Benign prostatic hyperplasia (BPH) or adenoma is an enlargement of the stratum corneum or prostate epithelium. The disease occurs in men over 40 years, less often at a young age. According to statistics, the probability of developing it after 50 years is about 40% and more than 75% - after 65. In fact, 90% of all men sooner or later face the disease, so you need to know in advancefor the causes, risk factors, symptoms and modern treatment of prostate adenoma.
Dangers
Adenoma is a benign formation, therefore, by itself, does not harm the body. However, as they grow, the formation tissues block the urethra, which prevents urination. This is due to a number of unpleasant complications and painful sensations, especially in the later stages. Emerging congestion leads to the formation of infections, stones in the bladder, damage to it, as well as serious disorders in the work of the kidneys, up to the development of failure. Therefore, with the slightest manifestation of symptoms, it is necessary to make an appointment with a urologist, undergo a thorough examination and, based on its 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 various symptoms:
- I - characterized by more frequent urges, nocturia (increase in the volume of nocturnal urine output), the first signs of incontinence, a slower flow. At this stage, the disease can remain for several years without progressing to a more severe form.
- II - more severe symptoms. Urine flow can be stopped, it is necessary to push often 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 takes relatively little time.
- III - due to the cumulative effect, the bladder stretches, its elasticity decreases, infections develop, kidney stones appear and incontinence increases. General symptoms of intoxication may also occur - weakness, lack of appetite, nausea, constipation, persistent dry mouth.
It should be understood that such symptoms are accompanied by certain types of nervous disorders and cancer. An accurate diagnosis can only be made in the clinic after proper research.
Treatment of the disease
At present, prostate hyperplasia is a fairly well-studied disease. Its treatment does not cause particular difficulties and can be carried out in different ways, depending on the severity of the disease, the type, speed and stage of development, the age of the patient, his general health and other factors.
In general, all methods are conventionally divided into medicinal, non-medicinal and surgical. 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, such methods of treating prostate adenoma only complicate the course of the disease. adversely affecting the patient's condition.
Drug-free techniques
For mild or more severe symptoms that do not affect the quality of life, careful waiting is used, also called active waiting. It consists of regular monitoring of the condition without the use of drugs. Behavioral therapy is also performed, which includes:
- refusal to take anticholinesterase and diuretics without additional instructions from the treating physician.
- mandatory complete emptying of the bladder before bedtime.
- Physiotherapy exercises, Kegel exercises and other activities aimed at training the pelvic muscles.
- reduce the use of diuretics and fluids, in particular - three hours before bedtime.
The technique is used both independently and as an adjunct to drug therapy.
Drug treatment
Some medicines may be prescribed for severe to moderate symptoms, such as:
- alfuzosin, tamsulosin and other alpha blockers;
- solifenacin, M-anticholinergics, muscarinic receptor blockers - with a clear predominance of congestion-induced symptoms.
- Phosphodiesterase type V inhibitors - commonly used to treat impotence and its causes, but have been shown to be effective in treating hyperplasia.
- finasteride and other 5-alpha-reductase inhibitors - reduce the rate of prostate tissue proliferation, reduce its size.
These and other drugs are usually used before surgery or in cases where it is 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 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 any stage of the disease. In our clinic, several basic types of surgery are performed. The decision on how to treat prostate adenoma is made by the treating physician together with the patient after a thorough examination and examination.
Open the adenomectomy
Open adenomectomy is a classic procedure that involves an incision in the perineum or lower abdomen and removal of the inflamed glandular tissue using various instruments. The main advantage of the method is the good knowledge and the absence of need for special equipment, so that it can be used in almost any clinic. However, due to the opening, the operation is often accompanied by extensive bleeding. In addition, due to the proximity of the prostate to the nerve nodes, there is always the risk of damage that leads to disorders of sexual and urinary function.
Transurethral resection
Prostate adenoma TURP is a procedure to remove part of the prostate gland using an electroplating loop. Today it is one of the most preferred and frequently performed operations due to its low intrusion. All the organs are brought to the formation through the urethra without incisions, with the result that there is no blood loss, there are no scars on the skin and the recovery period is only a few days. In addition, during the procedure, complete information about the condition of the urinary system is collected and any abnormalities are eliminated.
New in the treatment of prostate adenoma
The most promising are minimally invasive methods using advanced technologies and equipment. These include:
- Holmium laser nucleation of prostate hyperplasia (HoLEP) - the operation is performed with small incisions (up to 2 cm). With the help of a laparoscope, a laser fiber is inserted into the bladder and through its neck is transported to the gland. Adenomatous tissue is removed using soft incisions made with an extremely accurate and safe holmium crystal laser, after which it is dissected. This approach guarantees almost complete absence of damage to healthy tissues and minimal blood loss.
- Transdermal photoelective evaporation - the method involves completely burning damaged tissue using focused laser radiation without damaging healthy cells. The operation is performed through the urethral tube, which excludes any incisions and scars, allows you to achieve a minimum number of relapses, reduces the recovery time to several days.
- robotic assisted laparoscopy - performed using the advanced robotic assembly "Da Vinci", equipped with the necessary tools and equipment for video recording. The test is performed by an experienced surgeon in a special terminal and the image from the camera is displayed on a large screen in high resolution, which significantly expands the scope. Special robot algorithms smooth out all the abrupt and random movements of the operator, completely eliminating a human factor such as terror. Using the assembly allows you to perform the operation as accurately and accurately as possible through small, several millimeters incisions.
All of these methods have one major drawback - expensive equipment and the need for experienced qualified personnel to work with it. Therefore, such techniques may not be used in every hospital.