\u0103 de urin\u0103, reten\u021bia incomplet\u0103 de urin\u0103 cu reziduu vezical mare la evalu\u0103ri succesive, litiaza vezical\u0103, diverticuloza vezical\u0103 secundar\u0103 <a href=\"https:\/\/www.arcadiamedical.ro\/medinfo\/cand-si-cum-tratam-hiperplazia-benigna-de-prostata\">hiperplaziei benigne de prostat\u0103<\/a> (HBP), hematuria sau infec\u021biile urinare repetate, secundare HBP.<\/p>\n<p>\u00cen cazul \u00een care pacientul are indica\u021bie de tratament chirurgical al prostatei, tratamentul de elec\u021bie este reprezentat de <strong>rezec\u021bia transuretral\u0103 a prostatei.<\/strong> Rezec\u021bia endoscopic\u0103 a prostatei (TURP) reprezint\u0103 \u00eendep\u0103rtarea pe cale endoscopic\u0103 (f\u0103r\u0103 incizie, ci utiliz\u00e2nd oricifiile naturale ale organismului, \u00een cazul de fa\u021b\u0103 meatul uretral) a adenomului de prostat\u0103, leziunea benign\u0103 a prostatei, ce se dezvolt\u0103 din a\u0219a-numita zon\u0103 tranzi\u021bional\u0103 a prostatei, situat\u0103 \u00een jurul uretrei. Rezultatul este ob\u021binerea unui canal urinar larg, care nu mai obstrueaz\u0103 mecanic jetul urinar, pacientul reu\u0219ind s\u0103 \u00ee\u0219i reia mic\u021biunile dup\u0103 suprimarea sondei uretro-vezicale.<\/p>\n<p><strong>Tratamentul chirurgical deschis <\/strong>este rezervat pacien\u021bilor cu prostat\u0103 voluminoas\u0103, peste 100 de grame, asociat\u0103 sau nu cu calculi de dimensiuni crescute, ce fac dificil\u0103 fragmentarea intravezical\u0103, sau diverticuli volumino\u0219i ce necesit\u0103 excizie chirurgical\u0103 concomitent\u0103. Poate fi, de asemenea, recomandat pacien\u021bilor care nu pot fi a\u0219eza\u021bi pe masa operatorie \u00een pozi\u021bie ginecologic\u0103 din cauza afec\u021biunilor ortopedice asociate.<\/p>\n<p>\u00a0<\/p>\n<p>Un pacient \u00een v\u00e2rst\u0103 de 73 de ani a fost evaluat pentru <strong>absen\u021ba mic\u021biunilor timp de 24 de ore<\/strong> \u0219i a fost diagnosticat cu <strong>glob vezical. <\/strong>A fost montat un cateter uretro-vezical, iar suprimarea acestuia dup\u0103 14 zile, sub tratament alfa-blocant, nu a fost urmat\u0103 de reluarea mic\u021biunilor, motiv pentru care cateterul uretro-vezical a fost reintrodus \u0219i s-a luat decizia unei interven\u021bii chirurgicale.<\/p>\n<p>\u00cen cadrul examenului clinic \u0219i ecografic s-au identificat <strong>prostata de dimensiuni m\u0103rite<\/strong> (circa 150 de grame) \u0219i <strong>structura adenomatoas\u0103<\/strong> (a\u0219a-numitul <strong>adenom de prostat\u0103,<\/strong> tumora benign\u0103 a prostatei). Dup\u0103 ce i s-au prezentat pacientului variantele terapeutice, <strong>op\u021biunea principal\u0103 a fost interven\u021bia chirurgical\u0103 deschis\u0103<\/strong> av\u00e2nd \u00een vedere dimensiunile mult m\u0103rite ale prostatei.<\/p>\n<p>Dup\u0103 o evaluare cadiologic\u0103 \u0219i anesteziologic\u0103 am\u0103nun\u021bit\u0103, pacientul fiind cunoscut cu patologie cardiac\u0103 (angioplastie coronarian\u0103 transluminal\u0103 percutan\u0103 \u00een 2006, sindrom coronarian cronic, bloc de ram drept, dislipidemie), s-a efectuat sub anestezie general\u0103 <strong>enucleerea digital\u0103 a adenomului voluminos de prostat\u0103 pe cale transvezical\u0103<\/strong> (cale deschis\u0103).<\/p>\n<p>Evolu\u021bia postoperatorie imediat\u0103 a fost una f\u0103r\u0103 complica\u021bii, iar suprimarea cateterului uretro-vezical s-a realizat dup\u0103 circa 14 zile, cu reluarea imediat\u0103 a mic\u021biunilor. Controlul la 3 luni a relevat mic\u021biuni cu jet normal, f\u0103r\u0103 dificultate, absen\u021ba infec\u021biei urinare, iar ecografic s-a pus \u00een eviden\u021b\u0103 golirea complet\u0103 a vezicii urinare.<\/p>\n<p>\u00a0<\/p>\n<p>Frecven\u021ba urinar\u0103 crescut\u0103 pe parcursul nop\u021bii, dificultatea la urinare, mic\u021biunile cu jet slab \u0219i \u00eentrerupt sau senza\u021bia de golire incomplet\u0103 a vezicii reprezint\u0103 simptome ale adenomului de prostat\u0103 \u0219i indic\u0103 necesitatea unui consult de specialitate. Pentru program\u0103ri, pacien\u021bii au la dispozi\u021bie num\u0103rul de telefon <strong>0232 920, Call Center <\/strong><a href=\"http:\/\/www.arcadiamedical.ro\"><strong>Arcadia<\/strong><\/a><strong>.<\/strong><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Dr. C\u0103t\u0103lin Constandache, medic primar Urologie, Arcadia Adenomul de prostat\u0103 reprezint\u0103 m\u0103rirea de volum, de cauz\u0103 benign\u0103, a glandei prostatice, o gland\u0103 accesorie situat\u0103 sub vezica urinar\u0103, ce \u00eenconjoar\u0103 por\u021biunea ini\u021bial\u0103 a uretrei. \u00cen prezent, sunt considerate indica\u021bii absolute de interven\u021bie chirurgical\u0103 a prostatei: reten\u021bia complet\u0103 de urin\u0103, reten\u021bia incomplet\u0103 de urin\u0103 cu reziduu vezical [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89],"tags":[174],"class_list":["post-1424084","post","type-post","status-publish","format-standard","hentry","category-romania","tag-suceavanews-ro"],"_links":{"self":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1424084","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1424084"}],"version-history":[{"count":0,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1424084\/revisions"}],"wp:attachment":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1424084"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1424084"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1424084"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}