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Adenomectomy – Procedure, Risks & Recovery

An adenomectomy is a surgical procedure to remove an adenoma, a benign glandular tumor. It is commonly performed for prostate or pituitary adenomas.

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Things worth knowing about "Adenomectomy"

An adenomectomy is a surgical procedure to remove an adenoma, a benign glandular tumor. It is commonly performed for prostate or pituitary adenomas.

What is an Adenomectomy?

An adenomectomy is the surgical removal of an adenoma – a benign tumor arising from glandular tissue. Adenomas can develop in various organs, including the prostate, the pituitary gland, the parathyroid glands, the liver, or the adrenal glands. Depending on the affected organ and the size of the adenoma, different surgical techniques are used.

Common Indications

Prostate Adenoma (Benign Prostatic Hyperplasia)

One of the most frequent indications for adenomectomy is benign prostatic hyperplasia (BPH), an enlargement of the prostate gland. When the enlargement causes significant urinary symptoms and conservative treatments have failed, the adenoma is surgically removed. The prostatic capsule is preserved while the excess glandular tissue is excised.

Pituitary Adenoma

For tumors of the pituitary gland, adenomectomy is usually performed transsphenoidally – through the nasal septum. This minimally invasive approach allows targeted tumor removal without a large craniotomy (opening of the skull).

Parathyroid Adenoma

A parathyroid adenoma commonly leads to primary hyperparathyroidism (elevated calcium levels in the blood). Surgical removal of the affected parathyroid tissue is the curative treatment of choice in these cases.

Surgical Techniques

Several surgical approaches are available depending on the location and size of the adenoma:

Open surgery: Classical operation through a skin incision, mainly used for large adenomas.
Laparoscopic surgery: Minimally invasive procedure with small incisions and camera assistance, e.g., for adrenal adenomas.
Transsphenoidal surgery: Access through the nasal septum, typical for pituitary adenomas.
Transurethral resection (TURP): Endoscopic removal of prostatic tissue through the urethra; while not always strictly termed adenomectomy, it serves the same purpose.

Preparation and Procedure

Prior to surgery, imaging studies such as MRI or CT scans are performed to precisely determine the location and size of the adenoma. Blood tests and a pre-anesthetic evaluation are also part of the preparation. The procedure is typically performed under general anesthesia.

Risks and Possible Complications

As with any surgical procedure, adenomectomy carries certain risks:

Bleeding and hematomas
Infections or impaired wound healing
Injury to adjacent structures (e.g., nerves, blood vessels)
Hormonal changes (e.g., after pituitary or parathyroid surgery)
Urinary incontinence or erectile dysfunction (in prostate surgery)

Follow-up Care and Recovery

Follow-up care depends on the organ operated on and the extent of the procedure. Regular check-up examinations are often required to detect any recurrence of the adenoma at an early stage. For adenomas affecting hormone metabolism (e.g., pituitary, parathyroid), additional hormone level monitoring is carried out. Recovery time varies from a few days to several weeks depending on the type of surgery.

References

Melmed, S. et al. – Pituitary Tumors. New England Journal of Medicine, 2022; 386:2825-2836. DOI: 10.1056/NEJMra2101801.
EAU Guidelines on Benign Prostatic Hyperplasia. European Association of Urology (EAU), 2023. Available at: https://uroweb.org/guidelines/treatment-of-non-neurogenic-male-luts.
Wilhelm, S.M. et al. – The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surgery, 2016; 151(10):959-968.

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