Benign prostatic hyperplasia (BPH) or adenoma is the growth of the stromal or epithelial component of the prostate.This disease occurs in men over 40 years old, less often at an earlier age.According to statistics, the probability of its development after 50 years is about 40% and more than 75% after 65. In fact, 90% of all men sooner or later face this disease, so it is necessary to know in advance about the causes, risk factors, symptoms and modern treatment of prostate adenoma.
danger
Adenoma is a benign formation, so by itself it does not harm the body.However, when the tissues grow, they block the lumen of the urinary tract, which prevents the passage of urine.This is associated with some unpleasant complications and painful sensations, especially in the final stages.The resulting congestion leads to the formation of infections, stones in the bladder, damage to it, as well as serious disturbances in kidney function, including the development of failure.Therefore, at the slightest manifestation of symptoms, you must immediately make an appointment with a urologist, undergo a comprehensive examination and, based on the results, choose the most effective method of treating prostate adenoma.
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 urges, nocturia (increased amount of diuresis at night), first signs of incontinence, and slower flow.The disease may remain at this stage for several years without progressing to a more severe form;
- II – more severe symptoms.The flow of urine may be disturbed, you must often strain to urinate, which often leads to hernia and rectal prolapse.After visiting the toilet, there is still a feeling of dissatisfaction and incomplete emptying.The disease develops more actively, the transition to the next form takes relatively little time;
- III – due to the cumulative effect, the bladder stretches, its elasticity decreases, infections develop, gallstones appear, and incontinence increases.General symptoms of poisoning may also appear - weakness, lack of appetite, nausea, constipation, persistent dry mouth.
It should be understood that the same symptoms are accompanied by several types of nervous disorders and cancer.An accurate diagnosis can only be made in the clinic after appropriate research has been carried out.
Disease treatment
Currently, adenoma hyperplasia of the prostate is a well-studied disease.The treatment is not very difficult and can be carried out in various ways, depending on the severity of the disease, type, speed and stage of development, age of the patient, general health and other factors.
In general, all methods are conventionally divided into medical, non-medical and surgical.There are also many recipes from alternative (traditional) medicine, including using various herbal preparations, but their effectiveness has not been proven by clinical trials, and in some cases such methods of treating prostate adenoma only complicate the course of the disease, negatively affecting the patient's condition.
Non-drug methods
For mild symptoms of the disease or for more serious ones that do not affect the quality of life, watchful waiting, also called active waiting, is used.It consists of regular monitoring of the condition without the use of drugs.Behavioral therapy is also available, including:
- refusal to take anticholinesterase and diuretic drugs without additional instructions from the attending physician;
- complete emptying of the bladder is mandatory before going to bed;
- physical therapy, Kegel exercises and other activities aimed at training the pelvic muscles;
- reduce the use of diuretic products and liquids, especially three hours before bedtime.
This technique is used independently and in addition to drug therapy.
Drug treatment
For severe to moderate symptoms, patients may be prescribed several medications, including:
- alfuzosin, tamsulosin and other alpha blockers;
- solifenacin, M-anticholinergic, muscarinic receptor blocker - with a clear predominance of symptoms caused by congestion;
- phosphodiesterase type V inhibitors - usually used in the treatment of impotence and its causes, but have also been shown to be effective in the treatment of hyperplasia;
- finasteride and other 5-alpha reductase inhibitors - reduce the rate of reproduction of prostate tissue and reduce its size.
These and other drugs are used, as a rule, before surgery or in cases where they are contraindicated for certain reasons.
Surgery
Surgical operation is currently considered the "gold standard" and the most effective treatment for prostate adenoma.With their help, you can achieve complete removal of the prostate adenoma with minimal consequences for the body, maintaining normal urination and erection.Their main advantage is the possibility of use at any stage of the disease.Our clinic practices several types of major surgical interventions.The decision on how to treat prostate adenoma is made by the doctor present with the patient after a thorough examination and examination.
Open adenomectomy
Open adenomectomy is a classic surgery that involves making an incision in the perineum or lower abdomen and removing the inflamed glandular tissue using various instruments.The main advantage of this method is that it is well studied and does not require special equipment, so it can be used in almost any clinic.However, due to the open nature of the operation, it is often accompanied by a lot of bleeding.In addition, due to the location of the prostate close to nerve nodes, there is always a risk of damage to them, which leads to sexual and urinary dysfunction.
Transurethral resection
TUR prostate adenoma is a procedure to remove part of the prostate gland using an electroresection loop.Today it is one of the most preferred and frequently performed operations due to its low invasiveness.All instruments are brought to the formation through the urethral canal without any incision, as a result there is no blood loss, no scar on the skin, and the recovery period is only a few days.In addition, during the procedure, complete information about the state of the urinary system is collected and any abnormalities found are eliminated.
New in the treatment of prostate adenoma
Minimally invasive methods using advanced technology and equipment are considered the most promising.These include:
- Holmium laser enucleation of prostate hyperplasia (HoLEP) - the operation is performed through a small incision (up to 2 cm).Using a laparoscope, a laser fiber is inserted into the bladder and through its neck to the gland.Adenomatous tissue is removed using a careful incision made with an ultra-precise and safe holmium crystal laser, after which it is marcelled.This approach guarantees the almost complete absence of damage to healthy tissue and minimal blood loss;
- transurethral photoselective vaporization - the method consists in completely burning damaged tissue using focused laser radiation without damaging healthy cells.The intervention is performed through the urethral canal, which eliminates any incisions and scars, allows for a minimal amount of relapse, and reduces the recovery time to a few days;
- robot-assisted laparoscopy - performed using the sophisticated Da Vinci robotics complex, equipped with the necessary tools and equipment for video recording.Control is performed by an experienced surgeon at a special terminal, and the image from the camera is displayed on a large monitor in high resolution, which significantly expands the field of surgery.A special robot algorithm smooths out all sudden and random movements of the operator, completely eliminating human factors such as tremors.Using the complex allows you to perform the operation as accurately and precisely as possible, through a small incision of several millimeters.
All these methods have significant disadvantages - expensive equipment and the need for experienced and qualified personnel to work with it.Therefore, such a technique cannot be used in every hospital.