Prostate adenoma treatment for

Prostate adenoma

Prostate adenoma is a very common urological disease in men. The disease progresses in people over 45 years of age, and over the years, the percentage of patients only increases.

Unlike prostate cancer, adenoma is a benign growth of prostate tissue that does not spread to other tissues. Since the urethra passes through the prostate gland, with its compaction and growth, patients have problems with urination. Severe symptoms do not appear immediately, but over time, if left untreated, they become very serious.

Isolation of urine during urination is difficult, urine can be excreted in a thin stream or even drop by drop. With complete blockage of the urethra, complete urinary retention is possible. Along with this, the problem of urinary incontinence is becoming more acute, i.e. passing urine against the will of the patient. Other problems are added to urination disorders:

Inflammatory processes in the kidneys and bladder, leading to pyelonephritis and cystitis; chronic renal failure; urolithiasis disease; thinning of the muscles of the bladder; bleeding from the veins of prostate adenoma.

The lack of qualified treatment in the early stages of the disease leads to the progression of the disease and the need for surgical intervention.

Conservative treatment is justified only at the earliest stages of the disease: medications are selected to stimulate trophism and blood circulation, eliminate inflammation and reduce the size of the adenoma.

Such symptomatic treatment usually includes the following drugs:

Plant extracts; alpha-blockers; 5-alpha reductase inhibitors; antibiotics; immunostimulants; drugs that improve blood circulation.

Thermal methods of influencing the adenoma are also common: cryo- and hyperthermotherapy. Conservative therapy can only stop the development of the disease that has begun, but when the adenoma causes serious problems, it needs to be removed promptly.

The most modern, minimally invasive and sparing method of treating Prostate adenoma abroad is endoscopic resection. Complications are also minimized during TUR - transurethral (through the urethra) resection of the prostate that does not require incisions.

Laser techniques are also highly effective - evaporation of hyperplastic tissue with the so-called green laser, non-traumatic and accurate. The large size of the adenoma requires abdominal surgery to remove it.

Where to treat prostate adenoma?

Menu on the left side of the page). These, for example, can be such clinics as:

Specialized Urological Center Munich-Planegg is the largest specialized urological clinic in the federal state of Bavaria. The center is staffed by highly professional specialists.

The University Hospital Instituto Fundacio Puigvert is one of the largest centers of urology, nephrology and andrology in the world. Congenital anomalies of the urogenital tract, diseases of the genitourinary system are effectively treated here.

The Rudolfinerhaus clinic provides its patients with the services of highly qualified Viennese medical specialists. All major surgical operations are performed using cutting-edge techniques in three operating rooms.

The Chaim Sheba Medical Center is the largest medical institution in the country and a leading medical center in the Middle East. The center has 150 departments and clinics.

The University Hospital of Munich is a multidisciplinary medical institution and offers its services in almost all areas of medicine. Closely cooperates with many well-known clinics in the USA and Europe.

The Wellington Clinic is a multidisciplinary private clinic in the UK, one of the largest in the country. Due to the high quality of service and the effectiveness of the methods used, this clinic was able to gain an excellent reputation.

The Herzliya Medical Center Clinic is one of the best private hospitals in Israel, accepting patients from all over the world. The hospital employs more than 500 leading doctors. Laboratories are equipped with the latest technology.

Düsseldorf University Hospital is a multidisciplinary clinic offering a wide range of diagnostic and treatment services. The clinic has a huge range of therapeutic options.

Recently, the practice of medical tourism has been increasingly developed

Benign prostatic hyperplasia, or prostate adenoma, is a very common pathology. Some clinicians conclude that this disease is inevitable in men who live long enough for the adenoma to develop.The upward trend in the incidence in recent years is due, first of all, to a change in the lifestyle of the average person.

The incidence of prostate diseases in the world as a whole, and in the territory of the post-Soviet space, is quite high. There are several reasons for this: an increase in life expectancy in economically prosperous countries, an increase in the proportion of people engaged in mental work, a sharp decrease in the physical activity of the population of the entire planet.

Diagnosis of prostate adenoma abroad.

The relevance of the issues of diagnosis and treatment of prostate adenoma is confirmed by its wide prevalence. Thus, during microscopic examination of prostate tissue, it is found in more than 60% of 60-year-old patients, and the number of patients increases with age.

The prostate gland is an important part of the male genitourinary system, it is a small body with a diameter of about 4 cm, which covers the initial section of the urethra - the urethra. The morphological substrate of adenoma is the growth of glandular tissue.

As a result, the volume of the gland increases and it wraps around the urethra, the lumen of the urethra acquires a slit-like shape, which leads to difficulty in the outflow of urine. It is this sign that, as a rule, is noticed by men in the first place. You can even say that the disease develops at the moment when urination ceases to be a pleasure.

The clinic grows as the size of the gland increases. At the beginning of the process, there is an intermittency of the urine stream at the end of the act of urination, the time of urine excretion increases, for the complete emptying of the bladder, it is necessary to strain the abdominal muscles. Since the symptoms appear gradually, patients do not always pay attention to them.

With a significant increase in the prostate gland, residual urine begins to accumulate in the bladder. The patient has other complaints associated with a decrease in free volume in the bladder, there is a feeling of incomplete emptying of the bladder, frequent urges, and the inability to hold urine during urges. In the later stages, urine is dripping continuously, and despite the fact that the bladder is full, there is no urge to urinate.

Thus, three stages of development of prostate adenoma can be distinguished:

• compensated there is a gradual difficulty in urination, frequent urge at night, the bladder is completely emptied;
• subcompensated - symptoms intensify, the bladder is not completely emptied, there is a feeling of constant desire to urinate, the walls of the bladder thicken;
• decompensated - urine stagnation develops, irreversible changes in the kidneys and urinary tract occur, kidney failure appears.

For primary diagnosis, clinical research methods are used, primarily digital rectal examination, especially for screening studies.

Of the instrumental techniques, ultrasound of the pelvic organs, transrectal ultrasound, and X-ray examination are of the greatest importance. Of the laboratory methods in the urological departments of the world's leading clinics, the method for determining the level of prostate specific antigen in the blood is used. And to verify the diagnosis, a prostate biopsy, especially if there is doubt about the origin and nature of the tumor.

Prostate adenoma treatment abroad.

In general, they can be divided into medical and surgical (open and endoscopic operations of transurethral resection and laser vaporization of the prostate using the so-called -green- laser). In recent years, the method of thermotherapy (microwave coagulation) of the prostate has also been widely used.

With timely seeking medical help, drug therapy is highly effective, aimed at improving blood circulation at the location of the disease, stopping the growth of adenoma. The modern spectrum of drug therapy is quite wide.

With neglected forms or with the ineffectiveness of therapeutic methods, various types of surgical interventions are performed. Both open operations are performed, with access through the wall of the bladder, and the so-called transurethral resections (TUR) - without incision of the skin, through the urethra - using modern video endoscopic technology, depending on the stage of the disease, the size of the gland, the age and general condition of the patient.< /p>

Prostate adenoma is a benign tumor that occurs in 50% of men over 55 years of age. The least inconvenience that adenoma causes to men is frequent urination.However, as the tumor grows, it begins to compress the nerve endings, which causes acute pain and discomfort in the lower abdomen, squeezing the rectum and urinary canal leads to stagnation of urine, frequent constipation

The leaders in the treatment of prostate adenoma are Germany and Israel, in recent years the private medicine of South Korea and Turkey has been rapidly developing, the prices in clinics of which are much lower compared to similar clinics in the USA or Europe.

Many German clinics and centers locate their branches and representative offices in other countries

• Testing and examination can be completed in 1-2 days without the need to stand in long lines.
• The test results are 99% reliable and can be obtained within a few days

Back to index

Non-surgical treatment of prostate adenoma

Non-surgical, conservative treatment of prostate adenoma will help:

• Stop tumor growth.
• Relieve pain and discomfort.
• Relieve small swellings.

However, it is not always possible to radically cure prostate adenoma in this way, more than 15% of patients will need surgery, despite the fact that specialists in Europe and the United States annually develop more and more effective methods of non-surgical treatment.

Indications for surgery

Surgical intervention for prostate adenoma is indicated under the following circumstances:

• The patient has moderate or severe symptoms.
• Recurring, regular urinary tract infections.
• Presence of kidney or bladder stones.

Back to index

Types of operations for prostate adenoma

Surgical treatment of prostate adenoma today is not always a classic abdominal operation to remove it.

• Open prostatectomy.
• Transurethral resection (TUR-surgery).
• Laser resection.
• Robotic operation to remove prostate adenoma.
• Prostate artery embolization

Open prostatectomy

This type of operation is performed only in 2-3% of cases when it is not possible to use another technique, since open prostatectomy is quite traumatic and can lead to the following complications for the patient:

• Myocardial infarction.
• Retrograde ejaculation (reverse flow of sperm), which is observed in 50-80% of cases.
• Deep vein thrombosis
• Urinary incontinence for several weeks after surgery.
• Pulmonary embolism
• Erectile dysfunction (occurs in 3-5% of patients).
• Impaired cerebral circulation.

Transurethral resection

Transurethral resection of prostate adenoma is performed using an endoscope, which during the operation penetrates through the urethra (urethra) to the prostate gland. Using a special tool, the doctor makes a wide channel for the normal passage of urine. The operation is performed under general or spinal anesthesia, after which the patient is hospitalized for 1-2 days.

At first, a special catheter is used to remove blood from the bladder, and as soon as the urine is cleared, the patient is discharged home. The first 6 weeks after surgery, there is frequent urination, but after the rehabilitation period, 85% of patients experience significant relief of symptoms of prostate adenoma.

Possible complications after transurethral resection:

• Erectile dysfunction.
• Retrograde ejaculation that does not affect erectile function.
• Various degree of urinary incontinence (no more than 1% of cases).
• 2-3% of men may need reoperation after 3 years.

Laser resection

Laser resection is also performed by the endoscopic method, it resembles transurethral resection, but the doctor performs all the main actions during the operation with a laser

Laser resection is much faster and easier than transurethral resection, does not require hospitalization after it, and the recovery process is much faster.

The risk of complications after surgery is minimal, but in rare, individual cases, the patient may experience:

• Erectile dysfunction.
• Retrograde ejaculation
• Incontinence

Robotic operation to remove prostate adenoma

Da Vinci robotic surgery is one of the most modern methods of performing surgical intervention on the prostate gland. This is a whole surgical system that penetrates the prostate gland and other organs, renders a 3D image on a computer monitor screen, and allows the doctor to perform all basic actions using microsurgical instruments.

The main advantages of robotic surgery for the treatment of prostate adenoma:

• Quickly restore normal urination.
• Low risk of postoperative complications.
• Restoration of potency after surgery.

Prostate artery embolization

Prostate artery embolization is the latest modern method of treatment, which has been used only since 2009, but is already actively used in many developed clinics in Europe and the USA. The technique is minimally invasive and highly effective; special angiographic equipment is used for the operation. The operation is performed not by a urologist, but by an endovascular surgeon, and its essence lies in the embolization (actually blockage) of the arterial vessels supplying blood to the prostate gland, therefore, the representative gland, as a result of the restriction of its blood supply, is significantly reduced in size.

Indications for embolization of prostate arteries are:

• Severe diabetes.
• Concomitant diseases of the cardiovascular system.
• Blood clotting disorders.
• Concomitant kidney disease.

Doctors distinguish as contraindications:

• Floating blood clots in the veins of the lower extremities.
• Anomaly and lesions of the iliac vessels.

Back to index

• The cost of diagnosing a disease (passing a set of tests, passing examinations, consulting specialists).
• The cost of surgery for the treatment of prostate adenoma.
• Transportation costs (air ticket, train, bus).
• Visa requirement (visa is not required to treat BPH in Israel, a Schengen visa is required to visit Germany).
• Climatic conditions of the selected country.

The average cost of various operations for the treatment of prostate adenoma in clinics in Germany, Turkey and Israel:

• Open prostatectomy: Germany €16,000 - €17,000, Israel €12,000 - €14,000, Turkey €8,000 - €10,000
• Transurethral resection of prostate adenoma: Germany - 15,000 - 16,000 euros, Israel - 11,000 - 12,000 euros, Turkey - 5,000 - 7,000 euros.
• Prostate artery embolization: Germany - 24,000 - 26,000 euros, Israel - 18,000 - 20,000 euros, Turkey - 10,000 - 12,000 euros.
• Laser resection: Germany - 18,000 - 20,000 euros, Israel - 16,000 - 19,000 euros, Turkey - 8,000 - 10,000 euros.