Benign prostatic hyperplasia (BPH) or adenoma is an increase in the stromal component or epithelium of the prostate. This disease occurs in men over the age of 40 and is less common at an earlier age. According to statistics, the probability of its development after the age of 50 is about 40%, and more than 75%-after the age of 65. In fact, 90% of men will suffer from this disease sooner or later, so it is necessary to understand the cause, risk factors, symptoms and modern treatment of adenoma prostate in advance.
Danger
Adenoma is a benign formation, therefore, it does not harm the body itself. However, during the growth process, the stratum tissue can block the urinary tract cavity, thereby preventing the passage of urine. This is due to many unpleasant complications and painful feelings, especially in the later stages. New congestion leads to the formation of infections, bladder stones, bladder damage, and serious obstacles to the work of the kidneys, until they develop into failure. Therefore, once the slightest symptoms appear, you must immediately see a urologist for a thorough examination, and choose the most effective treatment for prostate adenoma based on the results of the examination.
Stages and symptoms
The course of the disease can be roughly divided into three main stages, accompanied by various symptoms:
- I-characterized by more frequent urgency, nocturia (increased urine output at night), first signs of urinary incontinence, slower flow. At this stage, the disease can last for several years without developing into a more serious form;
- II-more obvious symptoms. Urine flow can be interrupted, requiring frequent pushes, which often leads to hernias and rectal prolapse. After going to the toilet, there is a feeling of dissatisfaction, and the emptying is not complete. The disease develops more actively, and the time required to transition to the next form is relatively short;
- III-Due to the cumulative effect, the bladder stretches, its elasticity decreases, infection develops, kidney stones appear, and urinary incontinence increases. General symptoms of poisoning may also occur-weakness, loss of appetite, nausea, constipation, persistent dry mouth.
It should be understood that similar symptoms are accompanied by certain types of neurological disorders and cancer. Only after proper research can an accurate diagnosis be made in the clinic.
Treatment of disease
At present, benign prostatic hyperplasia is a disease that has been studied in depth. Its treatment does not cause any particular difficulties and can be carried out in a variety of ways, depending on the severity, type, speed and stage of development of the disease, the patient's age, general health and other factors.
Generally speaking, all methods are conventionally divided into drugs, non-drugs and surgery. There are also many alternative (traditional) drug formulations, including with the help of various herbal preparations, but their effectiveness has not been confirmed by clinical trials. In some cases, this method of treating prostate adenoma will only make the disease course. Complications have a negative impact on the patient’s condition.
Non-pharmaceutical technology
For mild or more severe symptoms that do not affect the quality of life, watchful waiting is used, also known as active waiting. It includes regular monitoring of the condition without the use of drugs. In addition, behavioral therapy is also performed, including:
- Refuse to take anticholinesterase and diuretics without additional instructions from the attending physician;
- Forcibly empty the bladder before going to bed;
- Physiotherapy exercises, Kegel exercises and other exercises designed to train the pelvic muscles;
- Reduce the use of diuretic products and fluids, especially-three hours before bedtime.
This technology can be used independently or as an auxiliary means of drug treatment.
medical treatement
Many drugs may be prescribed for severe to moderate symptoms, including:
- Alfuzosin, tamsulosin and other alpha blockers;
- Solinasine, M-anticholinergics, muscarinic blockers-mainly symptoms caused by hyperemia;
- Type V phosphodiesterase inhibitors-often used to treat impotence and its causes, but have been proven effective in the treatment of hyperplasia;
- Finasteride and other 5-α-reductase inhibitors-reduce the proliferation rate of prostate tissue and reduce its volume.
These and other drugs are usually used before surgery or when they are contraindicated for some reason.
surgery
Today, surgery is considered the "gold standard" and the most effective treatment for prostate adenoma. With their help, you can completely remove the prostate adenoma and maintain normal urination and erection with minimal impact on the body. Their main advantage is that they can be applied to any stage of the disease. In our clinic, several main types of surgical operations are performed. How to treat prostate adenoma is determined by the attending physician and the patient after thorough examination and examination.
Open gland resection
Open adenoma resection is a classic surgery that involves an incision in the perineum or lower abdomen and the use of various instruments to remove inflamed glandular tissue. The main advantage of this method is that it is knowledgeable and does not require special equipment, so it can be used in almost any clinic. However, due to openness, surgery is often accompanied by heavy bleeding. In addition, because the prostate is close to the nerve nodes, there is always a risk of impaired sexual and urinary function.
Transurethral resection
Prostatic adenoma TURP is a procedure that uses an electric resection ring to remove part of the prostate. Today, due to its low invasiveness, it is one of the most popular and most frequently performed procedures. All the instruments are brought into the ground through the urethral tube without any incision, so there is no blood loss, no scars on the skin, and the recovery period is only a few days. In addition, during the operation, complete information about the state of the urinary system will be collected and any abnormalities found will be eliminated.
New progress in the treatment of prostate adenoma
The most promising is the minimally invasive method using advanced technology and equipment. These include:
- Holmium Laser Removal of Prostatic Hyperplasia (HoLEP)-The operation is performed through a small incision (up to 2 cm). With the help of a laparoscope, the laser fiber is introduced into the bladder and brought to the gland through its neck. Use the ultra-precise and safe holmium crystal laser to make a gentle incision to remove the adenoma tissue and then crush it. This method ensures that there is almost no damage to healthy tissues and minimal blood loss;
- Transurethral light selective vaporization-This method involves the use of focused laser radiation to completely burn damaged tissue without damaging healthy cells. Intervention through the urethra to eliminate any incisions and scars, minimize your recurrences, and shorten the recovery time to a few days;
- Robot-assisted laparoscopy-performed using the advanced robotic complex "Da Vinci", equipped with the tools and equipment required for video shooting. Controlled by an experienced surgeon on a dedicated terminal, the image of the camera is displayed on a large monitor with high resolution, which greatly expands the scope of surgery. The robot's special algorithm eliminates all sharp and random actions of the operator, and completely eliminates human factors such as tremor. The use of the complex allows you to perform the operation as accurately as possible through a small incision of a few millimeters.
All these methods have an obvious disadvantage-expensive equipment and the need for experienced and qualified personnel to use it. Therefore, not every hospital uses this type of technology.