Benign prostatic hyperplasia (BPH) or adenoma is an enlargement of the stromal component or epithelium of the prostate. The disease occurs in men over 40 years of age, less at an early age. According to statistics, the probability of development after 50 years is about 40% and more than 75% - after 65. In fact, 90% of all men get the disease sooner or later, so it is important to know in advance the causes. , risk factors, symptoms and modern treatment of prostate adenoma.
Dangers
Adenoma is a benign formation, so it does not harm the body in itself. However, the tissues that form during growth close the lumen of the urinary tract, which prevents the passage of urine. This is due to a number of unpleasant complications and painful feelings, especially in the later stages. Obstruction can lead to infections, bladder stones, damage, and kidney failure. Therefore, at the slightest manifestation of symptoms, it is necessary to immediately see a urologist, undergo a thorough examination and, based on the results, choose the most effective method of treatment of prostate adenoma.
Stages and symptoms
The course of the disease can be divided into about three main stages, accompanied by different symptoms:
- I - more often with forced urges, nocturia (increased nocturnal urination), the first signs of seizures, characterized by a slower flow. At this stage, the disease may remain severe for several years;
- II - more pronounced symptoms. Urinary flow may be interrupted, urination must be pressed frequently, which often leads to hernias and prolapse of the rectum. After going to the toilet, there is a feeling of dissatisfaction, incomplete emptying. The disease develops more actively, the transition to the next form takes relatively less time;
- III - due to the cumulative effect, the bladder lengthens, elasticity decreases, infections develop, kidney stones form and incontinence increases. Common symptoms of poisoning may also appear - weakness, loss of appetite, nausea, constipation, persistent dry mouth.
It should be understood that similar symptoms are accompanied by some neurological diseases and cancers. A correct diagnosis can be made in the clinic only after appropriate research.
Treatment of the disease
Currently, prostate hyperplasia is a fairly well-studied disease. Treatment is not particularly difficult and can be done in different ways depending on the severity, type, speed and stage of development of the disease, the patient's age, general health and other factors.
In general, all methods are conventionally divided into drug, non-drug and surgical. There are 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 the treatment of prostate adenoma such methods only complicate the course of the disease. , adversely affects the patient's condition.
Non-drug methods
For mild symptoms or more severe symptoms that do not affect quality of life, so-called active waiting is also used. It consists of regular monitoring of the condition without the use of drugs. In addition, behavioral therapy is carried out:
- refusal to take anticholinesterase and diuretic drugs without additional instructions from the attending physician;
- absolute complete emptying of the bladder before bedtime;
- physiotherapy exercises, Kegel exercises and other exercises aimed at training the pelvic muscles;
- reduce the use of diuretic products and fluids, especially - three hours before bedtime.
The technique is used both independently and in addition to drug treatment.
Drug treatment
A number of medications can be prescribed for severe and moderate symptoms, including:
- alfuzosin, tamsulosin and other alpha blockers;
- solifenacin, M-anticholinergics, muscarinic receptor blockers - with a clear predominance of symptoms caused by obstruction;
- type V phosphodiesterase inhibitors - generally used in the treatment of impotence and its causes, but have been shown to be effective in the treatment of hyperplasia;
- finasteride and other 5-alpha-reductase inhibitors - reduce the rate of proliferation of prostate tissues, reduce their size.
These and other medications are usually used before surgery or for some reason.
Surgery
Today, surgery is the "gold standard" and the most effective treatment for prostate adenoma. With their help, you can achieve complete elimination of prostate adenoma by maintaining normal urination and erection, which have minimal consequences for the body. Their main advantage is the ability to apply at any stage of the disease. Several main types of surgical interventions are used in our clinic. The decision on how to treat a prostate adenoma is made by the attending physician after a thorough examination and examination.
Open adenomectomy
Open adenomectomy is a classic operation that involves cutting the perineum or lower abdomen and removing inflamed glandular tissue using various instruments. The main advantage of the method is good knowledge and no need for special equipment, so it can be used in almost any clinic. However, due to the openness, the operation is often accompanied by extensive bleeding. In addition, there is always a risk of damage to the prostate due to its proximity to the nerve nodes, which can lead to sexual and urinary dysfunction.
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 frequently performed surgeries due to its low invasiveness. All instruments are formed through the urethral canal without any incisions, resulting in no blood loss, no traces on the skin, and the recovery time is only a few days. In addition, during the procedure, complete information about the condition of the urinary system is collected and any abnormalities found are eliminated.
New in the treatment of prostate adenoma
The most promising are minimally invasive methods using advanced technology and equipment. These include:
- Holmium laser enucleation of the prostate hyperplasia (HoLEP) - the operation is performed through small (up to 2 cm) incisions. With the help of a laparoscope, laser fibers are inserted into the bladder and brought from the neck to the gland. Adenomatous tissue is removed using thin incisions made with an ultra-precise and safe holmium crystal laser and then morcellasia. This approach guarantees minimal damage to healthy tissues and minimal blood loss;
- transurethral photoelectric evaporation - the 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 any cuts and scars, allows to reach the minimum number of relapses, reduces the recovery time to several days;
- Robotic aided laparoscopy - performed using the advanced robotic complex "Da Vinci", equipped with the necessary tools and equipment for video recording. The control is performed by an experienced surgeon in a special terminal, and the image taken from the camera is displayed on a large monitor with high accuracy, which significantly expands the field of operation. The robot's special algorithms correct all sharp and random movements of the operator and completely eliminate a human factor such as vibrations. The use of the complex allows the operation to be performed as accurately and precisely as possible, through incisions small, a few millimeters.
All these methods have a significant disadvantage - expensive equipment and the need for experienced and qualified personnel to work with it. Therefore, such techniques can not be used in every hospital.