What kind of disease is prostatic hyperplasia

BPH what is it? Symptoms, treatment of benign prostatic hyperplasia

In modern medicine, abbreviations are often used that are not entirely clear to an ordinary person without honey. education. One of these obscure abbreviations is BPH. What it is? Speaking in the language of doctors, this is benign prostatic hyperplasia. But among the people it is called more simply - prostate adenoma ( a variant of prostate adenoma is possible). Often, prostate adenoma is confused with a disease such as prostatitis. BPH is a benign formation, and it grows not without the participation of the stromal component of the prostate (in other words, the glandular epithelium), and prostatitis is nothing more than inflammation of the prostate gland. Do not confuse them.

BPH. What it is? Statistics

As mentioned above, BPH is a benign neoplasm. With it, small nodules form in the prostate (abbreviated name of the same prostate gland), which, as they grow, more and more compress the urethra.

Because of this, a man develops urination disorders. This disease has a benign growth, and this is what distinguishes BPH from cancer.

BPH is one of the most common diseases in urology today. According to statistics, it appears in almost 80 percent of men in old age. In 20 percent of cases, instead of BPH, there is atrophy of the gland or its increase.

BPH disease most often develops in men over 45 years old.

More than half of men from 40 to 50 years old turn to a specialist with this ailment, and only in rare cases can the disease overtake the young.

Causes of BPH development

To date, the exact causes of the development of BPH in the prostate gland cannot be specified, since they simply have not been fully elucidated. It is believed that the disease is one of the signs of menopause in men.

The only risk factors are the level of androgens in the blood and the person's age.

Usually, as a man ages, the balance between estrogens and androgens is gradually disturbed, which causes a violation of control over the growth and function of gland cells.

It is known that there is no connection between BPH of the prostate and a person's sexual activity, orientation, bad habits, sexually transmitted and inflammatory diseases, and none of the above has any effect on the onset of the disease.

BPH of the prostate gland most often appears in its central part, but sometimes it can also capture the lateral lobes. The growth of benign hyperplasia depends on the adenomatous growth (tumor) of the paraurethral glands. As a result, the gland's own tissue is displaced outward, and a capsule is formed around the growing adenoma.

Hyperplastic (that is, affected by a tumor) cells of the prostate tissue also tend to grow both towards the rectum and the bladder, and this causes the internal opening of the bladder to shift upwards and lengthen the back of the urethra.

There are several forms of hyperplasia according to the type of its growth:

• Subvesical form of BPH. What it is? In this disease, the tumor grows towards the rectum.
• Intravesical form of BPH. The case history is characterized by the growth of the tumor to the bladder.
• Retrotrigonal form of BPH. The tumor in this case is located directly under the triangle of the human bladder

Quite often, several forms of BPH can be seen in one person at the same time. This happens when the tumor grows in several directions at once.

BPH: symptoms

The signs of this disease directly depend on the location of the tumor, on its growth rate and size, as well as the degree of dysfunction of the bladder.

BPH of the prostate can be divided into three stages:

Compensated, or the first stage. This form of the disease is manifested by delays in the onset of urination (frequent urge to empty, especially at night, is a concomitant symptom). With BPH 1 degree, the prostate gland increases in size, has a dense elastic consistency. Its boundaries are clearly delineated, and in general, palpation of the gland (and its median sulcus) is painless. At this stage of the disease, the bladder is still completely emptied, and there is no residual urine at all. Grade 1 BPH can last from one to three years. Subcompensated, or second stage. As the tumor develops, it compresses the urethra more and more, and the bladder is no longer able to function normally and empty completely (its walls thicken). As a result, with grade 2 BPH, residual urine appears, due to which the patient feels incomplete emptying of the bladder.Due to squeezing of the urethra, patients urinate in small portions, and after a while, urine begins to be excreted involuntarily (the reason for this is an overflowing bladder). Grade 2 BPH is sometimes accompanied by symptoms of chronic renal failure (developing against its background). Decompensated, or the third stage. The bladder is greatly distended due to residual urine, the urethra is still compressed, and urine is excreted literally drop by drop, sometimes even with an admixture of blood. At this stage, BPH leads to impaired kidney function (renal failure). There is also weakness, severe weight loss, poor appetite, constipation, anemia, dry mouth. Diagnosis of the disease The basis for diagnosis is the characteristic complaints of men, for which a special scale for assessing the symptoms of prostate adenoma (in English I-PSS) has been created. Basically, the diagnosis of BPH is made after a clinical examination of the patient, as well as such research methods:

BPH treatment

At the moment, there are many ways to treat the disease, each of which is highly effective at different stages of BPH. Treatment of this disease can be divided into three parts:

• Medical treatment
• Surgical treatment
• Other non-surgical treatments

Drug treatment is usually given at the first sign of BPH.

In the first stages of BPH of the prostate, treatment is aimed at reducing the growth rate of hyperplastic prostate tissue, improving blood circulation in nearby organs, reducing inflammation of the prostate and bladder, eliminating urinary stasis, eliminating constipation, and facilitating urination.

In addition to the use of medicines, the patient is advised to follow a mobile lifestyle, give up alcohol and harmful (too fatty, spicy, spicy) food, smoking.

It is also worth reducing fluid intake in the afternoon, especially before bedtime.

In the presence of clinical and laboratory signs of androgen deficiency, androgen replacement therapy is also prescribed.

Often, in parallel with the treatment of hyperplasia, its complications are treated - cystitis, prostatitis or pyelonephritis.

Sometimes (against the background of hypothermia or drinking alcohol), the patient may develop acute urinary retention. In this case, the patient needs to be urgently hospitalized and undergo a bladder catheterization.

Let's take a closer look at each type of treatment.

Drug treatment

Two types of drugs are most commonly used to treat BPH:

• Alpha-1 blockers (eg, tamsulosin, doxazosin, or terazosin). Their action is aimed at relaxing the smooth muscles of the prostate and bladder neck, which leads to easier passage of urine. The action of these drugs can be prolonged or short.
• 5-alpha reductase inhibitors (blockers) (permixon, dutasteride, or finasteride). These drugs prevent dihydrotestosterone (the biologically active form of testosterone) from being formed in the body of a sick person, due to which the prostate gland shrinks.

Surgical treatment

In especially severe cases, one Drug treatment is not enough, and, as a rule, one has to resort to surgical intervention. This can be excision of hyperplastic tissue (adenomectomy) or total resection of the prostate gland (prostatectomy).

There are two types of surgical intervention:

• Open surgery (transvesical adenomectomy). With this intervention, access to the tissue of the gland is obtained through the wall of the bladder. This type is the most traumatic, and is used only in advanced cases. Open surgery provides a complete cure for BPH.
• Minimally invasive surgery (in which there is little to no surgical intervention). They are performed using modern video endoscopic technology, without incision. Access to the prostate through the urethra.

There is another type of surgical intervention that cannot be compared with the above. Embolization of the prostate arteries is an operation that is performed by endovascular surgeons (the above are performed by urologists) and consists in blocking the arteries of the prostate with small particles of a special medical polymer (through the femoral artery). Hospitalization is not required, the operation is performed under local anesthesia and is not traumatic.

After any type of surgery, there is a small risk of complications such as urinary incontinence, impotence or urethral stricture.

Non-surgical treatments

Non-surgical methods of treatment include the following:

Transurethral needle ablation;

Treatment with high intensity focused ultrasound;

Prostate microwave coagulation method or thermotherapy;

Introduction of prostatic stents into the area of narrowing;

Balloon dilatation of the prostate.

Postoperative period

Alas, at some stages of the disease, surgery is simply necessary. BPH is a serious disease, and even after surgery, you need to follow some rules in order to finally get rid of the disease and not provoke a reappearance. The three main points that you must follow after the operation are the correct diet, a healthy lifestyle and regular visits to the doctor.

The diet in the postoperative period is extremely important for the patient, as it can significantly contribute to a speedy recovery. The diet after the operation completely excludes fatty foods, spices, salty and spicy foods and, of course, alcohol. It is recommended to eat low-fat foods rich in fiber.

As for work, if your profession does not involve frequent physical activity, then you can return to the workplace a couple of weeks after the operation. When sedentary work, it is recommended to do a warm-up every half an hour. A sedentary lifestyle can contribute to stagnation of blood in the organs, from which the disease only worsens. For the first few days after the operation, do not even think about lifting weights!

Give up smoking at least in the postoperative period (two weeks after surgery), if you can not quit the addiction completely. Nicotine damages the walls of blood vessels, and this affects the blood circulation of the prostate, as a result of which an inflammatory process may occur.

Many people think that after removing BPH, you should forget about sexual activity forever. This opinion is erroneous, and the sexual function of a man is completely restored after a while. However, it is worth resuming sexual relations no earlier than 4 weeks after the operation.

Another piece of advice worth paying attention to: you can't drive a car until a month after BPH removal.

In general, the postoperative period lasts about a month, after which the patient can already return to normal life. However, experts strongly recommend leading a healthy lifestyle to prevent the recurrence of the disease.

Urination after surgery

Almost immediately after the operation, the urine stream becomes stronger, and the emptying of the bladder is easier. After the catheter is removed, pain may occur during urination for some time, the reason for this is the passage of urine through the surgical wound.

Specialists do not exclude the occurrence of urinary incontinence or urgent urge to urinate in the postoperative period, these phenomena are completely normal. The more your symptoms bothered you during your illness, the longer your recovery period will be. Over time, all problems will disappear and you will return to the normal rhythm of life.

Some time after the intervention, there may be blood clots in the urine. This phenomenon is associated with wound healing. It is recommended to drink as much liquid as possible to properly flush the bladder. But with severe bleeding, you should immediately contact a specialist.

Prolonged urinary retention (if BPH is not treated) can eventually lead to urolithiasis, in which stones form in the bladder, and later infection. In this case, the most serious complication that a patient can expect without proper treatment is pyelonephritis. This ailment further exacerbates kidney failure.

In addition, prostate adenoma can give rise to malignant growth - prostate cancer.

The prognosis for adequate and timely treatment of the disease is very favorable.

Disease prevention

The best prevention of BPH is regular monitoring by specialists and timely treatment of prostatitis.

It is also worth eating right (reduce the amount of fried, salty foods, as well as spicy, spicy and smoked foods), stop smoking and alcoholic beverages. In general, a healthy lifestyle significantly reduces the risk of BPH.

So now you know what BPH is. The signs of this disease, treatment, postoperative period and even prevention are described in detail above.

In any case, this knowledge will be useful to you. Stay healthy!

Prostatic hyperplasia - features of treatment

With age, prostate tissue, under the influence of certain sex hormones, begins to increase in size. This condition is called prostatic hyperplasia (formerly adenoma).Despite the fact that pathologists do not apply to oncological diseases, it can threaten the life of the patient. Consider what means for the treatment of hyperplasia modern medicine has and list the names of some drugs.

What is prostatic hyperplasia

Even if a man did not have problems with the genitourinary system, irreversible changes begin in old age. Under the influence of testosterone and dihydrotestosterone, the glandular tissue of the prostate grows and takes the form of a nodule.

Increasing in size, it compresses the prostatic urethra, which causes dysuric disorders. In this case, the symptoms will depend precisely on the size of this benign neoplasm - if it is small, a man may not be aware of the problem for a long time and live a normal life.

Several decades ago, BPH was considered incurable, but now the opinions of doctors have changed. According to recent reports, the following statements apply to the disease:

Half of men over the age of 60 have benign prostatic hyperplasia, and one in ten will need surgery. Without medical help, acute urinary retention develops, then acute renal failure, which often ends in death.

Modern methods of treatment and their possibilities

As of the first decade of this century, there are three methods of medical care for benign prostatic hyperplasia - observation of changes in dynamics, drug treatment and surgery. There are alternative methods that are recognized by some doctors. Each of them has its own characteristics, including the expediency of application.

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Live Watch

The essence of the method lies in the systematic monitoring of the patient's health, which is comparable to medical examination. If the area of hyperplastic tissue does not increase in size and does not threaten organ dysfunction, no treatment is prescribed. This is due to the fact that in some cases, prostatic hyperplasia may be reversible - over time, the symptoms will go away on their own.

Dynamic observation is characterized by:

• annual examination of the patient;
• state assessment on a special scale in points;
• monitoring the rate of urine outflow within the time limits set by the doctor.

Most often, hospitalization is not needed for observation. A man can live a normal life, work, go about his business and visit a doctor only on appointed days. However, it is impossible to take any drugs without his knowledge, especially for the treatment of sinusitis or prostatitis. Some drugs can interfere with urination, which will increase the symptoms of hyperplasia. The same applies to tranquilizers and antidepressants.

Treatment with herbal extracts

Easy access to various information has led to a surge in the popularity of herbal treatment of benign prostatic hyperplasia. Men brew teas and infusions, buy dietary supplements, put candles with sea buckthorn extracts and wait for a positive result.

Meanwhile, the effect of such actions is unpredictable. Some of the products, especially those based on the extract of the dwarf palm (seenoa), have not been studied. Neither doctors nor pharmacists can predict what mechanism of action these drugs have, whether they can be trusted and whether there will be any complications.

Modern medicine does not recognize phytotherapy. However, if benign hyperplasia is complicated by chronic prostatitis, rectal suppositories may be prescribed. These include Prostatilen, suppositories with propolis or sea buckthorn oil. These medications should be selected by a doctor, self-medication is unacceptable here.

Treatment of hyperplasia with drugs

At the initial stage of growth of glandular tissue, alpha-blockers and 5-alpha reductase inhibitors are especially effective. They act on various receptors and affect urination, but they can also affect other organs, disrupting their functionality.

Alpha blockers act on alpha receptors that control the smooth muscles of the bladder and prostate. Already after the first intake of drugs, the tone of these muscles decreases, which leads to an increase in the rate of urine outflow.

The most popular tablets of this group are:

• Tamsulosin;
• Doxazosin;
• Terazosin.

Means are prescribed in case of progression of symptoms of hyperplasia, with residual urine in the volume of 300 ml and in the absence of indications for surgical intervention. After a course of treatment, the intensity of symptoms decreases by 30-60 percent, men feel much better.

However, side effects can be dangerous: 10% of men experience a sharp drop in blood pressure and dizziness.

5-alpha reductase inhibitors prevent the conversion of testosterone to dihydrotestosterone. As a result, the volume of the prostate gland decreases and urination is gradually restored. However, the effect is observed only after six months, in addition, there are risks of complications:

• growth of glands in the chest area;
• erectile dysfunction;
• reducing the volume of semen.

Most often, men are prescribed Finasteride, but its use is advisable only in cases where the test results clearly show the transition of testosterone to dihydrotestosterone, and according to the results of ultrasound or MRI there is reason to fear further growth of the prostate.

Partial prostatectomy

If an enlarged gland completely blocks the lumen of the prostatic urethra and threatens the development of acute urinary retention, a prostatectomy can be performed. During the surgical intervention, part of the glandular tissue of the prostate will be removed, which will lead to an improvement in well-being.

Indications for surgery are:

• renal failure due to obstruction of urine outflow;
• absent urination;
• ineffective drug therapy;
• detection of stones in the bladder;
• Increased residual urine value.

This method of surgical treatment of prostatic hyperplasia does not always give the desired result, because another technique is considered the gold standard.

Transurethral resection of the prostate

During the operation, a special device is inserted through the urethra - a resectoscope. Under visual control, an electrode is inserted into the prostate, to which an electric current of certain parameters is applied. As a result, the hyperplastic tissues of the organ are burned out, and the blood vessels are cauterized.

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It has been established that 93% of men feel better after this technique. After the operation, the patient is in the hospital, in the general ward. Three days later he is discharged. TURP (abbreviation for surgery) may cause some discomfort, but usually no pain. In general, men tolerate such surgery well, the death rate is 0.25%, and erectile disorders are possible in only 5% of those operated on.

A type of TURP is laser vaporization. In this case, areas with benign hyperplasia are evaporated by a laser beam, and the risk of complications is much less.

Open prostatectomy

If, as a result of the growth of glandular tissue, the prostate increases to 80 g, a prostatectomy is performed through an open access. A man under general anesthesia makes an incision in the lower abdomen, which serves as an operating access. The capsule of the gland is dissected, and the hyperplasia is removed.

Such a surgical intervention is more difficult for men than when removing hyperplasia using the methods described above. In addition, you will have to stay longer in the hospital, wear a urinary catheter and strictly monitor the rehabilitation period.

If a man cannot have an operation, and there is no positive result from the drugs, a catheter is placed in the urethra, which is constantly in it. This measure will restore the normal outflow of urine, although it will bring certain inconveniences.

Physiotherapy treatment

In advanced cases of prostate hyperplasia, operations give a good result, but are associated with various risks. Therefore, scientists are constantly looking for alternative methods, including those based on some physiotherapy techniques.

These include:

The most promising are developments in the field of application of holmium crystals. These techniques also include the currently practiced HoLEP effect, which makes it possible to isolate the entire prostate in an anatomically correct projection with a minimal risk of violating the integrity of its capsule. Exposure to the HoLEP laser allows the surgeon to work with prostatic hyperplasia of any size, while the risk of internal bleeding and other complications will be negligible.

Conclusion

Most often, prostatic hyperplasia is a natural process that develops in an aging body. It is impossible to warn him. The only way a man can help himself is an annual examination by a urologist. The sooner the treatment of hyperplasia is started, the more likely it is to maintain a habitual lifestyle and not suffer from dysuric symptoms.

Benign prostatic hyperplasia treatment and prevention

The treatment of diseases such as prostatic hyperplasia (BPH) is of particular interest to the strong half of humanity due to the relevance of pathologies associated with the functioning of the bladder and prostate. To date, the number of successfully performed therapeutic interventions has reached 80%, however, the problem is still not fully resolved. The main reason for the lack of positive results in the treatment of hyperplasia lies in the complications that develop against the background of delayed therapy.

What is prostatic hyperplasia

Benign prostatic hyperplasia is one or more nodules formed from the glandular epithelium. Some of them use the stromal component of the prostate gland for further development, but the end result is always the same - squeezing the urethra. As a result, the patient with hyperplasia has problems with emptying, which, if not properly treated, can lead to serious complications.

Disturbances in the functioning of the bladder trigger a pathological process that causes severe pain in men when they need to relieve themselves. Hyperplasia is characterized by benign growth, due to which the formation of metastases practically does not occur. With an unfavorable outcome, prostate adenoma can degenerate into malignant cancer, therefore, at the first signs of the disease, you should consult a specialist.

ICD-10 code

According to the International Classification of Diseases, benign prostate tumor or hyperplasia is number 40 and belongs to the class of diseases of the genitourinary system. In addition, pathologies of the male genital organs from this category include: adenofibromatous hypertrophy, fibroadenoma and fibroids. Other neoplasms, except for the above, are not included in the list.

Manifestations of prostate adenoma always depend on such indicators as the size, localization and growth rate of the tumor. Due to the violation of contractile functions, the bladder during hyperplasia is forced to be under constant pressure of an excess amount of urine. The inability to remove urine residues negatively affects the state of the whole organism.

A decrease in testosterone levels in the blood causes more than problems with urination. Most male patients in the urologist's office complain of general weakness, loss of appetite and a sharp decrease in weight with hyperplasia. Sudden anemia or constipation may be the first symptoms of prostate adenoma, heralding complications. In addition, men have:

• uncontrolled urination;
• night urge to go to the toilet;
• frequent or intermittent urination;
• lack of relief after voiding;
• tension of the abdominal muscles during urination.

Irritative symptoms

Detecting prostate adenoma by examining irritative symptoms is considered one of the progressive methods of modern medical institutions. Hyperplasia differs from other pathologies in such unpleasant manifestations as urinary incontinence, frequent urination, and regular nighttime urge to go to the toilet. Bladder instability is a major concern for many men over the age of forty. However, timely medical care and treatment can significantly alleviate these symptoms.

Proponents of traditional medicine firmly believe that the cause of prostate hyperplasia is solely the age of the patient. The risk of prostate adenoma increases in direct proportion to the number of years a man has lived, so doctors attribute this disease to the inevitable companions of aging. However, according to another version, other factors, such as ecology, also influence the likelihood of developing a tumor.

If we take into account only age-related changes, then the pathological process of hyperplasia begins from the moment of the appearance of disturbances in the hormonal background. Closer to the middle of life, some men have a decrease in the amount of androgen in the blood, which inevitably leads to an increase in another hormone - estrogen. Due to such an imbalance in the patient's body, uncontrolled growth of cells and tissues of the prostate gland can be observed.

According to recent studies, the formation of prostate adenoma is influenced by an unhealthy lifestyle. Smoking, alcohol, malnutrition and lack of sports activities lead to a decrease in immunity, which eventually causes the development of unnatural complications in the body. The period of the formation of the disease takes, on average, from one to three years, after which the treatment of BPH with medications will be difficult.

The clinical picture during the course of hyperplasia can be traced very clearly.Depending on the stage of the disease, the patient has symptoms of a certain nature. For example, at the compensated stage of adenoma, there is a slight urinary retention, which is inherent in the initial form of the disease. Also, frequent nightly visits to the toilet and a sluggish urine stream indicate an enlarged prostate gland.

In the subcompensated stage of hyperplasia, the main signs of BPH increase, the bladder is no longer able to completely empty and function naturally. This is due to squeezing of the urethra, as a result of which the patient feels constant discomfort. The presence of dark urine with blood clots indicates the development of the third stage of prostate hyperplasia, which is called decompensated. During this period, the walls of the bladder are stretched, which negatively affects the functioning of the kidneys.

Diagnosis

In order to accurately diagnose prostate adenoma, more than one medical examination can be carried out. The annual number of male citizens who suffer from acute pain during urination is increasing at a tremendous rate. Healthy patients after 40 years of age are very rare, because even the slightest negative environmental impact affects the state of the body. LVL is determined using several methods, the final result of which will give a complete picture of the patient's health status:

• instrumental diagnostics;
• laboratory blood and urine tests;
• IPSS (International Prostatic Symptom Scale). This test includes eight questions that the patient is asked to answer;
• radioisotope research;
• ultrasound;
• uroflowmetry;
• PSA analysis.

BPH treatment

At the moment, there are many different ways to treat prostate hyperplasia, ranging from folk recipes to surgical intervention. The latter option is used only in extreme cases, when all other methods were powerless. Much depends on the stage of development of prostate adenoma, so some patients can be cured by non-surgical methods (using drugs), while others have to undergo surgery.

Conservative treatment of prostate adenoma involves several ways to remove excess urine from the urethra. The action of modern drugs is aimed at blocking the development of hyperplasia. When it stops growing, doctors prescribe drugs such as alpha blockers to relieve the pain symptoms of hyperplasia.

Hormon therapy affects the secretion of dihydrotestosterone, thereby slowing down the growth of prostate adenoma. Doctors prescribe drugs: Tamsulosin, Dutasteride or Finasteride. Treatment of a benign tumor is carried out in courses, the minimum period of which is six months. With a shorter therapy, there is no guarantee that the development of hyperplasia will stop.

Surgical treatment

There are two types of operations designed to remove prostatic hyperplasia - adenomectomy and prostatectomy. Each of the species differs from each other in a therapeutic way of exposure, however, the result is approximately the same. Surgical intervention is indicated for patients at advanced stages of prostate adenoma, since no other methods have the desired effect. This type of operation is considered the most traumatic for a patient with hyperplasia, as the doctor penetrates through the wall of the bladder.

Minimally invasive methods

Some therapies are based on minimal surgical intervention, however, their use for the treatment of prostate adenoma is possible only in the absence of serious pathologies (acute urinary retention). With such symptoms, the urologist is forced to remove the remaining urine using a catheter that is passed through the urethra into the bladder. Minimally invasive methods of treating hyperplasia include embolization of the arteries of the prostate and enucleation. In the first and second cases, operations are performed without incisions, through the urethra.

Folk treatment

Traditional medicine contains many useful recipes that are used both for therapeutic and prophylactic purposes for prostate hyperplasia. For example, patients with prostate adenoma are advised to drink one glass of pumpkin juice every day, or at least add raw pumpkin seeds to their diet. In addition, it is very useful to eat walnuts with honey. Infusions and decoctions from medicinal plants have a special therapeutic effect, so they are drunk two or three times a day.

Prevention

To maintain the immune system and health, you need to take care of your body from a young age.Prevention of prostate adenoma includes three main areas of activity: proper nutrition, exercise and regular medical examinations. Rational nutrition can become a source of all the necessary elements for the full functioning of the body. Special exercises will increase muscle tone, thereby improving immunity. Doctors recommend taking tests every six months to prevent the development of adenoma.