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攝護腺手術要花多少錢?


攝護腺手術要花多少錢?治療攝護腺肥大的手術種類非常多種,目前最常執行的手術療法是「經尿道攝護腺刮除術」(TURP),這是最經典、最常被選擇的手術,手術方式可分為單極電刀與雙極電刀。此外,還有現在最夯的經尿道「雷射手術」治療。若攝護腺比較大,臨床還可透過傳統開腹式的攝護腺切除術來治療。

攝護腺手術要花多少錢?治療攝護腺肥大的手術種類非常多種,目前最常執行的手術療法是「經尿道攝護腺刮除術」(TURP)

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攝護腺問題是否需要手術,取決於多個因素,包括症狀的嚴重程度、病情的進展、對其他治療方法的反應以及個人的健康狀況。以下是一些常見情況下攝護腺手術可能被考慮的情況:

攝護腺肥大(BPH):如果攝護腺肥大導致嚴重症狀,例如頻尿、夜間尿頻、尿急、尿流虛弱或無法排空膀胱,且對藥物治療無效或無法耐受,醫生可能會建議手術。

攝護腺癌:根據癌症的分期和患者的整體健康狀況,手術可能是攝護腺癌治療的一部分。手術可以包括攝護腺切除術(如根治性前列腺切除術)或其他手術方式。

尿道狹窄:如果攝護腺肥大導致尿道狹窄,影響尿液排出,並對生活品質造成重大影響,可能需要手術來擴寬或修復尿道。

攝護腺結石:在某些情況下,攝護腺結石可能需要手術移除,特別是當結石導致尿液流失、導致反復尿路感染或引起嚴重痛楚時。

 
 
  單極電刀刮除術 雙極電刀刮除術 雷射手術
麻醉 半身麻醉為主,少數為全身麻醉
手術時間 30~120分鐘 30~120分鐘 可能較長
手術沖洗用水 蒸餾水 生理食鹽水 生理食鹽水
發生水中毒之機會 1% 不會 不會
輸血之比率 2% 2% <1%
有無病理檢體 可能較少
適合病患 攝護腺20~80cc,無重大疾病者 攝護腺40~60cc以上,或有腎功能不佳等重大疾病者 攝護腺60cc以上、有重大疾病或凝血功能異常者。
拔尿管時間 術後第3天 術後第3天 可能較短
住院天數 標準為5天4夜 標準為5天4夜 可能較短
自費或健保 健保給付 健保給付 自費約15萬元



分析3種手術差異性

我需要做雷射手術嗎?是不是越貴越好?是許多病友常有的疑問。其實不然,必須評估患者的狀況來選擇,每種手術的優缺點不同,也可一併考量。

以下是治療攝護腺肥大最常見的3項手術:單極電刀、雙極電刀、雷射手術的差異。

麻醉方式、手術時間

麻醉方式大同小異。在手術時間上,單極電刀與雙極電刀的時間也差不多,差別只在沖洗與電刀使用方式不太一樣,其他沒有太大差異。兩種電刀手術時間依照攝護腺需刮除的大小,大約需要30至120分鐘。至於雷射手術,因雷射的刮除效率沒有傳統手術好,所以手術時間可能較長。

手術沖洗用水

單極電刀只能使用蒸餾水,也就是純水沖洗,這是因為單極電刀的設計,讓手術過程中的沖洗用水不能出現離子。使用單極電刀手術患者,1%可能會因使用蒸餾水,出現「水中毒」的現象;雙極電刀與雷射手術,則是使用生理食鹽水沖洗,較不會出現水中毒的問題。

手術輸血

使用單極或雙極電刀,手術中需要輸血的比率約2%;而雷射治療因止血效果較好,出血機率較低,需要輸血的機率小於1%。

病理檢體

由於單極電刀跟雙極電刀,都是把肥大的攝護腺組織慢慢刮除下來,所以可以採集到攝護腺的病理檢體,方便日後檢查有無攝護腺癌的可能;至於雷射手術,是瞬間的汽化刮除,有一部分的組織會瞬間被汽化掉,所以有時無法採集到病理檢體,或是只能採集到少部分檢體。

適合病患

攝護腺的大小若是20至80cc,且沒有重大疾病者,可適用單極電刀治療;攝護腺的大小若是40至60cc以上,或有腎功能不佳等重大疾病患者,傳統可採雙極電刀治療。而攝護腺在60cc以上,有重大疾病,或是凝血功能異常者,則比較建議採用雷射手術治療。

拔除尿管時間

一般使用單極或雙極電刀刮除肥大的攝護腺,約在手術後第2天就會拔除尿管;而雷射手術因為止血效果較好,拔除尿管的時間,臨床上比傳統單極或雙極電刀的時間短,有的患者甚至術後隔天就可拔除。

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How much does prostate surgery cost? There are many types of surgery for the treatment of enlarged prostate. At present, the most commonly performed surgical treatment is "transurethral curettage of the prostate" (TURP), which is the most classic and most frequently selected surgery. The surgical methods can be divided into Monopolar and bipolar electrosurgical units. In addition, there is currently the most popular transurethral "laser surgery" treatment. If the prostate is relatively large, it can also be treated clinically through traditional open prostatectomy.

Whether a prostate problem requires surgery depends on several factors, including the severity of symptoms, the progression of the condition, response to other treatments, and the individual's health. The following are some common situations in which prostate surgery may be considered:

Enlarged prostate gland (BPH): If an enlarged prostate is causing severe symptoms, such as frequent urination, frequent nighttime urination, urgency, weak urine stream, or inability to empty the bladder, and medications are not responding or tolerated, your doctor may recommend Operation.

Prostate cancer: Depending on the stage of the cancer and the patient's overall health, surgery may be part of prostate cancer treatment. Surgery can include a prostatectomy (such as a radical prostatectomy) or other surgical procedures.

Urethral stricture: Surgery to widen or repair the urethra may be required if an enlarged prostate narrows the urethra, restricts the passage of urine, and has a significant impact on quality of life.

Prostate stones: In some cases, prostate stones may require surgical removal, especially if the stones cause loss of urine, cause repeated UTIs, or cause severe pain.

Analysis of the differences between the 3 surgeries

Do I need laser surgery? Is the more expensive the better? This is a question often asked by many patients. In fact, it is not the case. It is necessary to evaluate the patient's condition to choose. The advantages and disadvantages of each operation are different, and they can also be considered together.

The following are the 3 most common surgeries for the treatment of enlarged prostate: the difference between monopolar electrosurgical surgery, bipolar electrosurgical surgery, and laser surgery.

Anesthesia, operation time

The methods of anesthesia are similar. In terms of operation time, the time of monopolar electric knife and bipolar electric knife is similar. The only difference is that the flushing and electric knife are used differently, and there is not much difference in others. The operation time of the two types of electrosurgical surgery depends on the size of the prostate to be scraped, and it takes about 30 to 120 minutes. As for laser surgery, since the curettage efficiency of laser is not as good as that of traditional surgery, the operation time may be longer.

Surgical washing water

The monopolar electric knife can only be rinsed with distilled water, that is, pure water. This is because the design of the monopolar electric knife prevents ions from appearing in the washing water during the operation. 1% of patients undergoing monopolar electrosurgical surgery may suffer from "water intoxication" due to the use of distilled water; bipolar electrosurgical surgery and laser surgery are flushed with physiological saline, and water intoxication is less likely to occur.

Surgical transfusion

With monopolar or bipolar electric knife, the rate of needing blood transfusion is about 2%; while laser treatment has a better hemostasis effect, WWW.poxet.tw the rate of bleeding is lower, and the rate of needing blood transfusion is less than 1%.

Pathological specimen

Since both the monopolar electrosurgical unit and the bipolar electrosurgical unit scrape off the hypertrophic prostate tissue slowly, the pathological specimens of the prostate can be collected, which is convenient for checking the possibility of prostate cancer in the future; as for Laser surgery is instantaneous vaporization and curettage, and part of the tissue will be vaporized instantly, so sometimes pathological specimens cannot be collected, or only a small part of the specimen can be collected.

suitable for patients

If the size of the prostate is 20 to 80 cc, and there is no major disease, monopolar electrosurgical treatment can be used; if the size of the prostate is 40 to 60 cc or more, or patients with major diseases such as poor renal function, traditional bipolar electrosurgical treatment can be used. Electrosurgical treatment. For those whose prostate is over 60cc, have serious diseases, or have abnormal blood coagulation function, laser surgery is recommended.

catheter removal time

Generally, monopolar or bipolar electrosurgical scalpel is used to scrape the hypertrophic prostate, and the urinary catheter will be removed about 2 days after the operation; however, laser surgery has a better hemostasis effect, and the time to remove the urinary catheter is clinically shorter than traditional ones. The time of monopolar or bipolar electric knife is short, and some patients can even be removed the next day after operation.

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