Prostate adenoma - causes and symptoms, treatment in men

Men often put health problems on the back burner. Adenoma of the prostate is an insidious disease. The gradual onset and rapid onset of symptoms of benign prostatic hyperplasia can even lead to cancer.

Prostate adenoma - what is it?

Adenoma of the prostate is an increase in the volume of an organ, which is characterized by hyperplasia, that is, increased multiplication of cells, perurethral and transitional zones of the gland in men.

This happens due to a change in the hormonal balance of the body, is characterized by a benign course of the process, but sometimes it can transform into a malignant tumor.

Causes of occurrence

Finally, the reasons for the development of the disease are not known. Hyperplasia is a defensive reaction, the body tries to compensate for the deterioration in the functioning of the reproductive system. In this case, a decrease in the production of the hormone testosterone leads to the proliferation of the glandular epithelium.

Accordingly, the adenoma begins to appear at the age of 50 or more.

Some scientists consider benign prostatic hyperplasia to be a manifestation of menopause in men. Menopause is a period in the life of a person (a representative of the stronger sex), which is characterized by inhibition of sexual function against the background of hormonal changes associated with the aging of the body.

Signs and clinical symptoms

Due to the peculiarities of the structure of the male urethra (about 3 cm of it passes through the thickness of the prostate gland), the proliferation of prostate tissue mainly affects the act of urine emission, the gland begins to squeeze the urethra and prevent the free passage of urine.

The main symptoms of BPH in men are dysuric disorders, which are characterized by frequent and painful urination. These include signs such as straining, difficult onset of urine flow, weak stream, small bowel movements. Prolonged urination, which is often interrupted, is also a diagnostic manifestation, sometimes the patient may feel incomplete emptying.

If you go to the toilet 5 times a night (the norm is 1-2 times, an increase in this indicator is called nocturia), this is a good reason to consult a doctor, since this factor indicates serious disorders of the urinary system.

When a man has the urge to urinate, but urine is excreted in a drop-by-drop manner, this is incontinence and also testifies in favor of the described pathology. Accordingly, you need to immediately go to the clinic and start treatment.

Adenoma is a slowly but constantly progressive disease of the glandular epithelium of the prostate gland. With age, it grows in volume every year by 2% and it turns out that from the moment of the onset of pathological changes in 35 years it will increase 2 times!

Diagnostic methods

The urologist conducts a number of measures to identify pathology, for example, a digital examination through the anus. It is it that allows you to determine the size and surface, and, accordingly, to suspect an enlargement of the prostate, if any.

Laboratory tests necessarily include a general urine test, which will help determine inflammation in the urethra. It is also desirable to detect the level of prostate specific antigen in order to exclude the development of cancer (normal PSA values are not more than 4 ng / ml). It is imperative that a biopsy of the gland be performed to confirm the diagnosis.

The main diagnostic method is ultrasound, it allows you to determine the mass and structure of the prostate. It is also used to detect the amount of Residual urine, which identifies the degree of the disease.

Ultrasound can help detect complications such as thickening, stones and bulging of the bladder.

Grades of prostate adenoma

The first degree - the body still fully compensates for the dysfunction. Initial changes in urination are diagnosed, pathological manifestations are usually absent. Residual urine is not detectable.

The second stage - the body's defense mechanisms begin to weaken, moderate clinical signs are recorded. The volume of fluid that is constantly in the bladder is less than 100 ml.

Third degree - the urinary system is no longer able to overcome the obstacle in the form of an enlarged prostate gland, which leads to serious consequences. Severe urinary disorders contribute to stagnation in the middle and upper urinary tract and the development of chronic renal failure. The amount of liquid constantly in the bladder exceeds 100 ml.

Complications

With further progression of the disease, clinical consequences develop:

• acute (usually asymptomatic) or chronic urinary retention;
• urinary tract infection is detected in 10% of patients;
• formation of stones and protrusions in the bladder;
• ureteral dilatation due to reverse urine reflux was found in 5%;
• the formation of chronic or acute renal failure, due to blockage or compression of the lumen of the urethra.

Prostate adenoma - when is surgery necessary?

Surgical treatment is used in the following cases:

• Acute urinary retention (more than 3 days), which is not restored by medication and, as a consequence, acute renal failure.
• Dilation of the ureters and renal pyelocaliceal system;
• Recurrent bleeding from the urethra;
• Infection of the genitourinary system;
• Multiple stones or swelling in the bladder;
• Chronic renal failure;
• Medication therapy does not work for three months or more;
• If the patient wishes.

How to treat?

When choosing a therapy, the doctor prefers any method, depending on the severity of the symptoms and the presence of deterioration. They can be conditionally divided into three large groups: minimally penetrating methods, medical and surgical treatment of prostate adenoma.

Minimally invasive instrumental techniques

Temperature:

• microwave thermotherapy;

Laser treatment methods:

• laser enucleation;
• contact laser vaporization;
• contact laser resection (partial removal);
• mixed technique.

Operation: types, characteristics, prices

In the presence of complications and pronounced clinical signs of urinary retention, surgical procedures are required. Despite the introduction of new alternative methods of therapy, surgical removal of prostate adenoma remains the only radical way to cure grade 3 patients. The price is strictly individual and depends on many conditions.

Transurethral resection of the prostate (TUR):

• partial;
• subtotal (almost complete removal of the gland);
• total;
• radical (removal with nearby tissues).

TUR is an endoscopic method in which a part of the overgrown tissue is removed (under the influence of an electric current) through the urethra using an instrument

When performing TUR, there are a number of advantages: a low level of trauma, a man is discharged from the hospital already for 3-4 days, the intervention is repeated without a significant increase in his risk, a good, cosmetic effect.

It is recommended to perform the operation:

• with a small amount of growths (less than 80 g);
• at a young age of the patient (up to 50 years);
• when it is necessary to preserve sexual function;
• for extreme obesity;
• for suspected prostate cancer;
• for previous interventions on the lower urinary tract and intestines;
• in case of relapses of the disease; concomitant prostatitis, etc.

Prostatectomy:

• transbubble;
• retropubic;
• crotch.

Open surgery (prostatectomy) is performed when the volume of the prostate gland is more than 100 g and it is impossible to perform TUR, the expansion of the ureters due to reverse urine flow, the inability to stop profuse bleeding from the bladder or significant stones in it.

The frequency of complications that cause the greatest inconvenience to patients (lack of desire for sex, impotence, retrograde ejaculation) after prostatectomy does not differ significantly from their frequency after TUR. However, a large area of open intervention determines a longer hospitalization of patients (8-10 days) compared to TURP (4-7 days), as well as a greater likelihood of mortality

Conservative treatment

The use of drugs is possible in the absence of complications and the presence of clinical symptoms that do not lead to painful and unpleasant sensations in a man.

Medications can reduce the mass of the prostate gland, control the growth of foci of hyperplasia, improve the quality of life, reducing pain during urination and other dysuric phenomena. You should also dispense with surgery if your general health does not allow for surgical interventions.

The most effective drugs for the treatment of prostate adenoma

First of all, alpha-blockers of adrenaline receptors are used for symptomatic therapy: Omnik, Tamsulosin, Kornam. They should be taken according to the scheme: inside on an empty stomach, 400 mcg.They block the adrenaline receptors of the smooth muscles of the lower urinary tract, thereby increasing outflow. Medicines are effective after 2 weeks of administration.

The ability to inhibit the effect of testosterone on the growth of the prostate gland is characteristic of tablets - 5-alpha-reductase inhibitors. The most effective drugs for prostate adenoma in this group are Dutasteride and Finasteride. To facilitate the emptying and relaxation of the smooth muscle cells of the urethra, you can use suppositories with antispasmodics: Papaverine, Drotaverin.

Exercise and other side effects

In the case of a complete exclusion of the likelihood of prostate cancer, if a person has no complications and manifestations of impaired urination, the doctor should resort to expectant tactics, do not start immediately treating with medications. You can prescribe phytotherapeutic agents, exercises, diet, physiotherapy procedures to the patient. Re-examination should be carried out once a year, and include a PSA test.

At the initial stage, any exercise is useful, but swimming and yoga have the best effect on the body. They help relax and stretch the muscles in the perineum, abs, back and hips.

Folk remedies for BPH

All herbs that have anti-inflammatory and antimicrobial effects can be used in the fight against prostate adenoma. But it is especially worth noting a decoction of aspen bark and tincture of onion peel.

Recipes:

You can use ready-made herbal remedies: Tulosin, Likoprofit, Indigal. Treatment with folk remedies is used only as part of complex therapy at the first or initial manifestations of the second stage and always with the approval of the attending physician.

Diet

Proper nutrition and water regime are the basis of complex therapy. It is necessary to exclude the intake of large amounts of liquid at night. When following a diet, there are several basic principles to follow:

• to increase the intake of complex carbohydrates: unprocessed cereals, whole grain breads, nuts, greens. Due to their high fiber content, these foods enhance intestinal motility and eliminate the possibility of constipation.
• to ensure a sufficient supply of fatty acids for the normal synthesis of hormones. They are mainly found in dairy products and vegetable oils (you can take fish oil - both in capsules and liquid);
• avoid taking spicy foods.

Prevention of BPH

Unfortunately, the world has not yet invented a 100% cure for BPH, so let's look at preventive measures that will help reduce the risk of its occurrence.

Factors that increase the risk of pathology:

• hereditary predisposition;
• obesity grade 2 and higher;
• abuse of testosterone (anabolic steroids);
• and if we cannot influence genetics, then it is necessary to control our diet, engage in sufficient physical activity and without the need not to carry out hormone replacement therapy.

For the prevention of prostatic hyperplasia, physiotherapists recommend magnetic therapy with the domestic Almag apparatus, as well as with the Prostata help MP-1 device.