Benign prostatic hyperplasia (BPH) or adenoma is an enlargement of a component or epithelium of the prostate stroma. The disease occurs in men over the age of 40, less often at an earlier age. According to statistics, after 50 years, the probability of its development is about 40%, and more than 75% - after 65 years. In fact, 90% of all men face the disease sooner or later, so you need to know in advance the causes, risk factors, symptoms and advanced treatment of your adenoma prostate.
Dangers
Adenoma is a benign formation and therefore does not harm the body on its own. However, as it grows, the tissues of formation block the lumen of the urinary tract, preventing urine from passing through. This is caused by a number of unpleasant complications and painful feelings, especially in the later stages. The resulting congestion leads to the formation of infections and stones in the bladder, damage, and severe abnormalities in the work of the kidneys, all the way to failure. Therefore, at the slightest manifestation of symptoms, a urologist should be consulted immediately, a thorough examination should be performed, and the most effective method of treating prostate adenoma should be selected based on the results.
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 imperative urges, nocturia (increase in the amount of urine at night), the first signs of incontinence, slower flow. At this stage, the disease can persist for several years without becoming more severe;
- II - more pronounced symptoms. Urine flow may be interrupted, urine must be pressed frequently, often leading to hernias and rectal prolapse. After visiting the toilet, you feel dissatisfied, incomplete emptying. The disease develops more actively, with the transition to the next form taking relatively little time;
- III - due to the cumulative effect, the bladder lengthens, its elasticity decreases, infections develop, kidney stones appear, and incontinence increases. General symptoms of poisoning may also appear - weakness, loss of appetite, nausea, constipation, prolonged dry mouth.
It is to be understood that similar symptoms are associated with certain types of nervous system disorders and cancer. An accurate diagnosis can only be made at the clinic after proper research has been done.
Treatment of the disease
Currently, prostate hyperplasia is a fairly well-studied disease. Its treatment does not cause particular difficulties and can be performed 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 traditionally divided into pharmacological, non-pharmacological, and surgical methods. There are also many prescriptions for alternative (traditional) medicine using various herbal preparations, but their effectiveness has not been proven in clinical trials, and in some cases, such treatments for prostate adenoma only complicate the course of the disease. , negatively affects the patient's condition.
Non-pharmaceutical techniques
In the case of mild or more severe symptoms that do not affect the quality of life, vigilant waiting, also known as active waiting, is used. This condition consists of regular monitoring without the use of medications. Behavioral therapy is also provided, including:
- rejection of anticholinesterase and diuretics without further instructions from the treating physician;
- mandatory complete emptying of the bladder before bedtime;
- physiotherapy exercises, Kegel exercises and other actions aimed at training pelvic floor muscles;
- especially reducing the use of diuretics and fluids - three hours before bedtime.
The technique is used both on its own and as an adjunct to drug therapy.
Drug treatment
Many medications can be prescribed for severe or moderate symptoms, including:
- alfuzosin, tamsulosin and other alpha-blockers;
- solifenacin, M-anticholinergics, muscarinic receptor blockers - with a clear predominance of congestion 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 and size of prostate tissue proliferation.
These and other medications are usually used before surgery or in cases where it is contraindicated for some reason.
Surgery
Today, surgical surgeries are considered the "gold standard" and the most effective treatment for prostate adenoma. With their help, you can achieve complete removal of the prostate adenoma, with minimal consequences for the body, maintaining normal urine and erection. Their main advantage is the ability to apply at any stage of the disease. Several main types of surgery are practiced at our clinic. The treatment of prostate adenoma is decided by the treating physician together with the patient after a thorough examination and examination.
Open adenomectomy
Open adenomectomy is a classic operation that involves splitting the perineum or lower abdomen and removing inflamed glandular tissue using a variety of tools. The main advantages of the method are its good knowledge and lack of need for special equipment, so it can be used in almost all clinics. However, due to the openness, the operation is often accompanied by extensive bleeding. In addition, due to the proximity of the prostate to nerve nodes, there is always a risk of damage leading to impaired sexual and urinary functions.
Transurethral resection
Prostate adenoma TURP is a procedure for removing a portion of the prostate gland using an electrosection loop. Today, due to its low invasiveness, it is one of the most advantageous and most frequently performed operations. All instruments are brought into the formation through the urethral canal without incision, resulting in no blood loss, no scars on the skin, and a healing period of only a few days. In addition, the procedure collects complete information about the condition of the urinary system and eliminates any abnormalities.
Novelty in the treatment of prostate adenoma
The most promising are minimally invasive methods that use advanced technologies and equipment. These include:
- Holmium laser enucleation of prostate hyperplasia (HoLEP) - the operation is performed with small incisions (up to 2 cm). Using a laparoscope, a laser fiber is inserted into the bladder and through the neck into the gland. Adenomatous tissue is removed by gentle incisions made with an ultra-precise and safe holmium crystal laser and then morphed. This approach guarantees an almost complete absence of damage to healthy tissues and minimal blood loss;
- transurethral photoselective evaporation - the method consists of complete incineration of damaged tissues using focused laser radiation without damaging healthy cells. The procedure is performed through the urethral canal, which eliminates incisions and scars, allows a minimum number of relapses to be achieved, reduces recovery time to several days;
- robot-assisted laparoscopy - performed using the advanced "Da Vinci" robot complex, equipped with the tools and equipment needed for video filming. The control is performed by an experienced surgeon on a special terminal, and the image from the camera is displayed on a large monitor in high resolution, which significantly expands the operating space. The robot’s special algorithms smooth out all sharp and random movements of the operator, completely eliminating a human factor like tremor. The use of the complex allows you to perform the operation as accurately and accurately as possible, with small incisions of several millimeters.
All of these methods have significant drawbacks - expensive equipment and the need for experienced, trained staff. Therefore, such techniques cannot be used in all hospitals.