Benign prostatic hyperplasia (BPH) or adenoma is an enlargement of the stromal component or epithelium of the prostate. The disease occurs in men over the age of 40, more rarely at an earlier age. According to statistics, the probability of its development after 50 years is around 40% and more than 75% - after 65. In fact, 90% of all men sooner or later develop this disease, so you need to know in advance about its causes, risk factors, symptoms and modern treatment ofprostate adenoma.
Danger
Adenoma is a benign formation, therefore, by itself, it does not harm the body. Increasingly, however, the formation tissue blocks the lumen of the urinary tract, which obstructs the urinary tract. This is caused by a number of unpleasant complications and painful sensations, especially at a later stage. The congestion that arises leads to the formation of infections, stones in the bladder, damage in it, as well as serious disturbances in the work of the kidneys, to the development of failure. Therefore, at the slightest manifestation of symptoms, it is necessary to immediately make an appointment with a urologist, undergo a thorough 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 vital urges, nocturia (increased volume of nocturnal urine output), the first signs of incontinence, slower flow. At this stage, the disease can persist for several years without developing into a more severe form;
- II - more pronounced symptoms. Urine flow can be disrupted, need to frequently induce to urinate, which often leads to hernias and prolapse of the rectum. After visiting the toilet, there is a feeling of dissatisfaction, incomplete emptying. The disease develops more actively, the transition to the next form requires some time;
- III - due to the cumulative effect, the bladder stretches, its elasticity decreases, infection develops, kidney stones appear, and incontinence increases. Symptoms of general intoxication may also appear - weakness, poor appetite, nausea, constipation, persistent dry mouth.
It should be understood that similar symptoms are accompanied by several types of neurological disorders and cancer. An accurate diagnosis can only be made in the clinic after proper investigation.
Disease treatment
Currently, prostate hyperplasia is a well -studied disease. The treatment does not pose any particular difficulties and can be done in various ways, depending on the severity of the disease, its type, the speed and stage of its development, the age of the patient, general health and other factors.
In general, all methods are conventionally divided into drugs, non -drugs and surgery. There are also many recipes from alternative (traditional) medicine, including with the help of various herbal preparations, but their effectiveness has not been proven by clinical trials, and in some cases, methods to treat prostate adenoma only complicate the course of the disease, negatively affecting the patient's condition.
Non -drug techniques
For mild symptoms or more severe symptoms that do not affect quality of life, vigilant waiting, also called active waiting, is used. This consists in periodic monitoring of the condition without the use of medication. Behavioral therapy is also conducted, including:
- refusal to take anticholinesterase and diuretic medications without additional instructions from the attending physician;
- complete emptying of the bladder before bedtime;
- physiotherapy exercises, Kegel exercises and other actions aimed at training the pelvic muscles;
- reduce the use of diuretic products and liquids, in particular - three hours before bedtime.
This technique is used independently and in addition to drug therapy.
Drug treatment
A number of medications can be prescribed for severe to moderate symptoms, including:
- alfuzosin, tamsulosin and other alpha blockers;
- solifenacin, M -anticholinergics, muscarinic receptor blockers - with a predominance of symptoms caused by congestion;
- type V phosphodiesterase inhibitors - commonly used in the treatment of impotence and its causes, but proven effective in the treatment of hyperplasia;
- finasteride and other 5-alpha-reductase inhibitors-reduce the rate of proliferation of prostate tissue, reducing its size.
These and other medications are usually used before surgery or in cases where they are contraindicated for a number of reasons.
Surgery
Today, surgical operation is considered the "gold standard" and the most effective treatment for prostate adenoma. With their help, you can achieve complete removal of prostate adenoma with minimal consequences for the body, maintaining normal urination and erection. Their main advantage is the ability to apply at every stage of the disease. In our clinic, several types of surgical interventions are performed. The decision on how to treat prostate adenoma is made by the attending physician together with the patient after undergoing a thorough examination and examination.
Open adenomectomy
Open adenomectomy is a classic operation that involves incision in the perineum or lower abdomen and removal of inflamed glandular tissue using a variety of tools. The main advantages of this method are its good knowledge and the absence of the need for special equipment, so that it can be used in almost all clinics. However, because of the openness, surgery is often accompanied by extensive bleeding. Also, because of the distance of the prostate with the jugular vein, there is always a risk of damage leading to sexual dysfunction and urination.
Transurethral resection
TURP 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 often performed operations due to its low traction. All instruments were brought into formation through the urethral canal without incision, resulting in no blood loss, no scars on the skin, and the recovery time was only a few days. In addition, during the procedure, complete information on the condition of the urinary system is collected and any abnormalities found are eliminated.
New in the treatment of prostate adenoma
The most promising method is a minimally invasive method using advanced technology and equipment. This includes:
- Holmium laser excision of prostate hyperplasia (HoLEP) - surgery is performed through a small incision (up to 2 cm). With the help of a laparoscope, a laser fiber is inserted into the bladder and through its neck is carried to the gland. Adenomatous tissue is removed using a gentle incision made with a highly precise and safe holmium crystal laser, after which it is formed. This approach guarantees virtually no damage to healthy tissue and minimal blood loss;
- photoselective transurethral vaporization - its method involves the complete burning of damaged tissue using focused laser radiation without damaging healthy cells. The intervention is performed through the urethral canal, which excludes wounds and scars, allowing you to achieve a minimum number of relapses, reducing recovery time to several days;
- robot -assisted laparoscopy - performed using a sophisticated robot complex "Da Vinci", equipped with the necessary tools and equipment for video filming. Control is performed by an experienced surgeon in a typical terminal, and images from the camera are displayed on a large monitor in high resolution, which significantly expands the field of operation. The robot’s special algorithm smooths out all the sharp and random movements of the operator, completely eliminating human factors such as concussion. The use of this complex allows you to perform operations as accurately and precisely as possible, through small incisions, a few millimeters.
All of these methods have significant drawbacks - expensive equipment and the need for experienced qualified staff to work with them. Therefore, the technique cannot be used in every hospital.