King Charles III has to undergo prostate surgery. What pathology makes the operation necessary? Is the operation dangerous for the sovereign? Charles, 75, suffers from benign prostatic hypertrophy (or benign prostatic hyperplasia). According to Buckingham Palace, King Charles is expected to go to hospital for “corrective surgery” next week.
What is benign prostatic hyperplasia
It affects 5-10% of men after the age of 40 and over 80% after the ages of 70 and 80, but produces symptoms in only half. It is a pathology – benign in fact – which leads to an enlargement of the prostate. A common diagnosis among men, often related to advancing age.
Why is treatment needed? The enlarged gland can compress the urethral canal, causing partial obstruction and interfering with the ability to urinate, as clarified for example on the Irccs Humanitas website which offers a fact sheet on the pathology.
Benign prostatic hypertrophy, the experts highlight in the online focus, is also known as prostatic adenoma and coincides with an increase in the volume of the prostate gland, often due to aging. This benign growth occurs in the transition zone of the prostate, compressing the prostatic urethra and hindering the flow of urine. “This enlargement – it is specified – should not cause excessive alarm, because it is a benign and reversible pathology, in which there are no tumor formations and tissue infiltration”. The causes? Mainly “aging and hormonal changes in adulthood”, in fact. And scientific studies have demonstrated the existence of a genetic predisposition and family history.
Symptoms
The symptoms are of two types: obstructive urinary symptoms and irritative ones, we read in the card. “The compression on the urethral canal complicates urination, resulting in difficulty in starting urination, intermittent flow, incomplete emptying of the bladder, weak urinary flow and effort in urination. Irritant symptoms are frequency of urination (pollakiuria), nocturia, i.e. an increased need during the night, the need to empty the bladder (micturition urgency) and burning while urinating”.
Prevention lies in an early diagnosis which is achieved by undergoing periodic checks after the age of 40-50 and immediately when problems appear. In terms of diet, “a varied and balanced diet must be followed, rich in fruit, vegetables and whole grains, but low in saturated fats (red meat, cheese and fried foods), avoiding chilli pepper, beer, sausages, spices, pepper, spirits, coffee and shellfish”, and drinking enough water. In addition to carrying out “moderate and regular” physical activity.
The treatments for this pathology are pharmacological therapy with specific medicines that allow to alleviate the associated urinary disorders, although there are some side effects that can have a significant impact on humans. And if the enlargement of the prostate is such as to cause urinary obstruction, pharmacological therapy is insufficient and obstructive surgery is necessary, endoscopic techniques that are less invasive than traditional surgery can be used. Finally, experts mention the Holmium laser, another endoscopic technique: a minimally invasive, non-painful and well-tolerated treatment called Holep (Holmium Laser Excision of the Prostate), which is performed after spinal anesthesia. Among the advantages is the fact that the patient sees an almost immediate improvement in the main problem, while burning sensations and traces of blood in the urine tend to disappear within 4 weeks of the operation.
What specialists say: what the operation will be like, what happens without intervention
“King Charles III is suffering from benign prostatic hyperplasia, this is the right medical term, a very common disease linked to ageing. The longer life expectancy increases, the more the number of patients with enlarged prostates increases. The same disorder from which the sovereign suffers and will most likely be subjected to laser vaporization surgery, a routine surgery that we perform every day in Italy”, Vincenzo Mirone, professor of Urology and head of the Communications Office of the Italian Society, explains to Adnkronos Salute of urology (SIU).
“Laser vaporization is an operation that can last from 30 to 60 minutes at most”, underlines Mirone, and which is performed “endoscopically through the urethra. It requires spinal anesthesia and 3-4 days of hospitalization. After one week after the intervention King Charles will be able to return to his commitments”. In our country there are “6 million Italians over 50 with prostate pathologies. Among these – concludes Mirone – there is benign prostatic hyperplasia”.
Benign prostatic hypertrophy, if left untreated, can progress to cause urinary retention with the inability to empty the bladder. If caught in time “it can be treated with drugs. However, 30% of patients are resistant to therapies”, explains Pierfrancesco Bassi, professor of Urology at the Catholic University of Rome, to Adnkronos Health.
“In these cases we intervene endoscopically, no longer invasively, without cuts to be clear. There are two modern treatments for benign prostatic hypertrophy: vaporization of the prostate which requires 1 day of hospital stay, under sedation; ablation of the tissue through laser, after 3 days of hospitalization you return home. The choice of the type of treatment depends on the volume of the prostate: small prostate vaporization, medium and large volume prostate ablation with laser. The result is himself. Both surgeries require a short convalescence,” he adds.
Due to benign prostatic hypertrophy, the prostate increases in volume “and this enlargement – explains Bassi – reduces the caliber of the canal that carries urine to the outside. It is like when a landslide invades a tunnel, it blocks everything. This enlargement must be removed. In 70% of cases the intervention is successful thanks to drugs. Then there is an unfortunate 30% of patients who, being resistant to therapies, must undergo surgery. Nnothing worrying – specifies the specialist – not even for the 75-year-old sovereign” who has already canceled all public commitments, as Buckingham Palace says, but who “will be able to return to work soon”. In the world “20% of men over 50 complain of ailments urinary tests attributable to benign prostatic hypertrophy, in practice 1 in 5”, concludes Bassi.
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