Benign prostatic hyperplasia (BPH) or adenoma is a growth of the stromal component or epithelium of the prostate.The disease occurs in men over 40 years of age, less frequently at younger ages.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 all men sooner or later encounter the disease, so it is necessary to know in advance about the causes, risk factors, symptoms and modern treatment of prostate adenoma.
Dangers
An adenoma is a benign formation, therefore in itself it does not harm the body.However, as the tissues grow, they block the lumen of the urinary canal, which prevents the passage of urine.This is associated with a number of unpleasant complications and painful sensations, especially in the later stages.The resulting congestion leads to the formation of infections, bladder stones, bladder damage, as well as serious disturbances in the functioning of the kidneys, including the development of insufficiency.Therefore, at the slightest manifestation of symptoms, you should immediately make an appointment with a urologist, undergo a thorough examination and, based on the results, choose the most effective method of treating prostate adenoma.
Stages and symptoms
The course of the disease can be divided into three main phases, accompanied by various symptoms:
- I – characterized by more frequent imperative urges, nocturia (increased volume of nocturnal diuresis), first signs of incontinence and slower flow.The disease can remain in this phase for several years without evolving into a more serious form;
- II – more serious symptoms.The stream of urine can be interrupted, you often have to strain to urinate, which often leads to hernias and prolapse of the rectum.After going to the bathroom, a feeling of dissatisfaction and incomplete emptying remains.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 appear, kidney stones appear and incontinence increases.General symptoms of poisoning may also appear - weakness, lack of appetite, nausea, constipation, constant dry mouth.
It should be understood that similar symptoms are accompanied by some types of nervous disorders and cancer.An accurate diagnosis can only be made in a clinic after carrying out appropriate research.
Treatment of the disease
At the moment, prostate adenoma hyperplasia is a well-studied disease.Its treatment is not particularly difficult and can be carried out in different ways, depending on the severity of the disease, its type, speed and stage of development, the patient's age, their general health and other factors.
In general, all methods are conventionally divided into medicinal, non-medicinal and surgical.There are also many recipes for alternative (traditional) medicine, including the use 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, negatively affecting the patient's condition.
Non-drug methods
For mild symptoms of the disease or for more serious symptoms that do not affect quality of life, watchful waiting, also called active waiting, is used.It consists of regular monitoring of the condition without the use of medication.Behavioral therapy is also provided, including:
- refusal to take anticholinesterases and diuretics without additional guidance from the attending physician;
- mandatory complete emptying of the bladder before bed;
- physiotherapy, Kegel exercises and other activities aimed at training the pelvic muscles;
- reducing the consumption of diuretic products and liquids, especially three hours before bed.
The technique is used independently and as a complement to drug therapy.
Drug treatment
For severe to moderate symptoms, patients may receive several medications, including:
- alfuzosin, tamsulosin and other alpha blockers;
- solifenacin, M anticholinergics, muscarinic receptor blockers - with a clear predominance of symptoms caused by congestion;
- type V phosphodiesterase inhibitors – normally 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 medications are used, as a rule, before surgery or in cases where they are contraindicated for some reason.
Surgery
Surgical operations are currently 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.Its main advantage is the possibility of use at any stage of the disease.Our clinic practices several main 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 adenomectomy
Open adenomectomy is a classic operation 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 studied and does not require special equipment, and can be used in practically any clinic.However, due to the open nature of the operation, it is often accompanied by extensive bleeding.In addition, due to the close location of the prostate gland to the nerve nodes, there is always a risk of damaging them, leading to disruption of sexual and urinary functions.
Transurethral resection
Prostate adenoma TUR is a procedure to remove part of the prostate using an electroresection loop.Today it is one of the most preferred and frequently performed operations due to its low invasiveness.All instruments are taken into the formation through the urethral canal without any incisions, so there is no blood loss, no scars on the skin and the recovery period is just a few days.In addition, during the procedure, complete information about the state of the urinary system is collected and any abnormalities found are eliminated.
New in the treatment of prostate adenoma
Minimally invasive methods that use advanced technologies and equipment are considered the most promising.These include:
- Holmium laser enucleation of prostate hyperplasia (HoLEP) - the operation is performed through small incisions (up to 2 cm).Using a laparoscope, a laser fiber is inserted into the bladder and through the neck to the gland.The adenomatous tissue is removed through careful incisions made with an ultra-precise and safe holmium crystal laser, after which it is morcellated.This approach guarantees almost complete absence of damage to healthy tissues and minimal blood loss;
- transurethral photoselective vaporization - the method consists of completely burning damaged tissues using focused laser radiation, without damaging healthy cells.The intervention is carried out through the urethral canal, which eliminates any incisions and scars, allows for a minimum number of recurrences and reduces recovery time to several days;
- robot-assisted laparoscopy - performed using the advanced Da Vinci robotic complex, equipped with the necessary tools and equipment for video recording.Control is carried out by an experienced surgeon on a special terminal, and the camera image is displayed on a large monitor in high resolution, which significantly expands the surgical field.Special robot algorithms smooth out all sudden and random movements of the operator, completely eliminating the human factor such as shaking.The use of the complex allows you to carry out the operation with the greatest possible precision and accuracy, using small incisions of a few millimeters.
All these methods have a significant drawback - expensive equipment and the need for experienced and qualified personnel to work with them.Therefore, such techniques cannot be used in all hospitals.