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Course of treatmentTURP and HIFUThe application of heat causes a temporary swelling (oedema) of the prostate after the treatment. As a result of this, normal bladder voiding can be impaired for several days or even weeks afterwards. For this reason a concept was developed to combine HIFU with TURP (transurethral resection of the prostate) by means of which the inner portion of the prostate is cored out via the urethra. This considerably shortens the time during which bladder voiding is impaired and also reduces the size of the prostate, enabling treatment of prostates with larger volumes. In addition, calcifications of the interior of the prostate are removed which would prejudice an even distribution of the lesions. In our department, TURP is performed in combination with HIFU treatment on the same day in the case of prostate volumes less than 30 cc. In the case of prostate volumes above 30 cc, there should be a gap of 6 weeks between the two treatments, as this enables further shrinkage of the prostate, which in turn has a favourable effect on the outcome of the treatment. ProcedureIt TURP is carried out on the same day, this procedure is performed directly prior to HIFU treatment. In any case, an abdominal catheter is inserted prior to HIFU treatment in order to drain the urine. Subsequently the patient is placed on the HIFU treatment table (Figure 1) in a comfortable right lateral decubitus position (Figure 2). After insertion of the treatment probe into the rectum, the ultrasound images of the prostate are recorded and the areas to be treated determined on the computer. Subsequently, treatment as such is commenced. The total duration of HIFU treatment depends on the size of the prostate. As a rough guideline, it can be said that treatment of 10 cc of prostate takes approx. 1 hour. The patient can eat and drink normally on the same evening after treatment has taken place. (Figure 1) (Figure 2)
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HIFU
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