Prostate adenoma

The 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, benign growth in the glandular fabric of the prostate occurs, which can lead to the compression of the urethra, an alterated urinary exit alteration of the bladder and, therefore, unpleasant sensations during urination.Prostate adenoma can also cause serious problems with bladder and kidneys.

This article deals with the causes and symptoms of prostate adenoma, as well as modern methods of diagnosis and treatment of this disease.There are many effective methods of treatment of benign prostate hyperplasia, in particular not only pharmacy and open surgery, but also mini-invasive surgical treatment methods.If the first symptoms of the disease appear, you should consult a doctor who will take into account your symptoms, the size of hyperplasia, as well as the general condition of your health and offer you the best treatment option.

Reasons

To date, it is not quite clear what type 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 both testosterone, male hormone and a small amount of estrogen, female sex hormone.As the body ages, 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 higher fraction of estrogens entering the prostate gland can increase the activity of substances that accelerate the growth of prostate cells.

Another theory indicates 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 fall, in the prostate gland, there is still a high level of digidrotestosterone, which can push the cells of the prostate to continue to grow.

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

Risk factors to increase the prostate gland can be:

1. Age.In men under the age of 40, the symptoms of an increase in the prostate gland are rarely observed.About 30% of men have moderate symptoms of 60 years and around 50% - 80 years.
2. The presence of a DGPZ among parents.If your blood parents, for example, have a father or a 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, 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 above factors is not the basis of believing that you will certainly develop an adenoma of the prostate.

Symptoms

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

General signs and DGPZH symptoms include:

• Frequent or urgent desire to urinate.
• Increase in urination at night (Nokturia).
• The inability to empty completely.bladder.
• The presence of the residual volume of urine in the bladder.
• A low urine flow or periodic judgments during urination.
• The complexity of the beginning of urination.
• Urine growth at the end of urination.
• Frequent urinary tract infections.
• The total impossibility of urination (anuria).
• The presence of blood in the urine (hematuria).

It should be known that the prostate gland size does not necessarily determine the severity of your 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 for symptoms to be stabilized or even improved over time.

Diagnosis

In the event of DGPZ suspicion, your doctor asks detailed questions about the presence of disease symptoms and will carry out a physical examination.This initial step may include:

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

After carrying out 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 device, which measures the resistance and volume of the watercourse during urination.The test results help to follow the dynamics of the development of the disease, determining whether your condition becomes better or worse.
2. Test the residual volume of urine.This watch test if you can completely empty your bladder.The test can be carried out using an ultrasound study or by introducing a catheter into the bladder after helping to measure the amount of urine that remains in your bladder.
3. Maintaining a 8 -hour urination newspaper. The recording of urination and the amount of urine can be particularly useful if more than a third of your daily urination occurs at night.
4. Transrectal ultrasound.At the same time, the Zond Uz is introduced into the rectum to measure the size and assess the state of the prostate.
5. Study of the bladder (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 the 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 various procedures works better.DHCH light cases may not need treatment.

The main types of prostate adenoma treatment are:

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

If your doctor prefers this option, your illness will be carefully monitored without using drugs or surgical procedures.At the same time, you will be examined each year.If your symptoms deteriorate or new symptoms appear, your doctor may provide you with active treatment.Men with light symptoms can be good active observation candidates.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 be more difficult to reduce symptoms.

Medical therapy

Alpha blockers

Alpha blockers are drugs that relax the urethra, prostate and bladder muscles.They improve the flow of the urine and reduce the symptoms of the DHCH, while without affecting the prostate size.Alfa-blockers include alfuzososin, terazozine, doxazosine and tamsulosin.

One of the advantages of Alpha blockers is that they are starting to work immediately after admission.Side effects may include dizziness, fatigue and ejaculation problems.

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

5-alpha reductase inhibitors

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

These drugs considerably reduce the risk of developing DHCH complications.They also reduce the probability that you need an operation in the future.Side effects include erectile dysfunction and a decrease in libido (libido).At the same time, you will have to constantly continue to take tablets to avoid the repeated occurrence of the symptoms of the disease.

Combined therapy

In combined therapy, alpha blockers and 5-alpha reductase inhibitors are used jointly.Possible combinations of drugs include finersteride and doxasosin or dutasteride and tamsulosin.Your urologist can also prescribe a combination of alpha blockers and drugs called Muscarine receptor blockers 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, the sudden desires of urinary and urinary incontinence.Antoscarin drugs are drugs that relax the bladder muscles.

Combined therapy considerably improves symptoms and prevents deterioration in the state of DHGPH.However, it should be remembered that each medication can cause side effects.Take two drugs, you can have more side effects than if you only take one medication.

Alternative treatment methods

Self-medication, the use of traditional medicine or treatment using various herbs (plant-based medicine) is not recommended for medical workers.Many studies show that using such treatment is not effective and in some cases irreparable damage can cause.In addition, biologically active herbs and food additives (food supplements) do not transmit the same test process as drugs.Consequently, the quality and cleanliness of the additives sold without recipe may vary.

Invasive surgical interventions

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

Instant relief of the symptoms of the disease is the greatest advantage of mini-invasive surgery.Among many men, after having carried out a minimum invasive intervention, the flow of the urine and the control of the function of the bladder are improved.If you have problems of 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 if you have not noticed the effect of taking medication, then mini-invasive intervention may be the next step in the treatment of the disease.

However, it should be known that all surgical interventions, including poorly invasive interventions, have a risk of side effects, in particular:

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

Mini-invasive surgery methods include:

1. The elevation of a prostatic urethra (or PUR methodology) - with this procedure, a special device is used to install tiny implants in the prostatic gland.These implants are lifted above and contain an extended prostate in this position, while the pressure on the urethra decreases and the flow of the urine improves.In this case, the destruction or elimination of the fabric of the prostatic gland does not occur.Pul can be made with local and general anesthesia.Most patients notice symptoms improve in the 2 weeks.In some cases, pain or burn can occur during urinating it, blood in the urine or a strong constant desire to urinate.Usually these side effects take place within two to four weeks.Good candidates to make a prostatic urethra elevation may be patients who have 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 prostate tissues.First, the doctor introduces a catheter through the urethra to the gland of the prostate, then sends microwave built in the catheter to heat the selected sections of the prostate.The high temperature destroys an excess of fabric from the prostate.With this procedure, anesthesia is generally not required, the risk of side effects is minimal.
3. The method of processing the pathologies of prostate using the ablation of convection by water vapor (ground floor therapy) - This procedure uses thermal energy to destroy the excess of fabric of the prostate.In this case, sterile water inside a special portable device heats up to a temperature just above the boiling point when it turns into steam.This hot vapor then causes the rapid death of cells.Treatment can be carried out in the doctor's office under local anesthesia.After the procedure, you can have a blood mixture in the urine for a while, you will also need to use a catheter for several days.Painful or frequent urination after the procedure must pass after about 3 weeks.Sexual side effects, such as erectile dysfunction, are unlikely.

Traditional surgical operations

Surgical interventions with the elimination of part of the fabric of the prostate are carried out with the ineffectiveness of other therapy methods, with extremely expressed symptoms (for example, with a total impossibility of urilation).These include:

• Transuretral prostate resection (Turp)

  Turp is one of the most common operations in DHC.During this operation, after having carried out an anesthesia, the surgeon introduces a thin special tool through the head of the penis in the urethra.Using this tool, the doctor eliminates excessive fabric from the prostate gland.After the procedure, it is generally necessary to use a catheter for 1 to 2 days.The effect of such treatment generally 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.The side effects of the Turp can include retrograde ejaculation, erectile dysfunction, urinary tract infection after surgery and urinary incontinence.Complete recovery goes 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 inserted into the tool destroys an excess of fabric of the prostate.At the same time, as for the transurer prostate resection, no cut should be made.Recovery after laser enucleation is very fast, but after that for several days, you can have a mixture of blood in the urine and a frequent or painful urination.With this procedure, anesthesia is also required, which is associated with certain risks.

• Prostate deletion operations

  Currently, operations to eliminate prostate during DGPZ in men are extremely rare with the ineffectiveness of all other methods of therapy.These 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 a timely medical care in the DGPG can lead to the development of serious complications, in particular:

• Sudden incapacity and complete to urinate (delayed urine, anuria).In this state, it may be necessary to enter a catheter in the bladder to provide a urine flow of a crowded bladder.In some cases, surgery may also be necessary to reduce urinary retention.
• 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.Flashes of the bladder are also formed due to the impossibility of completely emptying the bladder.The stones can cause the development of infections, the irritation of the bladder, the impurities of the blood in the urine and other difficulties in the flow of the urine.
• Damage the bladder.With an incomplete emptying, the bladder can be stretched, which over time leads to a weakening of its muscle wall.Consequently, the bladder becomes unable to compress properly, which becomes the cause of new difficulties in its emptying.
• Kidney damage.Urine delay can cause an increase in the bladder pressure and the reverse output of the reins to the kidneys, which can lead to their direct damage or increase the risk of infectious diseases.Such complications are extremely serious and can stay for life.

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 constitute a serious threat to your health and your 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 and good nutrition with a high fruit and vegetable content in food.This may be due to the fact that excess 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 control the weight and level of hormones, thereby reducing the risk of developing a prostate adenoma.