Prostate adenoma

Prostate adenoma, also called Prostate Gland Benign Hyperplasia (DGPZ), is an extremely common disease in men over 40.With this disease, benign growth of prostate glandular tissue occurs, which can lead to compression of the urethra, the impaired urinary output of the bladder and, as a result, 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 diagnostic and treatment methods of this disease.There are many effective methods for treating benign prostate hyperplasia, including not only drug therapy and open surgical intervention, but also minimally invasive methods of surgical treatment.If the first symptoms of the disease appear, you will need to consult a doctor who will take into account your symptoms, the size of hyperplasia, as well as the general condition of your health and offers the best treatment option.

Reasons

So far, it is not totally clear what kind of reasons leads to an increase in the prostate.However, this may be due to a change in the balance of sex hormones in the male body.Throughout their lives, men produce testosterone, male hormone and a small amount of estrogen, female sex hormone.As the body is aging, the amount of testosterone active in the blood decreases, while the amount of estrogen remains approximately at the same level.Studies have shown that the highest estrogen fraction that enters the prostate gland can increase the activity of substances that accelerate prostate cell growth.

Another theory indicates the role of another male sex hormone - Digidrotastosterone - which is important for the development and growth of a prostate at a younger 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 dipidrotestosterone, which can push the prostate cells to continue to grow.

The prostate gland is located directly under the bladder.The urethra (or urethra), which removes the bladder urine, passes through the center of the prostate.It is because of such an anatomical structure that an increase in prostate is capable of blocking urine flow.

Risk factors to increase the prostate gland can be:

1. Age.In men under 40, symptoms of an increase in the prostate gland are rarely observed.About 30% of men have moderate symptoms in 60 years and about 50% - in 80 years.
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, it means that you may also have increased 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, may in some cases increase the risk of DGPZ.
4. Life.Obesity increases the risk of DGPZ and exercise can reduce this risk.

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

Symptoms

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

DGPZH General Signs and Symptoms include:

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

Diagnosis

In case of suspected DGPZ, your doctor asks detailed questions about the presence of symptoms of the disease and will conduct a physical examination.This early stage may include:

1. Research to identify symptoms and risk factors of the disease.
2. Rectal examination of the fingers.To evaluate the size and shape of the prostate, the doctor will need to insert a finger into the rectum.This study is extremely informative, allowing you to take the primary conclusion about the state of the prostate.
3. Urine analysis.An analysis of the sample of your urine can help eliminate infection or other conditions that may cause similar symptoms.
4. Blood test.Blood test results may indicate the availability of kidney problems.
5. Blood examination for specific prostate antigen (PSA).The dog is a protein produced only by a prostate tissue.When the prostate is healthy, very small dog is found in the blood.The test can be done in the laboratory, hospital or doctor's office.No special training is required.The rapid increase in dog level can be a sign that the rapid growth of prostate tissue occurs.DGPZH is one of the possible causes of a high level of PSA.Prostate inflammation, or prostatitis, is another common cause of the high level of the dog.

After performing an initial exam and necessary tests, your doctor may recommend additional studies to confirm the presence of a DVGPH and delete other conditions.These tests may include:

1. Urodynamic examination.In this study, the patient is urinated in a container attached to a special device, which measures the force and volume of the current during urination.Test results help track the dynamics of disease development by determining whether your condition becomes better or worse.
2. Test for the residual volume of urine.This test shows if you can completely empty the bladder.The test can be performed using an ultrasound study or introducing a bladder catheter after helping to measure the amount of urine into the bladder.
3. Maintain a 24 -hour urination diary.The registration of urination and the amount of urine can be especially useful if more than one third of their daily urination occurs at night.
4. Transtrene ultrasound.At the same time, the UZ-ZOND is introduced into the rectum to measure size and evaluate the state of the prostate.
5. Bladder Study (Cystoscopy).In this study, a flexible catheter with a camera at the end (cystoscope) is inserted into the urethra, allowing the doctor to see the inner surface of the urethra and bladder.
6. Prostate biopsy.Prostate tissue samples may be required to exclude prostate cancer.

Treatment

There are many different treatment options for prostate adenoma.You and your doctor together should decide which treatment is best.Sometimes a combination of various procedures works better.Light 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.
• Surgical interventions.
• Active observation.

If your doctor prefer this option, your illness will be carefully monitored without using surgical medications or procedures.At the same time, you will be examined annually.If your symptoms deteriorate or new symptoms will appear, your doctor may offer active treatment.Men with symptoms of light can be good candidates for active observation.Men with moderate symptoms that do not bother them are also good candidates.

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

Medical therapy

Alpha Blockers

Alpha blockers are drugs that relax the muscles of the urethra, prostate and bladder.They improve urine output and reduce the symptoms of DHCH without affecting the size of the prostate.Alpha blockers include alfuzosin, terazozine, doxazosin and tamsulosin.

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

Moderate to severe DGPZ men and men who are concerned about their symptoms are good candidates to start therapy with alpha blockers.

5-alpha reductase inhibitors

5-alpha reductase inhibitors are medications that block the production of dihydrotestosterone, male hormone, which can accumulate in the prostate and cause growth.These medications lead to a decrease in prostate size and increase urine output.Such medications include ending and ductasteride.

These medications significantly reduce the risk of developing DHCH complications.They also reduce the likelihood that you need an operation in the future.Side effects include erectile dysfunction and a decrease in libido (sexual unit).At the same time, you will have to continue constantly taking pills to prevent repeated occurrence of the symptoms of the disease.

Combined therapy

In combined therapy, alpha blockers and 5-alpha reductase inhibitors are used together.Possible drug combinations include finalsteride and doxosine or ductasteride and tamsulosin.Your urologist can also prescribe a combination of alpha blockers and medicines called muscarin receptors if you have symptoms of bladder hyperactivity.With a hyperactive bladder, the bladder muscles are uncontrolled and cause an increase in the frequency of urination, sudden desires of urinary and urinary incontinence.Anti -squeal drugs are drugs that relax the bladder muscles.

Combined therapy significantly improves symptoms and prevents deterioration in the state of DHGPH.However, it is worth remembering that each medicine can cause side effects.Taking two medications, you may have more side effects than if only one medicine took.

Alternative treatment methods

Self -mildness, the use of medicine or traditional treatment using various herbs (herbal medicine) is not recommended for medical workers.Many studies show that using this treatment is not effective and, in some cases, irreparable damage can bring.In addition, biologically active herbs and food additives (eating supplements) do not pass the same test process as medicines.As a result, the quality and cleaning of additives sold without revenue may vary.

Small invasive surgical interventions

Minimally invasive interventions are performed with minimal anesthesia and suggest faster recovery.Often the procedure can be performed directly at the doctor's office or an outpatient center.

Instant relief from disease symptoms is the greatest advantage of minimally invasive surgery.In many men, after conducting minimally invasive intervention, urine output and bladder function control are improved.If you have problems with urination, urinary tract obstruction, bladder stones, blood in the urine, the presence of the residual volume of urine in the bladder after emptying or you did not notice the effect of taking drugs, minimally invasive intervention may be the next step in treating the disease.

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

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

Minimally invasive surgery methods include:

1. The elevation of a prostatic urethra (or pulse methodology) - with this procedure, a special device is used to install small implants in the prostate gland.These implants are high above and maintain a prostate increased in this position, while the pressure in the urethra decreases and the urine output improves.In this case, the destruction or removal of the prostate gland tissue does not occur.Pul can be done with local and general anesthesia.Most patients perceive an improvement in symptoms within 2 weeks.In some cases, pain or burning may occur when urinating, blood in the urine or a strong constant desire to urinate.Generally, these side effects occur within two to four weeks.Good candidates to rise prostate urethra may be patients who have a history of other health problems or patients for whom surgical intervention has a high risk.
2. Transureral Microwave Thermotherapy (or Tumt Method) - Microwaves are used in this procedure to destroy prostate tissue.First, the doctor presents a catheter through the urethra in the prostate gland and sends microwaves embedded in the catheter to heat the selected sections of the prostate.High temperature destroys excess prostate tissue.With this procedure, no anesthesia is not required, the risk of side effects is minimal.
3. The method of treatment of prostate pathologies using water vapor convection ablation (Rezum therapy) - This procedure uses thermal energy to destroy excess prostate tissue.In this case, sterile water within a special portable device heats up to a temperature just above the boiling point when it turns into steam.This hot steam causes rapid cell death.Treatment can be performed at the doctor's office under local anesthesia.After the procedure, you may have a blend of blood in the urine for a while, you will also need to use a catheter for several days.Painful or frequent urination after the procedure should pass after about 3 weeks.Sexual side effects, such as erectile dysfunction, are unlikely.

Traditional surgical operations

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

• Transuretral Prostate Resection (Turp)

  Turp is one of the most common DHC operations.During this operation, after performing anesthesia, the surgeon has a special thin tool through the head of the penis in the urethra.Using this tool, the doctor removes the excessive tissue from 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, is associated with a certain risk.Side effects of Turp may include retrograde ejaculation, erectile dysfunction, urinary tract infection after surgery and urinary incontinence.Total recovery takes 4 to 6 weeks.

• Prostate laser enucleation

  With this intervention, the surgeon puts a thin tool through the penis in the urethra.The laser inserted into the tool destroys an excess of prostate tissue.At the same time, as in the transureral resection of the prostate, they do not need to be done.Recovery after laser enucleation is very fast, but after that, for several days, you may have a blend 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, operations to remove the prostate during DGPZ in men are extremely rare with the ineffectiveness of all other therapy methods.Such operations are associated with significant risks and side effects, including urination, violations of erectile function and serious complications during the operation itself.

Complications

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

• Sudden and complete disability of urinating (late urine, anuria).In this state, it may be necessary to enter a bladder catheter to provide a urine output from an crowded bladder.In some cases, surgery may also be necessary to reduce urinary retention.
• Urinary tract infections.The inability to completely empty the bladder may increase the risk of urinary tract infections.
• The bladder stones.Bladder stones are also formed due to the impossibility of completely emptying the bladder.Stones can cause the development of infections, bladder irritation, blood impurities in the urine and other difficulties in leaving urine.
• Damage to the bladder.With incomplete emptying, the bladder can be stretched, which over time leads to a weakening of the muscle wall.As a result, the bladder becomes unable to compress properly, which becomes the cause of the most difficulty in its emptying.
• Damage in the kidneys.Delay of urine can cause an increase in bladder pressure and reverse urine output to the kidneys, which can lead to their direct damage or increase the risk of infectious diseases.Such complications are extremely serious and can remain for a lifetime.

In most men with increased prostate gland, these complications develop extremely rarely, however, it should be remembered that many complications, including acute urinary retention or kidney damage, may represent a serious threat to their health and life.If any symptoms occur, consult a doctor immediately.

Prostate adenoma development and prevention of development

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