Prostate adenoma

Prostate adenoma, also known as benign hyperplasia of the prostate gland (DGPZ), is a very common disease in men over 40.With this disease, benign growth of prostate gland tissue occurs, which can cause urethra compression, urinary tract outflow and, consequently, unpleasant sensations during urination.Prostate adenoma can also cause serious problems with the bladder and kidneys.

This article discusses the causes and symptoms of prostate adenoma, as well as modern methods of diagnosis and treatment of the disease.There are many effective methods for treating benign prostate hyperplasia, including not only drug therapy and open surgical intervention, but also a slight invasive surgical treatment method.If the first symptom of the disease appears, you should consult a doctor who will take into account your symptoms, size of hyperplasia, as well as your general health and offer the best treatment options.

Cause

To date, it has not been completely clear what the causes have led to an increase in the prostate.However, this may be due to changes in the balance of sex hormones in the male body.Throughout their lives, men produce testosterone, male hormones, and little estrogen, female sex hormones.When the body is aging, the amount of testosterone active in the blood decreases, while the amount of estrogen remains about the same level.Studies have shown that higher estrogen fractions entering the prostate gland can increase the activity of materials that accelerate the growth of prostate cells.

Other theories show the role of other male sex hormones - digidrotestosterone - which is important for the development and growth of prostate at a younger age.Some studies have shown that while testosterone levels in the blood begin to fall, in the prostate gland there is still high levels of digidrotestosterone, which can lead to prostate cells to continue to grow.

The prostate gland is located under the bladder.Urethra (or urethra), which removes urine from the bladder, through the center of the prostate gland.This is because of such anatomical structure that the increase in prostate can prevent urine flow.

Risk factors to increase the prostate gland can be:

1. Age.In men under the age of 40, symptoms of increased prostate gland are rarely observed.About 30% of men experience moderate symptoms of 60 years, and about 50% -with 80 years.
2. The presence of the DGPZ in the brothers.If your blood clots, for example, have a father or brother, have problems with the prostate gland, then this means you can also increase the risk of prostate hyperplasia.
3. Other diseases such as diabetes, cardiovascular disease 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. Live.Obesity increases the risk of DGPZ, and physical training can reduce this risk.

However, the presence of any of the above factors is not the basis for believing that you will definitely develop prostate adenomas.

Symptom

Symptoms of symptoms in people different from prostate adenomas are different.

General signs and DGPZH symptoms include:

• Frequent or urgent desire to urinate.
• Increased urination at night (nocturia).
• Inability to fully empty.bladder.
• The presence of the amount of urine in the bladder.
• Urine flow or periodic stop during urine.
• The complexity of urine.
• Urine growth at the end of the urine.
• Frequent urinary tract infections.
• Complete impairment for urination (anuria).
• The presence of blood in urine (hematuria).

It should be noted that the size of the prostate gland does not necessarily determine the seriousness of your symptoms.Some men with slightly enlarged prostates may experience serious symptoms, while other men even with highly enlarged prostate glands can be insignificant.Almost all patients are characterized by gradual deterioration of symptoms over time.Very rarely symptoms can be stable or even improve over time.

Diagnostics

If you are suspected of DGPZ, your doctor asks a detailed question about the presence of symptoms of the disease and will perform a physical examination.This early stage may include:

1. A survey to identify the symptoms and risk factors of the disease.
2. Finger rectal examination.To assess the size and shape of the prostate gland, the doctor needs to insert the finger into the rectum.This study is very informative, allowing you to draw a key conclusion about the state of the prostate gland.
3. Urine analysis.Your urine sample analysis can help eliminate infections or other conditions that can cause the same symptoms.
4. Blood test.The results of the blood test may indicate the availability of kidney problems.
5. Blood test for prostate -specific antigen (PSA).The dog is a protein produced only by the prostate fabric.When the prostate is healthy, very small dogs are found in the blood.This test can be done in laboratories, hospitals or doctors.No special training is required.The rapid increase in the dog level may be a sign that the rapid growth of the prostate fabric occurs.DGPZH is one of the most likely sources of PSA levels.Inflammation of the prostate, or prostatitis, is another common cause of dog levels.

After conducting the initial examination and the necessary tests, your doctor may recommend additional studies to confirm the presence of DVGPH and excluding other conditions.This test may include:

1. Urodinamic examination.In this study, the patient was discarded in a container attached to a special device, which measures the strength and amount of the flow during urination.Test results help detect the dynamics of the development of the disease, determining whether your condition is better or worse.
2. Test for urine amounts.This test shows whether you can completely empty your bladder.This test can be done using an ultrasound study or by introducing a catheter into the bladder after you help measure how much urine is left in your bladder.
3. Maintain a 24 -hour urine diary.Urinary registration and urine amounts can be very useful if more than one -third of your daily urine occurs at night.
4. Transrectal ultrasound.At the same time, UZ-Zond was introduced into the rectum to measure the size and evaluate the prostate condition.
5. Cystoscopy study.In this study, the flexible catheter with the camera at the end (cystoscope) was inserted into the urethra, allowing doctors to see the inner surface of the urethra and bladder.
6. Prostate biopsy.It may be necessary to take a sample of prostate tissue to exclude prostate cancer.

Treatment

There are many different treatment options for prostate adenomas.You and your doctor must decide which treatment best suits you.Sometimes the combination of various procedures works well.DHCH's mild cases may not require treatment.

The main type of treatment for prostate adenoma is:

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

If your doctor prefers this option, then your disease will be carefully monitored without any medication or surgical procedure.At the same time, you will be checked every year.If your symptoms will deteriorate or new symptoms appear, your doctor may offer active treatment.Men with symptoms of light can be a good candidate for active observation.Men with moderate symptoms that do not bother them are also good candidates.

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

Medical therapy

Alpha blockers

Alpha blockers are drugs that relax the urethra, prostate and bladder muscles.They increase the flow of urine and reduce the symptoms of DHCH, temporarily without affecting the size of the prostate.Alfa-blockers include alfuzososine, terazozin, doxazosin and tamsulosin.

One of the advantages of alpha barriers is that they start working shortly after entry.Side effects can include dizziness, fatigue and problems with ejaculation.

Men from moderate to severe DGPZ and men who are worried about their symptoms are a good candidate to start therapy with an alpha barrier.

5-alpha reductase inhibitors

5-alpha reductase inhibitors are drugs that inhibit the production of dihydrotestosterone, male hormones, which can accumulate in the prostate and cause its growth.These drugs lead to a decrease in prostate size and increase urine flow.Such medicines include finatoride and dutasteride.

These drugs significantly reduce the risk of developing DHCH complications.They also reduce the likelihood that you need surgery in the future.Side effects include erectile dysfunction and decreased libido (sex drive).At the same time, you should continue to take tablets to prevent recurrent occurrence of the symptoms of the disease.

Coalition

In combined therapy, alpha barrier and 5-alpha reductase inhibitors are used together.A combination of drugs that may include fininide and doxasosine or dutasteride and tamsulosin.Your urologist can also prescribe a combination of alpha barriers and drugs called muscarin receptor barrier if you have hyperactive symptoms of bladder.With hyperactive bladder, the bladder muscles are uncontrolled and cause an increase in frequency of urination, a sudden desire for urination and urination.Antimoscarin drugs are drugs that relax the muscles -The bladder.

Combined therapy significantly improves symptoms and prevents deterioration in dhgph.However, keep in mind that each drug can cause side effects.Taking two drugs, you can have more side effects than if you only take one drug.

Alternative treatment methods

Self, the use of traditional medicine or treatment using various herbs (herbal remedies) is not recommended for medical workers.Many studies have shown that the use of such treatment is ineffective, and in some cases, irreparable hazards can be brought.In addition, biological herbs and supplements (supplements) do not pass the same test process as drugs.As a result, the quality and hygiene of supplements sold without recipes can vary.

Small surgical intervention

Minimal invasive intervention is carried out with minimal anesthesia and suggests faster recovery.Often, the procedure can be performed right at the doctor's office or in the outpatient center.

The immediate release of the symptoms of the disease is the greatest advantage of minimal invasive surgery.In many men, after making a slight invasive intervention, urine outflow and the control of the bladder function were improved.If you have problems with urination, urinary tract obstruction, stones in the bladder, blood in the urine, the presence of urine in the bladder after emptying or you do not see the effects of taking medications, so slightly invasive intervention may be the next step in the treatment of the disease.

However, it is advisable to know that any surgical intervention, including slightly invasive, has a risk of side effects, including:

• Urinary tract infections.
• Blood in the urine.
• Burns while urinating.
• The need to clear the bladder more frequently.
• The urine suddenly.
• Erectile dysfunction.

Invasive minimum surgical methods include:

1. The height of the prostatic urethra (or PUL methodology) - with this procedure, a special device is used to install small implants in the prostate gland.The implants are raised above and hold the enlarged prostate in this position, while the pressure on the urethra decreases and the urine outflow improves.In this case, the destruction or removal of the prostate gland tissue does not occur.PUL can be made with local and general anesthesia.Most patients see an increase in symptoms within 2 weeks.In some cases, pain or burning can occur when urinating, blood in urine or constant desire for urination.Usually these side effects occur within two to four weeks.A good candidate for performing the height of the prostatic urethra can be a patient with a history of other health problems or a high -risk surgical intervention.
2. Transurethral microwave thermotherapy (or TUMT method) - microwave is used in this procedure to destroy prostate tissue.First, the doctor introduces the catheter through the urethra to the prostate gland, and then sends a microwave built into the catheter to heat the selected part of the prostate.High temperatures destroy excess prostate fabric.With this procedure, anesthesia is usually not required, the risk of side effects is minimal.
3. Methods of treating prostate pathology using convection ablation by water steam (reserving therapy) - this procedure uses heat energy to destroy excess prostate tissue.In this case, sterile water in a special mobile device heats the temperature right above the boiling point when it becomes steam.This hot steam then causes rapid cell death.Treatment can be carried out at a doctor's office under local anesthesia.After the procedure, you may have a mixture of blood in the urine for some time, you should also use a catheter for several days.Pain or frequent urination after the procedure should pass after about 3 weeks.Sexual side effects, such as erectile dysfunction, are not possible.

Traditional surgery operations

Surgical intervention with the removal of some prostate tissue is performed with inefficiencies of other therapeutic methods, with highly stated symptoms (for example, with complete impairment for urination).These include:

• Transuretral prostate resection (Turp)

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

• Enucleases of prostate laser

  With this intervention, the surgeon places a thin tool through the penis in the urethra.The laser is inserted into the device to destroy the excess prostate fabric.At the same time, such as prostate transurethral resection, no cuts need to be made.Recovery after laser enucleation is very fast, but after a few days, you may have blood mixture in urine and urine regularly or painful.With this procedure, anesthesia is also needed, which is associated with certain risks.

• Prostate removal operation

  Currently, the operation to eliminate the prostate during DGPZ in men is extremely rare with the uncertainty of all other therapeutic methods.Such operations are associated with significant risks and side effects, including urine, violation of serious erection function and complications during the operation itself.

Complication

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

• Disability -Complete and complete for urinating (delayed urine, Anuria).In the state, it may be necessary to enter the catheter into the bladder to provide urine flow from congested bladder.In some cases, surgery may also be needed to reduce urinary retention.
• Urinary tract infections.The inability to fully clear the bladder can increase the risk of infection in the urinary tract.
• The bladder stone.The stones in the bladder are also formed due to the completely disadvantage of emptying the bladder.Stones can cause the development of infection, bladder irritation, blood impurities in the urine and further difficulties in the flow of urine.
• Damage to the bladder.With incomplete emptying, the bladder can be stretched, which over time leads to the weakness of the muscle wall.As a result, the bladder becomes unable to compress properly, which is the cause of further difficulty in its emptying.
• Kidney damage.Urine delays can lead to increased pressure in the bladder and the outflow of urine to the kidneys, which can cause direct damage or increase the risk of infectious diseases.Such complications are very serious and can last for a lifetime.

In most men with increased prostate glands, these complications develop very rarely, however, keep in mind that many complications, including acute urinary retention or kidney damage, can pose a serious threat to your health and life.If you have any symptoms of the disease, consult your doctor immediately.

Diet and prevention of prostate adenoma development

Unfortunately, there is no reliable way to prevent the development of prostate adenoma, but the rate of improvement in the prostate can reduce weight loss and proper nutrition with high fruit and vegetable content in the diet.This may be due to the fact that excessive amounts of adipose tissue in the body can increase hormone levels and other blood factors and stimulate prostate cell growth.Persistent physical activity also helps control weight and hormone levels, thus reducing the risk of developing prostate adenomas.