Benign prostatic hyperplasia (BPH) or adenoma is the growth of the stromal or epithelial component of the prostate.The disease occurs in men over 40 years old, less commonly at earlier ages.According to statistics, the probability of its development after 50 years is about 40% and more than 75% after 65. In fact, 90% of men sooner or later suffer from the 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 form, so it does not cause harm to the body.However, as the tissues grow, they block the lumen of the urinary tract, preventing urine from passing through.This is associated with a number of unpleasant complications and painful sensations, especially in the later stages.Obstruction leads to the formation of infections, stones in the bladder, damage to the bladder as well as serious disorders in the functioning of the kidneys, including the development of kidney failure.Therefore, at the slightest manifestation of symptoms, you must immediately make an appointment with a urologist, conduct a thorough examination and, based on its results, choose the most effective method of treating prostate tumor.
Stages and symptoms
The course of the disease can be divided into three main stages, accompanied by different symptoms:
- I – characterized by more frequent urgent urges, nocturia (increased urine output at night), first signs of urinary incontinence and slower flow.The disease can persist at this stage for several years without developing into a more severe form;
- II – more severe symptoms.The flow of urine may be interrupted, you often have to strain when urinating, often leading to hernia or rectal prolapse.After going to the toilet, there remains a feeling of dissatisfaction and incompleteness.The disease develops more actively, the transition to the next form takes relatively little time;
- III – due to cumulative effects, the bladder stretches, elasticity decreases, infections develop, kidney stones appear, urinary incontinence increases.General symptoms of poisoning may also appear - weakness, loss of appetite, nausea, constipation, constant dry mouth.
It is worth understanding that similar symptoms accompany some types of neurological disorders and cancer.An accurate diagnosis can be made only in the clinic after conducting appropriate research.
Disease treatment
Currently, prostate hyperplasia is a disease that has been researched quite thoroughly.Its treatment is not particularly difficult and can be done in different ways, depending on the severity of the disease, type, speed and stage of development, patient's age, general health and other factors.
In general, all methods are usually divided into medicinal, non-pharmacological and surgical.There are also many recipes from alternative (traditional) medicine, which include the use of various herbal preparations, but their effectiveness has not been proven by clinical trials, and in some cases, these methods of treating prostate adenoma only complicate the course of the disease, negatively affecting the patient's condition.
Non-drug method
For mild symptoms of the disease or for more severe symptoms that do not affect quality of life, watchful waiting, also known as active waiting, is used.It involves regular monitoring of the condition without the use of medication.Behavioral therapy is also offered, including:
- refusal to take anticholinesterase drugs and diuretics without additional instructions from the doctor;
- It is imperative to completely empty the bladder before going to bed;
- physical therapy, Kegel exercises and other activities to train the pelvic muscles;
- Reduce consumption of diuretic products and liquids, especially three hours before bedtime.
This technique is used independently and in addition to drug treatment.
Treatment with medication
For severe to moderate symptoms, patients may be prescribed certain medications, including:
- alfuzosin, tamsulosin, and other alpha blockers;
- solifenacin, M-anticholinergics, muscarinic receptor blockers - with a clear preference for symptoms caused by congestion;
- phosphodiesterase type V inhibitors - commonly 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 proliferation of prostate tissue and reduce its size.
These and other drugs are often used before surgery or when contraindicated for some reason.
Surgery
Surgery is currently considered the “gold standard” and the most effective treatment for prostate cancer.With their help, you can completely eliminate 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 performs several major types of surgical interventions.The decision on how to treat prostate adenoma is made by the attending physician together with the patient after a thorough examination and examination.
Open gland excision surgery
Open glandectomy is a classic surgery that involves making an incision in the perineum or lower abdomen and removing inflamed glandular tissue using various instruments.The main advantage of the method is that it is well researched and does not require special equipment, so it can be used in almost any clinic.However, due to the open nature of the surgery, it is often accompanied by heavy bleeding.In addition, because the prostate is located near nerve nodes, there is always a potential risk of damage, leading to sexual and urinary dysfunction.
Transurethral resection
TUR of prostate adenoma is a procedure to remove part of the prostate using an electroablation loop.Today, this is one of the most popular and frequently performed surgeries due to its low level of invasiveness.All tools are inserted into the urethral canal without any incisions, so there is no blood loss, no scarring on the skin and recovery time is only a few days.In addition, during the procedure, complete information about the state of the urinary system will be collected and any detected abnormalities will be eliminated.
New in prostate tumor treatment
Minimally invasive methods using advanced technology and equipment are considered the most promising.These include:
- Holmium laser enucleation of prostatic hyperplasia (HoLEP) - surgery is performed through small incisions (up to 2 cm).Using the endoscope, a laser fiber is inserted into the bladder and through the bladder neck to the gland.The glandular tissue is removed with careful incisions made with an extremely precise and safe holmium crystal laser, after which it is shredded.This approach ensures almost complete damage to healthy tissues and minimal blood loss;
- Selective transurethral vaporization - this method consists in completely burning damaged tissue using focused laser radiation without harming healthy cells.The intervention is performed through the urethral tube, helping to eliminate all incisions and scars, minimizing the number of recurrences and reducing recovery time to a few days;
- Robotic-assisted endoscopy - performed using an advanced Da Vinci robot complex, equipped with the necessary tools and equipment for video recording.Control is performed by an experienced surgeon at a special terminal, and images from the camera are displayed on a large screen with high resolution, which significantly expands the surgical field.Special robotic algorithms smooth out any sudden and random movements of the operator, completely eliminating human factors such as vibrations.Using the complex allows you to perform the operation as accurately and precisely as possible, through small incisions of a few millimeters.
All of these methods have one significant drawback - the equipment is expensive and requires qualified, experienced personnel to work with it.Therefore, such techniques cannot be used in every hospital.