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Prostate adenoma

Prostate adenoma, also called benign hyperplasia of the prostate gland (DGPZ), is an extremely common disease in men over the age of 40.With this disease, a benign growth of the glandular tissue of the prostate occurs, which can lead to the compression of the urethra, altered urinary outflow from the bladder and, consequently, unpleasant sensations during urination.Prostate adenoma can also cause serious problems with the bladder and kidneys.

Healthy prostate and adenoma

This article discusses the causes and symptoms of prostate adenoma, as well as modern methods of diagnosis and treatment of this disease.There are many effective methods for the treatment of hyperplasia of the benign prostate, including not only drug therapy and open surgery, but also minimally invasive methods of surgical treatment.If the first symptoms of the disease appear, it is necessary to consult a doctor who takes into account the symptoms, the dimensions of hyperplasia, as well as the general conditions of your health and offer you the best treatment option.

Reasons

To date, it is not entirely clear what type of reasons does it lead to an increase in the prostate.However, this may be due to a change in the balance of sex hormones in the male body.During their life, men produce both testosterone, male hormone and a small amount of estrogen, female sex hormone.As the body is aging, the quantity of testosterone active in the blood decreases, while the amount of estrogen remains approximately at the same level.Studies have shown that the highest fraction of estrogen that enters the prostate gland can increase the activity of the substances that accelerate the growth of prostate cells.

prostate adenoma in a man

Another theory indicates the role of another male sex hormone - Digidrotestosterone - which is important for the development and growth of a prostate at a young age.Some studies have shown that even when the level of testosterone in the blood begins to fall, in the prostate gland there is still a high level of digidrotestosterone, which can push prostate cells to continue growing.

The prostate gland is located directly under the bladder.The urethra (or urethra), which removes the urine from the bladder, passes through the center of the prostate gland.It is due to such anatomical structure that an increased prostate is able to block the flow of urine.

Risk factors to increase the prostate gland can be:

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

However, the presence of one of the aforementioned factors is not the basis to believe that you will surely develop a prostate adenoma.

Symptoms

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

Dgpzh's general signs and symptoms include:

  • Frequent or urgent desire to urinate.
  • Increased urination at night (nokturia).
  • The inability to empty completely.Vescia.
  • The presence of the residual volume of urine in the bladder.
  • Weak flow of urine or periodic stops during urination.
  • The complexity of the beginning of the urination.
  • Growth of urine at the end of urination.
  • Frequent urinary tract infections.
  • The complete 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 seriousness of the symptoms.Some men with a slightly enlarged prostate may have serious symptoms, while other men even with extremely enlarged prostate glands can be insignificant.Almost all patients are characterized by the gradual deterioration of symptoms over time.It is extremely rare that the symptoms can be stabilized or even improved over time.

Diagnostics

In case of suspicion of DGPZ, the doctor asks detailed questions about the presence of symptoms of the disease and will lead a physical examination.This initial phase may include:

  1. A survey to identify the symptoms and risk factors of the disease.
  2. Rectal examination of the finger.To evaluate the size and shape of the prostate gland, the doctor will have to insert a finger in the rectum.This study is extremely instructive, allowing you to draw the main conclusion on the state of the prostate gland.
  3. Urine analysis.An analysis of the urine sample can help eliminate infection or other conditions that can cause similar symptoms.
  4. Blood test.The results of the blood tests can indicate the availability of kidney problems.
  5. Blood test for the specific prostat antigen (PSA).The dog is a protein produced only by a prostate fabric.When the prostate is healthy, the dog is in the blood.The test can be performed in the laboratory, hospital or medical office.No special training is required.The rapid increase in the dog's level can be a sign that the rapid growth of the prostate fabric occurs.DGPZH is one of the possible causes of a high level of PSA.Inflammation of the prostate or prostatitis is another common cause of the high level of the dog.

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

  1. Urodynamic examination.In this study, the patient is urgged in a container attached to a special apparatus, which measures the resistance and volume of the flow during urination.The test results help to keep track of the dynamics of the development of the disease, determining whether the conditions improve or worse.
  2. Test for the residual urine volume.This test shows if you can completely empty the bladder.The test can be performed using an ultrasound study or by introducing a catheter into the bladder after you are helping to measure the amount of urine left in the bladder.
  3. Maintain a 24 -hour urination diary.The registration of urination and the amount of urine can be particularly useful if more than a third of daily urinous urination occurs.
  4. Transrettal ultrasound.At the same time, the Uz-Zond is introduced in the rectum to measure the size and evaluate the state of the prostate.
  5. STUDY OF THE BAILIC (Cistoscopy).In this study, a flexible catheter with a camera in the end (cystoscope) is inserted in the urethra, allowing the doctor to see the internal surface of the urethra and the bladder.
  6. Prostate biopsy.It may be necessary to withdraw prostate tissue samples to exclude prostate cancer.

Treatment

There are many different treatment options for prostate adenoma.You and your doctor together you have to decide which treatment is suited most.Sometimes a combination of various procedures works better.Slight cases of DHCH may not need treatment.

The main types of treatment for prostate adenoma are:

  • Active observation of the disease.
  • Drug therapy.
  • Small invasive surgery.
  • Surgery.
  • Active observation.

If the doctor prefers this option, the disease will be carefully monitored without using drugs or surgical procedures.At the same time, you will be examined every year.If the symptoms determine or new symptoms appear, the doctor may offer you active treatment.Men with light symptoms can be good candidates for active observation.Even men with moderate symptoms that do not disturb them are good candidates.

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

Medical therapy

Alpha Blocker

Alfa blockers are drugs that relax the muscles of the urethra, prostate and bladder.They improve the outflow of urine and reduce the symptoms of DHCH, even without influencing the size of the prostate.Alfa blockers include alfuzososin, therapy, doxazosine and tamsulosine.

One of the advantages of Alfa blockers is that they start working immediately after admission.Side effects may include dizziness, fatigue and problems with ejaculation.

Men from DGPZ from moderates to serious and men who are worried about their symptoms are good candidates to start the therapy with Alfa blockers.

5-ALFA inhibitors Redittasi

The inhibitors of the 5-ALFA REDUTTASES are drugs that block the production of dihydrotestosterone, male hormone, which can accumulate in the prostate and cause its growth.These drugs lead to a decrease in the size of the prostate and increase the outflow of urine.These 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.The side effects include erectile dysfunction and a decrease in libido (sexual desire).At the same time, you will have to constantly continue to take tablets to prevent repeated occurrence of the symptoms of the disease.

Combined therapy

In combined therapy, Alfa blockers and 5-Alfa inhibitors Reductase are used jointly.The possible combinations of drugs include Finsteride and Doxasosin or Dutasteride and Tamsulosine.Your urologist can also prescribe a combination of alpha blockers and drugs called muscarine receptor blockers if you have symptoms of the ipractivity of the bladder.With a hyperactive bladder, the bladder muscles are not controlled and cause an increase in the frequency of urination, the sudden desires for urgently urinary and urinary incontinence.Antimoscarin drugs are drugs that relax the bladder muscles.

Combined therapy significantly improves symptoms and prevents the deterioration of the state of the DHGPH.However, it is worth remembering that each drug can cause side effects.By taking two drugs, you can have more side effects than if you have only taken a drug.

Alternative treatment methods

The car -marization is not recommended, the use of traditional medicine or treatment with various herbs (herbal medicine) for medical operators.Many studies show that the use of this treatment is not effective and, in some cases, can cause irreparable damage.In addition, the herbs and biologically active food additives (food supplements) do not pass the same drug test process.Consequently, the quality and cleaning of the additives sold without a recipe may vary.

Small invasive surgical interventions

The minimally invasive interventions are carried out with minimal anesthesia and suggest faster recovery.Very often, the procedure can be performed directly in the doctor's office or in an outpatient center.

Immediate relief of the symptoms of the disease is the greatest advantage of minimally invasive surgery.In many men, after performing a minimally invasive intervention, the outflow of urine and the control of the function of the bladder have improved.If you have problems with urination, obstruction of the urinary tract, stones in the bladder, blood in the urine, the presence of the residual volume of urine in the bladder after emptying or you have not noticed the effect of taking drugs, therefore a minimally invasive intervention could be the next step in the treatment of the disease.

However, it is worth knowing that any surgical interventions, including the minimally invasive ones, have a risk of side effects, including:

  • Urinary tract infections.
  • Blood in the urine.
  • Burn during urination.
  • The need for a more frequent emptying of the bladder.
  • Sudden urination.
  • Erectile dysfunction.

The minimally invasive surgery methods include:

  1. The elevation of a prostate urethra (or Pul methodology) - With this procedure, a special device is used to install small plants in the prostate gland.These systems are raised above and hold a nursing prostate in this position, while the pressure on the urethra decreases and the outflow of the urine improves.In this case, the destruction or removal of the fabric of the prostate gland does not occur.Pul can be made with both local and general anesthesia.Most patients note an improvement in symptoms within 2 weeks.In some cases, pain or combustion can occur when urinating, blood in the urine or a strong desire to urinate.Usually these side effects take place within two or four weeks.Good candidates to perform an increase in prostate urethra may be patients who have a history of other health problems or patients for whom surgery has a high risk.
  2. Transureral microwave therapy (or Tumt method) - microwaves are used in this procedure to destroy the prostate tissue.First of all, the doctor introduces a catheter through the urethra to the prostate gland, then send microwaves integrated into the catheter to heating the selected sections of the prostate.The high temperature destroys an excess of prostate tissue.With this procedure, anesthesia is usually not required, the risk of side effects is minimal.
  3. The method for the treatment of prostate pathologies by means of the convection ablation by water steam (rezum therapy) - this procedure uses thermal energy to destroy the excess of prostate tissue.In this case, the sterile water inside a special portable device warms up to a temperature just above the boiling point when it turns into steam.This hot steam therefore causes the rapid death of the cells.The treatment can be carried out in the medical office under local anesthesia.After the procedure, you may have a mixture of blood in the urine for some time, you will also have to use a catheter for several days.The painful or frequent urination after the procedure should pass after about 3 weeks.They are improbable sexual side effects, such as erectile dysfunction.

Traditional surgical operations

Surgical interventions with the removal of part of the prostate tissue are performed with the ineffectiveness of other therapy methods, with extremely express symptoms (for example, with complete impossibility of urination).These include:

  • Transition of the transureureral prostate (Turp)

    Turp is one of the most common operations in DHC.During this operation, after performing anesthesia, the surgeon introduces a special thin tool through the head of the penis in the urethra.Using this tool, the doctor removes the excessive tissue of the prostate gland.After the procedure, it is usually necessary to use a catheter for 1-2 days.The effect of this treatment usually lasts 15 years or more.Like any other operation, Turp has side effects and anesthesia used in the intervention, are associated with a certain risk.The side effects of the Turp can include retrograde ejaculation, erectile dysfunction, urinary tract infection after surgery and urinary incontinence.Complete recovery lasts from 4 to 6 weeks.

  • Prostate laser enucleation

    With this intervention, the surgeon puts a thin tool through the penis in the urethra.The laser entered in the tool destroys an excess of prostate tissue.At the same time, as with the transureual resection of the prostate, it is not necessary to make cuts.The recovery after laser enucleation is very fast, but after several days you may have a mixture of blood in the urine and frequent or painful urination.With this procedure, anesthesia is also required, which is associated with certain risks.

  • Prostate removal operations

    Currently, the operations to remove the prostate during DGPZ in men are extremely rare with the ineffectiveness of all other therapy methods.These operations are associated with significant risks and side effects, including urination, violations of the erectile function and serious complications during the operation itself.

Complications

The absence of timely medical care in the DGPG can lead to the development of serious complications, which include:

  • Sudden and complete inability to urinate (delayed urine, anuria).In this state, it may be necessary to enter a catheter into the bladder to provide a outflow of urine from a crowded bladder.In some cases, surgery may also be necessary to reduce urinary conservation.
  • Urinary tract infections.The inability to completely empty the bladder can increase the risk of infections in the urinary tract.
  • The stones of the bladder.The stones in the bladder are also formed due to the impossibility of completely emptying the bladder.Stones can cause the development of infections, the irritation of the bladder, the impurities of the blood in the urine and further difficulties in the outflow of urine.
  • Damage to the bladder.With incomplete emptying, the bladder can be elongated, which over time leads to a weakening of its muscle wall.Consequently, the bladder is not able to compress correctly, which becomes the cause of further difficulties in its emptying.
  • Renal damage.Urine delay can cause an increase in pressure in the bladder and the reverse outflow of the kidneys to the kidneys, which can lead to their direct damage or increase the risk of infectious diseases.These complications are extremely serious and can remain for life.

In most men with an increase in the prostate gland, these complications develop extremely rarely, however, it must be remembered that many complications, including acute urinary retention or the damage to the kidneys, can represent a serious threat to health and life.If symptoms of the disease occur, consult a doctor immediately.

Diet and prevention of the development of prostate adenoma

Unfortunately, there is no reliable way to prevent the development of prostate adenoma, but the prostate increase rate can lose weight loss and proper nutrition with a high content of fruit and vegetables in the diet.This may be due to the fact that the excess quantity of adipose tissue in the body can increase the level of hormones and other blood factors and stimulate the growth of prostate cells.Constant physical activity also helps to control the weight and level of hormones, thus reducing the risk of developing prostate adenoma.