Effective treatment of prostate adenoma in men

Let's decide right away that prostate adenoma refers to benign formations with characteristic features: its growth does not extend beyond the organ, and it is not prone to metastasis. In quite rare cases, such a tumor can degenerate into a malignant neoplasm.

But even it can completely and irreversibly disrupt the urinary system and other internal organs in men. Therefore, BPH clearly needs treatment. But what tactics of patient management the doctor chooses depends on many factors. We will dwell on this in detail, but a little lower. And now let's get back to the history of the issue.

Causes and manifestations of the disease

As already mentioned, a small number of men over the age of seventy manage to avoid prostatic hyperplasia.

The main reasons for its development:

• Age-related hormonal changes associated with a decrease in the secretion of the male sex hormone - testosterone. The consequences of such a restructuring can be quite easily corrected, the main thing is to identify them in time.
• Slow inflammatory reactions in the organs of the urogenital area.
• Hereditary predisposition. It is of the greatest importance in detecting pathology at a younger age.
• Individual or national dietary habits.

Interesting: long-term observations of the male part of the population of different countries have found a direct relationship between eating habits and age-related changes in the prostate gland. So, in populations where there are a lot of tomatoes, soy products, pumpkins and zucchini in the diet, and green tea is preferred from drinks, adenoma develops in fewer men.

Based on the stage of hyperplasia of the glandular tissue of the prostate, the pathology is manifested by the following symptoms:

• For the first stage of the disease, which is considered the initial one, the erased symptoms are characteristic, it is difficult to judge the nature of the pathological process from them. As a rule, men who have previously been diagnosed with congestion in the pelvis and inflammatory diseases of the urogenital area complain about them. After fifty years, such patients complain of problems with urination, when after emptying there is a feeling that the bladder has not been completely emptied, and the urine stream has a weak filling and is discontinuous. During sexual intercourse, premature ejaculation is noted. At this stage, the treatment of prostate adenoma may well do with conservative therapy and shows good efficiency.
• The second stage is characterized by dystonia and dysuria. This period is characterized by several specific symptoms that make it possible to draw an unambiguous conclusion in favor of prostate adenoma. One of them is imperative urges. Most often they are observed at night and have such intensity that the man does not have time to get to the restroom. Later, similar symptoms extend to the daytime, and urinary incontinence gives a man great discomfort and is another specific sign of the disease. In some patients, dysuric manifestations can completely disappear, which is mistakenly regarded as self-healing. But the pathological process continues its development, and the symptoms return many times stronger. The addition of a secondary infection exacerbates them even more

• The third stage of prostatic hyperplasia is characterized by the presence of residual urine in the bladder and the increase in dysuric symptoms, incomplete urinary retention is chronic, and it is already very difficult to cope with urinary retention. The hypertrophied organ is so enlarged in size that it tightens the ureters - a symptom of a fishhook. The muscular structures of the bladder are overstretched, and the hypertrophy of the walls is replaced by their thinning. This reduces not only the contractility of the bladder, but also its sensitivity. The patient does not feel the traditional urge and is able to carry up to two liters of waste fluid. The weak resistance of the sphincter muscles and the pressure of a large amount of urine lead to the fact that the urine begins to drip, this indicates that the disease is approaching the final stage. At this stage, irreversible changes occur in the bladder, and the treatment of prostate adenoma in men at this point will no longer bring a complete recovery.
• The fourth stage of the disease is characterized by paradoxical ischuria, when, against the background of incomplete urinary retention and weakening of the urinary sphincter, an unusual situation is observed - urinary retention with incontinence. At the same time, kidney failure, a disorder of the gastrointestinal tract, and general intoxication develop.

Important: at this stage there is a high risk of misdiagnosis. This is due to the variety of symptoms caused by the involvement of other organs and systems in the process.

During this period, the patient is tormented by intense thirst caused by azotemia, over time, dehydration is manifested by emaciation, and intoxication affects liver function, leading to yellowness of the skin and sclera. At the same time, the symptoms of a genitourinary nature fade into the background.

Complications of the disease

The most common complication of prostate adenoma is acute urinary retention (AUR). The risk of its development begins with the second stage of the disease and most often occurs against the background of the inflammatory process.

Other factors contributing to AUR:

• Alcohol addiction,
• Severe hypothermia,
• Overwork,
• Consciously holding back urine,
• Hypodynamic lifestyle.

The only help in this condition is catheterization as soon as possible. In the absence of adequate treatment, such a problem may occur regularly, and in the third stage of the disease it may be present all the time, which is the reason for surgical intervention.

Diagnosis

To confirm the diagnosis, the following diagnostic tests must be performed:

This pathology must be differentiated from acute prostatitis, malignant degeneration of the prostate and tuberculosis, tumor pathologies of the pelvic organs, diseases of the bladder and central nervous system.

Therapeutic measures

If at the end of the last century prostate adenoma was considered exclusively a surgical pathology, then today medical science can provide such drugs that will stop and sometimes reduce prostatic hyperplasia, remove unpleasant symptoms and improve the patient's quality of life.

Today, direct indications for the use of surgical methods of treatment are: acute urinary retention, hemorrhage from the bladder and some other conditions. In all other cases, the decision on the operation is made individually, taking into account the wishes of the patient.

Despite the fact that the effectiveness of surgical treatment is much higher and quickly manifests itself, more and more patients prefer conservative therapy. Its first results can be seen no earlier than six months after the start of treatment, but there are no complications that often develop after surgery.

So, if a man has no problems with potency, and his urination is not disturbed, then the doctor can choose expectant tactics. It consists in dynamic monitoring of the development of pathology against the background of lifestyle correction and the use of folk recipes. The patient is advised to completely eliminate alcohol and smoking, lead a mobile lifestyle, avoid constipation and urinary retention, adjust the diet and drinking regimen, and prevent hypothermia.

At this stage, walking, running, special gymnastic complexes are shown, moreover, physical exercises for prostatitis and adenoma are identical.

Drug therapy is prescribed at stages 1-2 of the disease, or as a preparatory stage before surgical treatment. The duration of the course is never shorter than six months, sometimes it can last five years, or even for life.

The following drug groups are used:

• Inhibitors (suppress activity) of 5-a-reductase. This enzyme promotes the formation of one of the forms of testosterone in the glandular tissue of the prostate. Inhibitors break this chain, preventing excessive production of dihydrotestosterone. This leads to a gradual decrease in the volume of the gland, to the elimination of compression of the urethra and the normalization of urination.
• Alpha-blockers. They are able to relax the smooth muscles of the bladder and vascular walls, which leads not only to a decrease in the tone of muscle structures and normalization of urination, but also to the expansion of the arteries of the bladder, fighting its hypoxia and improving metabolism in its wall. Since the action of these drugs is limited to muscle fibers and does not extend to the glandular tissue, they are not able to influence the growth of adenoma. This explains the complex use of these two groups of medicinal substances.
• Hormonal drugs are used in a limited number of cases, as they have pronounced side effects. They are aimed at reducing the production of testosterone, or at blocking its effect on prostate tissue.
• Phytotherapy. The use of herbal preparations is indicated for many urinary disorders. It is believed that their action is due to the presence of phytosterols. With prostate adenoma, it is recommended to use products based on the extract of nettle, pumpkin, poplar buds, sago palm fruits, flower pollen. In addition to factory medicines, home-made products are also welcome.
• Tissue preparations. They are made on the basis of extracts from the prostate gland of some animals and are peptide bioregulators.They reduce swelling and inflammatory response, stimulate blood circulation and immune response. But their action is short-lived and is observed only during the course of therapy.

It is important to understand that each of the groups of these drugs is not suitable for monotherapy, they must all be used in combination.

The following technologies can be considered modern methods of treating adenoma, not associated with surgery:

• Stenting - maintaining the patency of the urethra through the installation of special prostheses. They can be implemented for a short or long period, sometimes for life.
• Transrectal hyperthermia, when a temperature of 40-45 degrees is maintained in the organ with the help of special antennas, which has a detrimental effect on hypertrophied cells. The treatment course consists of 8-10 sessions and is prescribed in cases where adenoma is accompanied by chronic prostatitis, and there is no pronounced urination disorder.
• The treatment of prostate adenoma in one session can be achieved through thermotherapy or thermal oblation. These methods do not require general anesthesia, and can be performed on an outpatient basis.
• Focused thermal ablation with ultrasound is a more traumatic method of therapy with a relatively long recovery period. It is used for young patients for whom it is important to maintain sexual function. Pain relief is achieved through the use of intravenous drugs or other general anesthesia.

But even these treatments can cause complications. But their frequency does not exceed fifteen percent of cases.

Laser surgery is also associated with thermal effects on the tissues of the organ. The treatment is carried out through the urethra, through which the endoscope is delivered to the prostate.

The main effects achieved by laser radiation:

• Coagulative necrosis of tissues with the formation of a scab, which is independently rejected after 2-5 weeks through the urethra, sometimes it requires lysis.
• Evaporation of hypertrophied tissue, accompanied by the rapid formation of a point or widespread defect.

Surgical treatment is used for complicated course of adenoma. To date, preference is given to the following types of operations:

• Laparoscopic prostatectomy,
• Transurethral resection of the prostate (TURP),
• Radical prostatectomy.

Operations of this type are in second place in terms of frequency of performance in older men. And, despite the fact that modern medicine has many ways to treat this pathology, surgical removal of prostate adenoma is performed on three out of ten men.