Benign prostatic hyperplasia (BPH) or adenoma is an enlargement of the stromal component or epithelium of the prostate. The disease is found in men over 40, more rarely in young age. According to statistics, the probability of its development after 50 years is about 40% and more than 75% - after 65 years. In fact, 90% of all men are at risk for the disease sooner or later, so you need to know in advance about the causes, prostate adenoma risk factors, symptoms, and modern treatment.
Dangers
An adenoma is a benign growth, so by itself, it does not harm the body. As it grows, the forming tissues block the lumen of the urinary tract, preventing the outflow of urine. It is caused by a number of unpleasant complications and painful sensations, especially in the later stages. Developed edema leads to infections, the formation of bladder stones, its damage, as well as serious disorders of renal function, leading to the development of insufficiency. Therefore, in case of minor symptoms, it is necessary to immediately make an appointment with a urologist, undergo a thorough examination and choose the most effective method of treatment of prostate adenoma based on its results.
Stages and symptoms
The course of the disease can be divided into three main stages, accompanied by various symptoms:
- I - characterized by more frequent imperative needs, nocturia (increase in the volume of night urine output), the first signs of incontinence, more sluggish flow. At this stage the disease may remain for several years, without developing a more severe form;
- II - more pronounced symptoms. Urinary flow can be stopped, frequent urination is required for urination, which often leads to rectal hernias and prolapse. After visiting the toilet, you feel dissatisfied, incomplete emptying. The disease develops more actively, then the transition to the next form takes a relatively short time;
- III - Due to the cumulative effect, the bladder tightens, its elasticity decreases, infections develop, kidney stones appear and incontinence increases. General symptoms of poisoning may also occur - weakness, loss of appetite, nausea, constipation, dry mouth.
It should be understood that similar symptoms are accompanied by some types of nervous disorders and tumors. Accurate diagnosis can be made only in the clinic, after conducting appropriate research.
Treatment of the disease
Prostate hyperplasia is a fairly well-studied disease at this time. Its treatment does not cause any particular difficulty and can be carried out in different ways, depending on the severity of the disease, type, speed and stage of development, the patient's age, his health and other factors.
In general, all methods are conventionally divided into curative, non-medical, and surgical. There are also many recipes from alternative (traditional) medicine, including with the help of various herbal preparations, but their effectiveness has not been proven by clinical studies, and in some cases, such methods of treating prostate adenoma only complicate the course of the disease, adversely affecting the patient.
No drug technology
For mild symptoms or more severe symptoms that do not affect quality of life, vigilant anticipation is used, also called active anticipation. It involves regular monitoring of the condition without the use of medication. Behavioral therapy is also provided, including:
- Refusal to take anticholinesterase and diuretics without additional instructions from the attending physician;
- Mandatory emptying of the bladder before bedtime;
- Physiotherapy exercises, kegel exercises and other activities aimed at pelvic floor muscle exercises;
- Reduce the use of diuretics and fluids, in particular - three hours before bedtime.
The technique is used both independently and in addition to drug therapy.
Medication treatment
A number of medications can be prescribed for acute and moderate symptoms, including:
- Alfuzosin, tamsulosin and other alpha blockers;
- Solifenacin, M-anticholinergics, muscarinic receptor blockers - with a clear advantage over the symptoms of edema;
- Type V phosphodiesterase inhibitors - often used to treat impotence and its causes, but have been shown to be effective in treating hyperplasia;
- Finasteride and other 5-alpha-reductase inhibitors - reduce the rate of proliferation of prostate tissue, reduce its size.
These and other medications are usually used before surgery or in cases where it is contraindicated for any reason.
Surgery
Today, surgery is considered the "gold standard" and the most effective treatment for prostate adenoma. With their help you can achieve complete removal of prostate adenoma with minimal results for the body, maintaining normal urination and erection. Their main advantage is the ability to use at any stage of the disease. Several basic types of surgery are performed in our clinic. The decision on how to treat a prostate adenoma is made by the attending physician with the patient, after a thorough examination and examination.
Open adenomectomy
Open adenomectomy is a classic operation that involves cutting the perineum or lower abdomen and removing inflammatory glandular tissue using a variety of tools. The main advantage of the method is its good knowledge and the absence of the need for special equipment, so it can be used in almost any clinic. However, due to the opening, surgery is often accompanied by extensive bleeding. In addition, due to the proximity of the prostate to the nerve nodes, there is always a risk of damage leading to impaired sexual and urinary functions.
Transurethral resection
Prostate adenoma TURP is a procedure to remove part of the prostate gland using an electro-resection loop. Today it is one of the most desired and frequently performed surgeries due to its low invasiveness. All instruments go through the formation through the urethral canal without any incisions, resulting in no blood loss, no scars on the skin, and a recovery period of only a few days. In addition, complete information about the condition of the urinary system is collected during the procedure and any deviations found are eliminated.
New in the treatment of prostate adenoma
The most promising are minimally invasive methods using advanced technologies and equipment. ენიYour include:
- Laser enucleation of Holmium prostate hyperplasia (surgery is performed through small (up to 2 cm) incisions). With the help of a laparoscope, the laser fiber enters the bladder and travels through its neck to the gland. Adenomatous tissue is removed using an ultra-precise and safe laser of holmium crystal using gentle wounds, after which it is fused. This approach ensures almost complete absence of damage to healthy tissues and minimal blood loss;
- Transurethral photoelectric evaporation - The method involves complete burning of damaged tissues, using laser radiation, without damaging healthy cells. The intervention is performed through the urethral canal, which eliminates any wounds and scars, allows you to achieve a minimum number of relapses, reduces the recovery time to several days;
- Robot-assisted laparoscopy - performed using the advanced robotic complex "Da Vinci", equipped with the necessary tools and equipment for video recording. The control is performed by an experienced surgeon on a special terminal, while the image from the camera is displayed on a large monitor in high resolution, which significantly expands the operating field. The robot's special algorithms correct all sharp and accidental movements of the operator, completely eliminating the human factor such as tremor. The use of the complex allows you to perform the operation as accurately and precisely as possible, through a small, several millimeter incision.
All these methods have a significant disadvantage - expensive equipment and the need for experienced professional staff to work with it. Therefore, such equipment may not be used in all hospitals.