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Adenoma prostate

Adenoma prostate, also known as benign hyperplasia of prostate (DGPZ), is an extremely common disease in men over 40 years of age.With this disease, the benign growth of the prostate glandular tissue, which can lead to urethra compression, impaired to the urethra bladder, and as a result, discomfort during urination.Prostate adenoma can also cause serious problems with bladder and kidneys.

Healthy prostate and adenoma

This article deals with the causes and symptoms of prostate adenoma, as well as the modern methods of diagnosing and treating the disease.There are many effective methods to treat benign prostate hyperplasia, including not only medication and open surgical intervention, but also minimally invasive methods of surgical treatment.If the first symptoms of the disease appear, you should consult a doctor who takes into account the symptoms, the size of hyperplasia, and the general condition of health and offer the best treatment.

Reasons

To date, it is not quite clear what the reasons lead to prostate growth.However, the reason for the balance of sex hormones in the male body may be due to.Throughout their lives, men produce both testosterone, male hormone and small amounts of estrogen, female sex hormone.With the aging of the body, the amount of active testosterone decreases, while the amount of estrogen remains at approximately the same level.Studies have shown that a higher estrogen fraction entering the prostate gland can increase the activity of accelerating the growth of prostate cells.

prostate adenoma in a man

Another theory refers to another male sex hormone - digidrotestosterone - which is important for the development and growth of the prostate at a young age.Some studies have shown that even if testosterone levels in the blood start to decrease, the prostate gland still has high digidrotestosterone, which further increases the prostate cells.

The prostate is located directly below the bladder.The urethra (or urethra) that removes the urine from the bladder passes through the middle of the prostate.Due to such anatomical structure, the increased prostate can block urine flow.

They may have risk factors to increase prostate increases:

  1. Circle.In men under the age of 40, the symptoms of prostate gland grow are rarely observed.Men approx.30% of moderate symptoms are 60 years old, about 50% -80 years.
  2. The presence of DGPZ in relatives.For example, if blood relatives have a father or brother, have problems with the prostate gland, this means that it can increase the risk of prostate hyperplasia.
  3. Other diseases such as diabetes, cardiovascular diseases and erectile dysfunction.Studies show that diabetes, erectile dysfunction, and heart disease and blood vessels may increase the risk of DGPZ in some cases.
  4. Life.Obesity increases the risk of DGPZ and physical exercises can reduce this risk.

Nevertheless, the presence of any of the above factors is not the basis for believing that it is firmly forming a prostate adenoma.

Symptoms

The severity of the symptoms is different in people with different prostate adenoma.

The general signs and symptoms of DGPZH are as follows:

  • Frequent or urgent desire for urine.
  • Increase in urination at night (nokturia).
  • Inability to completely empty.bladder.
  • The presence of the residual volume of urine in the bladder.
  • Weak urine flow or periodic downtime during urination.
  • The complexity of the beginning of urination.
  • Increase in urine at the end of urination.
  • Frequent urinary tract infections.
  • The full impossibility of urination (anuria).
  • The presence of blood in the urine (hematuria).

It is worth knowing that the size of the prostate gland does not necessarily determine the severity of the symptoms.Some men who have a slightly increased prostate may have severe symptoms, while other men, even with extremely increased prostate glands, may be insignificant.Almost all patients are characterized by a gradual deterioration of symptoms over time.It is extremely rare that the symptoms can be stabilized or even repaired over time.

Diagnosis

In the event of DGPZ suspicion, your doctor will ask detailed questions about the symptoms of the disease and perform physical examination.This initial stage may include:

  1. Survey to identify the symptoms and risk factors of the disease.
  2. Finger rectal test.To assess the size and shape of the prostate gland, the doctor must insert the finger into the rectum.This study is extremely informative, allowing the primary conclusion on the condition of the prostate gland.
  3. Urine analysis.Analysis of urine sample can help eliminate infection or other conditions that can cause similar symptoms.
  4. Blood test.Blood test results may indicate the availability of kidney problems.
  5. Blood test for prostate-specific antigen (PSA).The dog is a protein produced only by prostate fabric.When the prostate is healthy, there are very few dogs in the blood.The test can be done in the laboratory, hospital or at the doctor's office.No special training is required.The rapid increase in the dog level may indicate that prostate tissue increases rapidly.DGPZH is one of the possible causes of high levels of PSA.Inflammation of prostate or prostatitis is another general cause of the dog's high level.

After the initial examination and the necessary tests, your doctor may recommend further examinations to confirm the presence of DVGPH and to exclude other conditions.These tests may include:

  1. Urodynamic examination.In this study, the patient should be urinated in a container fixed to a special device, which measures the strength and volume of the stream during the urinary process.Test results help to monitor the dynamics of the disease, determining whether its condition will be better or worse.
  2. Examine the remaining volume of the urine.This test shows that you can completely empty the bladder.The test can be done using an ultrasound examination or introduced a catheter into the bladder after helping to measure the size of the urine left in the bladder.
  3. Maintaining a 24 -hour urination log.Urine registration and urine can be especially useful if more than one third of the daily urination occurs at night.
  4. Transrectal ultrasound.At the same time, the UZ-Zond is taken into the rectum to measure the size and assess the condition of the prostate.
  5. Examination of bladder (cystoscopy).In this study, a flexible catheter is placed at the end of the camera (cystoscope) in the urethra, allowing the doctor to see the inner surface of the urethra and bladder.
  6. Prostate biopsy.You may need to take prostate tissue patterns to exclude prostate cancer.

Treatment

There are many different treatment options for prostate adenoma.You and your doctor need to decide which treatment best meets.Sometimes a combination of various procedures works best.Mild cases of DHCH may not require treatment.

Main types of treatment for prostate adenoma:

  • Active observation of the disease.
  • Drug treatment.
  • Small invasive surgery.
  • Surgical interventions.
  • Active observation.

If your doctor prefers this option, the disease is carefully monitored without using medicines or surgical procedures.However, it is examined annually.If the symptoms deteriorate or new symptoms occur, your doctor can offer you active treatment.Men with light symptoms can be good candidates for active observation.Men with moderate symptoms who do not disturb them are also good candidates.

The advantage of this approach is that there are no side effects, but it is likely that it is more difficult to reduce the symptoms.

Medical treatment

Alpha -blockers

Alpha blockers are drugs that relax the muscles of the urethra, prostate and bladder.They improve urine outflow and reduce DHCH symptoms while affecting the size of the prostate.Alpha blockers include alfuszine, terazosine, doxazosin and tamsulosin.

One of the benefits of alpha blockers is that they start working immediately after entering.Side effects can include dizziness, fatigue and ejaculation problems.

Moderate and severe DGPZ is a good candidate for therapy for alpha blockers for men and symptoms.

5-alpha-reductase inhibitors

5-alpha reductase inhibitors are drugs that block dihydrotestosterone, male hormone production that can accumulate in prostate and cause growth.These drugs lead to a reduction in the size of the prostate and increase urine outflow.Such drugs include finatoride and dutasteride.

These drugs significantly reduce the risk of developing DHCH complications.They also reduce the probability that you will need an operation in the future.Side effects include erectile dysfunction and a decrease in libido (sexual desire).At the same time, you need to continue the tablets to prevent the symptoms of the disease from being repeated.

Combined treatment

In combination therapy, alpha blockers and inhibitors of the 5-alpha reductase are commonly used.Possible combinations of drugs include Finsteride and doxazosine or dutasteride and tamsulosin.Your urologist can also prescribe a combination of alpha blockers and medicines called Muskarin receptor blockers if the bladder has hyperactivity.In the case of a hyperactive bladder, the muscles of the bladder are uncontrolled and cause an increase in the frequency of urination, suddenly longing for urgent urinary tract and urinary tract incontinence.Antimoskarine drugs are drugs that relax the bladder muscles.

Combined therapy significantly improves symptoms and prevents DHGPH from deteriorating.However, it is worth remembering that all drugs can cause side effects.You can take two drugs, you can have more side effects than taking only one medicine.

Alternative treatment methods

It is not recommended for medical workers to use self -medication, traditional medicine or treatment using various herbs (herbs).Many studies show that the use of such treatment is ineffective and, in some cases, can cause irreparable damage.In addition, herbs and biologically active food additives (dietary supplements) do not pass the same testing process as medicines.As a result, the quality and purity of the additives sold without prescription may vary.

Small -invasive surgical interventions

Minimum invasive interventions are performed with minimal anesthesia and suggests faster healing.Often the procedure can be performed directly at the doctor's office or in an outpatient center.

Immediate alleviation of the symptoms of the disease is the greatest advantage of minimally invasive surgery.Many people, after minimally invasive intervention, improve urine outflow and control of the bladder function.If you have problems with urination, urinary tract obstruction, bladder stones, blood in the urine, presence of residual urine in the bladder after emptying, or did not notice the effect of taking medication, the minimally invasive intervention may be the next step in treating the disease.

However, it is worth knowing that surgical interventions, including minimally invasive, are at risk of side effects, including the following:

  • Urinary tract infections.
  • Blood in the urine.
  • Combustion during urination.
  • The need for frequent emptying of the bladder.
  • Sudden urination.
  • Erection dysfunction.

The methods of minimally invasive surgery are as follows:

  1. Increase in the prostate urethra (or PUL methodology) - this process is used to use a special device to install small implants in the prostate gland.These implants are elevated above and an increased prostate belongs to this position while the pressure on the urethra decreases and the urine outflow is improved.In this case, the destruction or removal of the prostate gland tissue does not occur.PUL can be produced with both local and general anesthesia.Most patients notice the improvement in symptoms within 2 weeks.In some cases, pain or burns may occur in urine, blood in the urine or constant desire for urination.Usually these side effects take place within two to four weeks.Good candidates may be patients who have other health problems or patients who have a high risk of surgery to raise the prostate urethra.
  2. Transuretral microwave thermotherapy (or TUMT method) - in this process, microwave ovens are used to destroy the prostate tissue.First, the doctor introduces the catheter through the urethra to the prostate gland and then sends microwaves built into the catheter to heat the selected sections of the prostate.High temperature destroys the surplus of the prostate tissue.This procedure usually does not require anesthesia, the risk of side effects is minimal.
  3. Method of treating prostate with pathologies with water therapy with convection ablation - this procedure uses heat energy to destroy the excess of prostate tissue.In this case, the sterile water heats up inside a special portable device at a temperature directly above the boiling point when it becomes steam.This hot vapor then causes rapid deaths of the cells.Treatment in the medical office can be performed during local anesthesia.After the procedure, there may be a mixture of blood in the urine for a while, using the catheter for several days.Painful or frequent urination after the procedure approx.You have to go after 3 weeks.Sexual side effects, such as erectile dysfunction are unlikely.

Traditional surgical operations

Surgery interventions by removing some of the prostate tissue are performed with the effectiveness of other therapeutic methods, with extremely expressed symptoms (such as the complete impossibility of urination).They belong to:

  • Transuretral Prostate Resection (Turp)

    Turp is one of the most common DHC operations.During this operation, after completing anesthesia, the surgeon introduces a special thin tool on the penis head into the urethra.Using this device, the doctor removes excessive tissue of the prostate gland.After the procedure, a catheter should usually be used for 1-2 days.The effect of such treatment usually lasts at least 15 years.Like all other operations, there are side effects of TURP, and the anesthesia used in the intervention has a certain risk.The side effects of TURP may include retrograde ejaculation, erectile dysfunction, post -operative urinary infection and urinary tract incontinence.Complete healing lasts for 4-6 weeks.

  • The laser enclosation of the prostate

    With this intervention, the surgeon places a thin tool on the penis of the urethra.The laser inserted into the tool destroys the surplus of the prostate tissue.However, as with the transuretral resection of the prostate, it does not need to be cut.Healing after laser enluation is very fast, but then blood can be mixed in the urine for several days and frequent or painful urination.This procedure requires anesthesia that is related to certain risks.

  • Prostate removal operations

    Currently, the actions for the removal of prostate in men are extremely rare during DGPZ, with the effectiveness of all other therapeutic methods.Such operations lead to significant risks and side effects, including urine, erectile damage, and severe complications during surgery.

Complication

In DGPG, the lack of timely medical care can lead to serious complications that include:

  • Sudden and complete inability to urinate (delayed urine, anuria).In this state, you may need to enter a catheter into the bladder to ensure that urine outflow from the crowded bladder.In some cases, surgery may also be needed to reduce urinary retention.
  • Urinary tract infections.Inability to completely empty the bladder can increase the risk of urinary tract infections.
  • The bladder stones.The stones in the bladder also develop due to the impossibility of completely emptying the bladder.Stones can cause infections, bladder irritation, blood contamination in the urine and further difficulties in the outflow of urine.
  • Damage to the bladder.With the incomplete emptying, the bladder can be stretched, which over time leads to a weakening of the muscle wall.As a result, the bladder is unable to compress properly, which becomes the cause of further difficulties of emptying.
  • Kidney impairment.Urine delay can cause an increase in bladder pressure and reverse urine outflow in the kidneys, which can cause direct damage or increase the risk of infectious diseases.Such complications are extremely serious and can survive.

In most men with increased prostate glands, these complications are extremely rare, but it should be remembered that many complications, including acute urinary retention or kidney damage, can be a serious threat to health and life.If any symptom of the disease occurs, seek medical attention immediately.

To prevent the development of a diet and prostate adenoma

Unfortunately, there is no reliable method to prevent prostate adenoma, but the rate of prostate growth may lose weight with the high content of weight loss and proper nutrition in the diet.This may be due to the fact that the excessive amount of adipose tissue in the body can increase the levels of hormones and other blood walls and stimulate the growth of prostate cells.Constant physical activity promotes regulation of the weight and levels of hormones, thereby reducing the risk of developing prostate adenoma.