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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 40 years of age.With this disease, a benign increase in the prostate gland tissue occurs, which can lead to compression of the urethra, damaged urinary flow from the bladder and, as a result, 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 diagnosing and treating this disease.There are many effective methods for treating benign prostate hyperplasia, including not only medication therapy and open surgical intervention, but also minimum invasive surgical treatment methods.If the first symptoms of the disease appear, you should consult a doctor who will consider your symptoms, the size of hyperplasia, and the general condition of your health and provide you with the best treatment option.

Reason

So far, it is not entirely clear what kind of reasons lead to a prostate growth.However, this may be due to a change in the balance of sex hormones in the male body.Throughout their lives, men produce two testosterone, male hormone and a small amount of estrogen, female sex hormone.As the body is aging, the amount of active testosterone 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 the growth of prostate cells.

prostate adenoma in a man

Another theory shows the role of another male sex hormone - digidrotestosterone - 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 decline, there is still a high level of digidrotestosterone in the prostate gland, which can push the prostate cells to continue to grow.

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

Risk factors for growth of 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 experience moderate symptoms with 60 years, and about 50% - with 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, then it means you may 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. Life.Obesity increases the risk of DGPZ, and physical exercise can reduce this risk.

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

Symptoms

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

Signs and General Symptoms of DGPZH include:

  • Frequent or urgent desire to urinate.
  • Increased urination at night (nocturia).
  • The inability to completely empty.bladder.
  • The presence of the remaining volume of urine in the bladder.
  • Poor flow of urine or periodic stops during urination.
  • The complexity of the onset of urination.
  • Increased urine at the end of urination.
  • Frequent urinary tract infections.
  • Complete impossibility of urination (Anuria).
  • The presence of blood in the urine (hematuria).

It is worth noting that the size of the prostate gland does not necessarily determine the seriousness of your symptoms.Some men with a slightly enlarged prostate can have serious symptoms, while other men even with extremely enlarged prostate glands may be irrelevant.Almost all patients are characterized by the gradual deterioration of symptoms over time.Extremely is extremely rare that symptoms can stabilize or even improve over time.

Troubleshooting

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

  1. A study to identify the symptoms and risk factors of the disease.
  2. Examination of the finger rectum.To evaluate the size and shape of the prostate gland, the doctor will need to put a finger in the rectum.This study is extremely informative, allowing you to draw the main conclusion about the condition of the prostate gland.
  3. Urine analysis.An analysis of your urine sample can help eliminate the infection or other conditions that can cause similar symptoms.
  4. Blood test.Blood test results can indicate the availability of kidney problems.
  5. Blood test for specific prostate antigen (PSA).The dog is a protein that is produced only by a prostate fabric.When the prostate is healthy, very little dog is found in the blood.The test can be done in the office of the lab, hospital or doctor.No special training is required.The rapid rise in the dog 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 prostate, is another common cause of high dog level.

After performing an initial examination and the necessary tests, your doctor may recommend additional 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 urinated in a container attached to a special apparatus, which measures the strength and volume of the flow during urination.The test results help to track the dynamics of the development of the disease, determining whether your condition becomes better or worse.
  2. Test for the remaining volume of urine.This test shows whether you can completely empty your bladder.The test can be performed using an ultrasound study or by inserting a catheter into the bladder after helping to measure how much urine has remained in your bladder.
  3. Keeping a 24-hour urination diary.Urinary recording and the amount of urine can be especially useful if more than a third of your daily urination at night occurs.
  4. Trankectal ultrasound.At the same time, Uz-zond is inserted into the rectum to measure the size and evaluate the prostate condition.
  5. Bladder study (cystoscopy).In this study, a flexible catheter with a camera at the bottom (cystoscopy) is inserted into the urethra, allowing the doctor to see the inner surface of the urethra and bladder.
  6. Prostate biopsy.It may be necessary to take prostate tissue samples to exclude prostate cancer.

Treatment

There are many different treatment options for prostate adenoma.You and your doctor together should decide which treatment suits you the most.Sometimes a combination of different procedures works better.DHCH mild cases may not need treatment.

The main types of treatment for prostate adenoma are:

  • Active observation of the disease.
  • Medication therapy.
  • Small invasive surgery.
  • Surgical interventions.
  • Active observation.

If your doctor prefers this option, then your illness will be carefully monitored without using medication or surgical procedure.At the same time, you will be examined every year.If your symptoms will worsen or new symptoms appear, your doctor may provide you with an active treatment.Men with mild symptoms 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 are no side effects, but it is likely that it will then be harder to reduce the symptoms.

Medical therapy

Blocking alpha

Alpha blockers are medicines that relax the urethra, prostate and bladder muscles.They improve the flow of urine and reduce the symptoms of DHCH, while without affecting the size of the prostate.Alfa-blockers include Alfuzosin, terasosis, doxazos and tamsulosin.

One of the advantages of Alpha Blockers is that they start working immediately after accepting.Side effects can include dizziness, fatigue and spill problems.

Men from moderate to severe DGPZ and men who worry about their symptoms are good candidates to start therapy with alpha blockers.

5-alpha reductase inhibitors

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

These medicines significantly reduce the risk of developing DHCH complications.They also reduce the likelihood you will need in the future.Side effects include erectile dysfunction and a decrease in sexual desire (sex machines).At the same time, you will need to continue to take tablets constantly to prevent the repeated appearance of the symptoms of the disease.

Combined therapy

In combined therapy, alpha blockers and 5-alpha reductase inhibitors are used jointly.Possible drug combinations include finsteride and doxasosine or dutasteride and tamsulosin.Your urologist can also prescribe a combination of alpha blockers and medicines called muscarin receptor blockers if you have symptoms of bladder hyperactivity.With a hyperactive bladder, the bladder muscles are uncontrolled and cause an increase in urination frequency, sudden desires for urinary and urinary incontinence.Antimoscarinal drugs are medicines that relax the bladder muscles.

Combined therapy significantly improves symptoms and prevents deterioration in the condition of DHGPH.However, it is worth remembering that any medicine can cause side effects.By taking two medicines, you may have more side effects than if you only received one medicine.

Alternative treatment methods

Self -medication, the use of traditional medicine or treatment using different herbs (herbal medicine) is not recommended for medical staff.Many studies show that using such treatment is not effective, and in some cases, it can lead to irreparable damage.Moreover, biologically active food plants and additives (dietary supplements) do not go through the same testing process as medicines.As a result, the quality and cleanliness of the additives sold without a prescription may vary.

Small surgical intervention -invasive

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

Immediate relief of the symptoms of the disease is the greatest advantage of minimal invasive surgery.In many men, after performing minimal invasive intervention, urine leakage and bladder function control 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 remaining urine volume in the bladder after emptying or you have not noticed the effect of taking the drug, then minimal invasive interference may be the next step in treating the disease.

However, it is worth knowing that any surgical intervention, including minimum invasive ones, has the risk of side effects, including:

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

Minimum invasive surgery methods include:

  1. The height of a prostate urethra (or PUL methodology) - with this procedure, a special device is used to install small implants in the prostate gland.These implants are raised above and maintain an extended prostate in this position, while pressure on the urethra decreases and urine flow 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 notice an improvement in symptoms within 2 weeks.In some cases, pain or burning can occur when urinating, blood in the urine or a strong constant desire to urinate.Usually these side effects occur within two to four weeks.Good candidates to perform a prostate urethra increase may be patients who have a history of other health problems or patients for whom surgical intervention has a high risk.
  2. Transurethral microwave thermotherapy (or tumt method) - microwaves are used in this procedure to destroy the prostate tissue.First, the doctor presents a catheter through the urethra in the prostate gland, and then sends microwaves built into the catheter to heat the selected prostate sections.High temperature destroys an excess of prostate clothes.With this procedure, anesthesia is usually not required, the risk of side effects is minimal.
  3. The method of treating prostate pathologies using convection ablation from water steam (resum Therapy) - this procedure uses thermal energy to destroy the excess of prostate tissue.In this case, sterile water inside a special portable device is heated to a temperature just above the boiling point when it turns into steam.This hot steam then causes the rapid death of cells.Treatment can be performed at the doctor's office under local anesthesia.After the procedure, you can have a mixture of blood in the urine for some time, you will need to use a catheter for a few 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 the prostate tissue are performed with the ineffectiveness of other methods of therapy, with extremely expressed symptoms (for example, with complete impossibility of urination).These include:

  • Transuretral prostate resection (shame)

    Shame is one of the most common operations in DHC.During this surgery, after performing the anesthesia, the surgeon presents a special thin tool through the penis head in 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 effect of such treatment usually lasts 15 years or more.Like any other operation, shame has side effects and anesthesia used in the intervention, associated with a certain risk.Side effects of shame may include retrograde ejaculation, erectile dysfunction, urinary tract infection after surgery and urinary incontinence.Complete healing lasts from 4 to 6 weeks.

  • ENUCLEATION LASER OF PROSTATE

    With this intervention, the surgeon places a thin tool through the penis in the urethra.The laser inserted into the tool destroys an excess of prostate fabric.At the same time, as with transurethral prostate resection, no cuts should be made.Recovery after laser enussion is very fast, but after that for a few days you may have a blood mix in the urine and frequent or painful urination.This procedure also requires anesthesia, 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 methods of therapy.Such operations are accompanied by significant risks and side effects, including urination, raid function and serious complications during surgery itself.

Complications

Lack of timely medical care in 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 urine leak from a crowded bladder.In some cases, surgery may also be required to reduce urine retention.
  • Urinary tract infections.The inability to completely empty the bladder can increase the risk of urinary tract infections.
  • Bladder stones.The stones in the bladder are also formed due to the inability to complete the bladder.Stones can cause the development of infections, bladder irritation, blood impurities in the urine and further difficulty in urine.
  • Bladder damage.With incomplete emptying, the bladder can extend, which over time leads to a weakening of its muscle wall.As a result, the bladder becomes unable to compress properly, which becomes the cause of further difficulties in emptying it.
  • Kidney damage.Urinary delay can cause an increase in the pressure in the bladder and the reverse emergence of 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 life.

In most men with adult prostate glands, these complications develop extremely rarely, however, it should be remembered that many complications, including acute urine maintenance or kidney damage, can pose a serious threat to your health and life.If any symptoms of the disease appear, consult a doctor immediately.

Diet and preventing prostate adenoma development

Unfortunately, there is no reliable way to prevent the development of prostate adenoma, but the rate of prostate growth 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 excessive amount of adipose tissue in the body can increase the level of hormones and other blood factors and stimulate the growth of prostate cells.Continuous physical activity also helps to control the weight and level of hormones, thereby reducing the risk of developing prostate adenoma.