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Prostate BPH: what it is, causes, treatment and prevention

Prostate adenoma - a disease that occurs as a result of proliferation of the prostate gland, leading to obstruction of the lower urinary tract.

The manifestation of adenoma depends mainly on the localization of nodes in the prostate gland, and not on the size of the gland itself. The fastest blockage of the urinary tract occurs when the nodes are located in the middle lobe of the gland.

The reasons for the development of prostate adenoma are a sedentary lifestyle, irregular sex, vibration (this disease is common among drivers, cyclists), drinking alcohol (especially beer).

All these factors lead to a slowdown in blood circulation in the lower body and in the pelvic organs, including in the prostate gland. Due to a slowdown in blood circulation, swelling of the prostate gland occurs, which favors the entry and consolidation of infection in it. The triggering factor of adenoma is infection. Infection into the prostate gland can pass through the urethra, with blood flow, through the lymphatic tract.

Every man after 45 years old should be examined by a urologist at least once a year and perform a blood test for PSA antigen (prostate cancer marker) at least once every two years.

Prostate adenoma is the old name for the disease. New name - benign prostatic hyperplasia. Changing the name is fundamental to understanding the essence of the problem.

The word adenoma means that it is a tumor. In fact, this is an increase in the mass and volume of the prostate gland, which occurs in people after 40-50 years of age and is caused by a certain hormonal restructuring of the male body. By the age of 70, the vast majority of men have some degree of prostatic hyperplasia. Actually, this is the physiological state of the prostate gland in a certain age period. Moreover, if benign prostatic hyperplasia does not cause a narrowing of the urethra and does not cause a violation of the outflow of urine from the bladder, then it does not require treatment.

Compensated Adenoma Stage the prostate gland is characterized

  • frequent urination, especially at night,
  • delayed onset of urination
  • sluggish stream of urine.

However, at this stage, the bladder is still completely empty, and there are no significant changes in the upper urinary tract.

In the second stage as a result of growing difficulty in the outflow of urine from the bladder, a compensatory thickening of its muscle wall gradually develops, which is accompanied by the presence of residual urine after natural urination in an amount of 100 ml or more. A patient at this stage of the disease begins to have a feeling of incomplete emptying of the bladder, he urinates in several stages with a sluggish thin stream.

In the first and second stages of prostate adenoma, cases of acute urinary retention caused by alcohol or hypothermia are sometimes noted. However, the performed catheterization leads to the restoration of urination.

For the third stage prostate adenomas are characterized by loss of muscle tone of the bladder. This is manifested by a delay or urinary incontinence, expressed in the form of involuntary discharge of urine dropwise with an overflowing bladder.

Diagnosis of prostate adenoma is carried out by a urologist:

  • Digital rectal examination of the prostate gland,
  • Prostate-specific antigen (PSA) - a moderate increase is characteristic of prostate adenoma, a sharp increase - for prostate cancer. The ratio of free PSA / total PSA less than 15% when the concentration of PSA in serum in the range of 3-10 μg / l indicates an increased likelihood of prostate cancer,
  • Uroflowmetry,
  • Ultrasound
  • Cystoscopy is indicated to exclude bladder tumors,
  • X-ray methods.

When treating patients with prostate adenoma, it is recommended to avoid hypothermia, prolonged sitting, eating spicy foods, alcohol and significant amounts of fluid, especially at night.

Showing walks in the fresh air, physical therapy exercises with an emphasis on exercises for the muscles and organs of the pelvic floor and hips. Sex life in such patients should continue and be rhythmic.

Medicinal and physiotherapeutic treatment

For drug therapy of prostate adenoma are used:

  • hormonal drugs
  • 5-alpha reductase inhibitors
  • alpha adrenergic blockers
  • herbal remedies
  • cytostatics
  • polyene antibiotics
  • tissue preparations.

The choice of the drug, the course of treatment, its duration, are determined depending on the clinical picture and on the severity of the signs of the disease. The duration of the course also depends on whether this is an independent treatment method or is carried out in order to prepare the patient for surgery.

Hormone therapy is carried out with drugs that block the synthesis of testosterone (male hormone) by the testes at the level of the brain or prevent the action of male hormones on the prostate gland. The first group includes zoladex, buserelin, depostat, the second - flutamide, casodex, androcur and megestrol. However, at present, drugs of this group are used limitedly due to frequent adverse reactions (erectile dysfunction, decreased libido, gynecomastia) and their high price.

5-alpha reductase inhibitors are widely used. These are drugs such as finasteride (proscar) and episteride. The drugs are well tolerated by patients, but among adverse reactions there is erectile dysfunction, decreased sex drive and a decrease in the volume of ejaculate.

Herbal preparations - Permikson, Tadenan (trianol), Harzol, Peponen, Speman, Optimal and the domestic preparation of pumpkin. Their anti-inflammatory and decongestant effect is especially pronounced. The effectiveness of permixon reaches 70%. However, treatment with herbal remedies is long - at least one year. Herbal preparations do not affect sexual function.

Recently, alpha-adrenoblockers have begun to play a large role in the treatment of prostate adenomas. Mostly used are prazosin, alfuzosin, doxazosin, terazosin, tamsulosin. The safety and effectiveness of treatment with these drugs with prolonged (more than 6 months) use has been proven. Marked improvement and favorable dynamics are already evident in the first 2–4 weeks of their use. If a positive effect is not achieved within the specified time, then the further use of these drugs is futile. Among the adverse reactions: malaise, weakness, dizziness, headache, palpitations, therefore, treatment with alpha-blockers should begin with minimal doses. The most effective and least toxic drug is tamsulosin.

Non-surgical methods also include treatment methods, when the prostate gland is locally affected by some physical factor that partially causes its death, wrinkling and, as a result, size reduction. Such treatment methods include:

  • cryotherapy of prostate adenoma (freezing),
  • thermotherapy of prostate adenoma (warming),
  • ethanol ablation of prostate adenoma (the introduction of alcohol into the prostate gland).

It should be noted that each treatment method has its own strict indications for prescribing.

Most operations for prostate adenoma are currently performed in a less traumatic way without incision of the skin using special equipment.

An operation to remove prostate adenoma is usually performed under anesthesia of the lower body without turning off consciousness. A special operating system is introduced into the urethra before the prostate gland, with the help of which the part of the prostate gland that prevents the free outflow of urine from the bladder is removed under the control of the surgeon's eye. Removal of prostate tissue is done using an electric loop that runs through the operating system. In the postoperative period, a catheter is left in the bladder for some time. With a favorable course, the patient is discharged for outpatient treatment after 5-7 days.

The most common complications of prostate adenoma include:

  • urethra
  • cystitis
  • epididymis
  • kidney inflammation
  • renal failure.

Prolonged, frequent urinary retention leads to overstretching and degeneration of the walls of the bladder, gaping of the mouth of the ureters and, as a result, to anatomical changes.

The prognosis for the timely treatment of prostate adenoma is favorable.

Disease characteristics

BPH is an abbreviation for benign prostatic hyperplasia, better known as prostate adenoma. This is the condition in which small formations (nodules) are formed in the prostate, gradually increasing in size. Their pathological proliferation leads to compression of the urinary canal, which is manifested by serious violations in the functioning of the urinary system.

The disease is benign, that is, it does not give metastases, although under the influence of a number of factors it can go into prostate cancer. But even if this does not happen, the presence of a tumor in the gland negatively affects men's health and the entire body as a whole, significantly reducing the quality of life. In young men, BPH is rare, but after 50-60 years it is diagnosed in every third case. By eighty years, the risk of developing the disease increases to 70%.

The prostate gland consists of three types of tissues - muscle, glandular and connective, and any of them can be involved in the pathological process. Typically, the lesion focus is located in the central part of the organ and affects the lateral lobes, in some cases it can be shifted to one or the other side. Tissue proliferation most often occurs in one direction, as a result of which three forms of pathology are distinguished.

Table. Forms of BPH by type of growth

Form of pathologyMain characteristics
SubbubbleIt is considered the most common. Tissues grow in a straight line.
intestines, resulting in deterioration of motility of the prostatic part of the urethra, and urine does not come out completely. This form does not strongly affect the process of urination.
IntravesicalTissues grow in the direction of the bladder. A tumor through the urethra closes the lumen of the bladder, squeezes the internal sphincter and partially or completely disrupts its work.
RetrotrigonalIt is rarely observed. A tumor forms between the internal outlet of the urethra and the mouths of the ureters. The most severe form, characterized by a simultaneous deterioration in the outflow of urine and the difficulty of its passage through the mouth.

The focus of the disease is more often single, although multiple are not so rare. The manifestations of pathology change depending on this. The size of the tumor in the most advanced cases can exceed 80 mm in diameter, but usually varies between 10-40 mm.

The development of BPH occurs in stages, and experts distinguish three stages of pathology:

  • compensated - An early stage, developing over 1-3 years. It is characterized by mild urination disorders, a slight increase in the gland, a change in its density,
  • subcompensated - Violations of the urinary system are more pronounced, the bladder is not completely empty, there is a thickening of its walls. Iron itself increases 1.5 times, its tissues become much denser,
  • decompensated - The most severe stage with pronounced disorders in the bladder. In many men, it is accompanied by renal failure with typical manifestations.

Each stage has its own characteristic manifestations and, accordingly, requires different treatment methods.

Causes and symptoms of BPH

The main cause of the pathology is considered to be hormonal changes in the male body, in which the balance of testosterone and estrogen is disturbed. This leads to uncontrolled growth of prostate cells, as a result of which adenoma develops. Among the risk factors, the main thing is the natural extinction of sexual functions, which begins with about 50 years.

Less commonly, the development of BPH occurs for other reasons:

  • the presence of chronic diseases of the genitourinary sphere,
  • urinary tract infections
  • injuries
  • the presence of oncological tumors and metastases.

At the early stage, only a specialist can determine the development of adenoma, because the first symptoms are weakly expressed and are similar to manifestations of other prostate diseases. Later, when nodules begin to form in the tissues of the gland, common signs appear that are already an occasion to consult a doctor:

  • urge to urinate more often, especially at night, while the stream of urine is noticeably weaker than before,
  • urination control worsens, incontinence may occur,
  • periodically there is general weakness and apathy, body weight decreases,
  • more often constipated,
  • erection decreases.

With the development of BPH, the symptoms worsen, a pain syndrome occurs, the nature and severity of which depends on the form of the tumor, the stage of the disease and the presence of concomitant pathologies in the body. Often, the disease is accompanied by the formation of calculus in the prostate, which greatly complicates the treatment process. In patients with advanced BPH, the urine is cloudy, often with an admixture of blood, excreted in small portions.

General information

Benign prostatic hyperplasia (prostate adenoma, BPH, BPH) is a common global problem that one third of men over 50 years old and 90% of patients who have survived to 85 years of age experience. According to statistics, about 30 million men have genitourinary dysfunction associated with BPH, and this figure is increasing every year. Pathology is more common in African Americans with initially higher levels of testosterone, 5-alpha reductase activity, growth factors, and androgen receptor expression (population feature). In residents of eastern countries, prostate adenoma is recorded less frequently, which, apparently, is associated with the consumption of a large number of products containing phytosterols (rice, soy and its derivatives).

Diagnostic Methods

Based on these symptoms, you cannot independently diagnose yourself and choose a treatment, because this can lead to the most serious consequences. A urologist specializes in the treatment of BPH, he also prescribes all the studies necessary for making a diagnosis. To accurately determine the presence of a tumor, its localization, size, and possible complications, several methods of complex diagnostics are applied at once.

Table. Diagnosis of BPH

Research methodSpecifications
Using a digital examination, a specialist determines the presence of seals in the prostate, its size, and soreness. In addition, this allows you to take on the analysis of the secretion of the gland, which is released during massaging lobules.

The use of an ultrasonic sensor allows you to get an accurate image of a diseased organ and determine the size of the nodules, localization of the tumor site, the presence of calculi in the gland.

This method helps to accurately assess the condition of the genitourinary system, to identify possible complications in the form of stones in the bladder and kidneys, the formation of diverticula, and so on. The study can be carried out both with and without contrast.

It necessarily includes a biochemical and general blood test, urinalysis, if necessary, the secretion of the prostate or smear is examined (if there is a suspicion of infection).

Non-invasive method for assessing the condition of the urethra. It is performed during urination and consists in measuring the flow rate and some other parameters.

If a malignant nature of the disease is suspected, the doctor prescribes a biopsy. In some cases, an MRI of the pelvic organs can be additionally prescribed, especially if the disease is started and is accompanied by severe violations in the work of the kidneys.

Causes of BPH

Obviously, prostate adenoma is a multifactorial disease. The main factor is a change in hormonal levels associated with natural aging during normal testicular functioning. There are many hypotheses that explain the mechanisms of the development of pathology (the theory of stromal-epithelial relationships, stem cells, inflammation, etc.), however, most researchers consider hormonal theory as fundamental. It is assumed that the age-related predominance of dihydrotestosterone and estradiol stimulate specific receptors in the gland that trigger cell hyperplasia. Additional background risk factors include:

  • Overweight / obesity. The accumulation of adipose tissue, especially in the abdomen, is one of the indirect causes of an enlarged prostate. This is due to reduced testosterone in obese men. In addition, with hypoandrogenism, the amount of estrogen increases, which increases the activity of dihydrotestosterone, which contributes to hyperplasia.
  • Diabetes. High glucose and insulin resistance accelerate the progression of BPH. The glucose level in diabetes is higher not only in the blood, but also in all prostate cells, which stimulates their growth. In addition, diabetes mellitus leads to damage to blood vessels, including the prostate gland, resulting in an enlarged prostate. A number of studies demonstrate that among men with diabetes and elevated low-density lipoproteins, BPH is detected 4 times more often.
  • Features nutrition. Eating foods high in fat increases the likelihood of prostate hyperplasia by 31%, and daily inclusion of red meat in the diet by 38%. The exact role of fatty foods in the occurrence of hyperplastic processes is unknown, presumably, it contributes to the hormonal imbalance associated with BPH.
  • Heredity. The genetic predisposition is of some importance: if prostate adenoma with pronounced symptoms was diagnosed early in first-line male relatives, the risk of its development in the next generation of men increases.

Pathogenesis

Testosterone in a man’s body is contained in various concentrations: in the blood its level is higher, in the prostate - less. In older men, a decrease in testosterone levels occurs, but the level of dihydrotestosterone remains high. A significant role belongs to the prostate-specific enzyme 5-alpha-reductase, due to which testosterone is converted to 5-alpha-dihydrotestosterone. Androgen receptors and DNA of the nuclei of prostate cells are most sensitive to its action, which stimulate the synthesis of growth factors and inhibit apoptosis (a violation of the programmed processes of natural dying). As a result, old cells live longer, and new cells actively divide, causing tissue proliferation and adenoma growth.

An enlarged prostate makes it difficult to urinate against the background of a narrowing of the prostatic part of the urethra (especially if the growth of the adenoma is directed inside the bladder) and an increase in the tone of the smooth muscle fibers of the stroma. At the initial stage of the pathology, the condition is compensated due to the increased work of the detrusor, which, when tensed, allows the urine to evacuate completely.

With progression, morphological changes in the wall of the bladder appear: part of the muscle fibers is replaced by connective tissue. The capacity of the organ gradually increases, and the walls become thinner. The mucous membrane also undergoes changes: hyperemia, trabecular hypertrophy and diverticula, erosive ulceration and necrosis are typical. With the addition of a secondary infection, cystitis develops. Benign prostatic hyperplasia and stagnation of urine lead to reverse urine flow, cystolithiasis, hydronephrotic transformation of the kidneys and chronic renal failure.

Classification

In andrology, several classifications of BPH have been adopted. Depending on the volume of the gland (it is determined using ultrasound and measured in cubic centimeters), small (up to 25 cm³), medium (26-80 cm³), large (more than 80 cm³) and giant adenoma (over 250 cm³) are distinguished. Guyon classification distinguishes three clinical stages of BPH:

  • Compensation. Dysuric phenomena are absent or slightly expressed, there is no residual urine. The bladder, kidneys with no visible signs of pathology.
  • Subcompensation. Clinical phenomena are more pronounced, which is caused by the progression of the disease. Residual urine is determined. The upper urinary tract is modified, which is manifested by a violation of the functional ability of the kidneys.
  • Decompensation. The functions of the bladder are impaired, there is a paradoxical ischuria, severe ureterohydronephrosis, the onset of chronic renal failure.

Drug therapy

At the first stage of BPH, medications are not always prescribed, since therapeutic exercises and diets are usually enough to normalize the genitourinary system. If necessary, the doctor may prescribe the administration of 5 alpha reductase inhibitors that suppress tumor growth in the prostate. The most effective drugs of this group include: “Avodart”, “Penester”, “Urofin”.

For the second stage, taking medication is the main type of therapy, as it allows you to eliminate pain manifestations, normalize urine outflow, and slow the growth of nodules. In addition to alpha-reductase inhibitors, the patient is shown adrenergic blockers and herbal preparations that have an antispasmodic effect. The most famous of them are Omnik, Kornam, Kardura, pumpkin and chamomile extracts.

In the third stage, medications are prescribed as adjunctive therapy before and after surgery. The type of drugs is selected exclusively by a specialist, depending on the condition of the prostate itself and the urinary system.

Symptoms of BPH

Symptoms depend on the degree of obstruction of the urethra. If the enlarged prostate compresses the urethra, complaints appear about frequent urination in small portions, especially at night, a sluggish stream, a feeling of incomplete emptying, regardless of the frequency of urination. As the adenomatous nodes grow, innervation changes, resulting in urgent urges - an uncontrolled desire to urinate, followed by urinary incontinence.

At an advanced stage, paradoxical ischuria develops - the inability to completely urinate with the simultaneous leakage of urine dropwise, which is associated with atony of the walls of the bladder, as well as detrusor-sphincter dysinergy - the lack of synchronous work between the muscle responsible for expelling urine and the relaxation of the urethra sphincter. To empty the bladder, some men are forced to urinate according to the female type - sitting. The clinical manifestations of benign prostatic hyperplasia are non-pathognomonic and can accompany any obstruction, including urethral stricture, diverticulum, tumor, etc., therefore, it is impossible to establish a diagnosis only on the basis of an assessment of symptoms.

Non-operative methods

The list of conservative treatment methods includes:

  • ultrasound therapy
  • implantation of special expanding stents in the urethra,
  • cryotherapy,
  • radiofrequency treatment with the introduction of special needles through the urethra.

In addition to these procedures, physiotherapy exercises are of great importance (especially at an early stage of the disease), which helps to improve blood circulation in the affected tissues, the outflow of fluid, and the elimination of stagnation in the gland. A set of exercises is also selected by a doctor, and they need to be performed regularly for a long time.

Complications

Complications of a hyperplastic prostate can include a number of conditions. Against the background of BPH, acute urinary retention manifests itself in 35%. Residual urine tends to crystallize, in which case calculi with secondary inflammation form in the bladder. Increased intravesical pressure contributes to the formation of vesicoureteral reflux, hydronephrosis and chronic renal failure. If we consider the complications of prostate adenoma therapy, then there is a chance of developing urethral strictures after transurethral resection (5-7%), urinary incontinence (1-2%), erectile dysfunction (9-14%), retrograde ejaculation (74-87%) , cervical sclerosis of the bladder (2-4%).

Prostate hyperplasia: causes, symptoms and treatment

Prostate hyperplasia is observed mainly in older men. According to statistics, in people over 65 years of age, pathology is detected in 85% of cases and is expressed in the formation of a benign tumor, which increases in size over time. As a result, representatives of the stronger sex have difficulty urinating due to squeezing the urethra. In the absence of timely medical care, the disease gives serious complications.

Surgical treatment

Surgical intervention is also carried out in different ways. In severe advanced cases, an open operation is performed to remove the tumor. If the formations are not too large and there are no complications, minimally invasive methods are used, for example, laser vaporization. After surgical treatment, the patient is given a catheter for urine diversion, medication and a diet are prescribed.

What is this pathology?

Benign prostatic hyperplasia is a change in the tissues and cells of the prostate and a further increase in this organ. The neoplasm is formed from the glandular epithelium, which at the initial stage of development takes the form of small nodules. But over time, the nodules increase in size, leading to the growth of a benign tumor. The development of a tumor does not lead to the growth of metastases, but with advanced pathology and the absence of timely treatment, prostate hyperplasia can develop into a malignant formation (carcinoma). In medical terminology, there is another common name for this ailment - prostate adenoma or prostatitis.

Diagnostics

The diagnosis is made by a urologist or andrologist. A rectal examination is informative only if the achievable location of the tumor. On finger examination, the prostate is enlarged, homogeneous, painless, its consistency is elastic, the median groove is flattened. A prostate biopsy is not a routine method and is indicated only if prostate cancer is suspected. A patient with suspected renal impairment needs a nephrologist consultation.

There is a special questionnaire designed to assess the severity of symptoms of lower urinary tract obstruction. The questionnaire consists of 7 questions related to common symptoms of benign prostatic hyperplasia. The frequency of each symptom is evaluated on a scale of 1 to 5. When summarizing, a general score is obtained that affects the further treatment tactics (dynamic observation, conservative therapy or surgery): from 0-7 - mild symptoms, 8-19 - average, 20- 35 is a serious problem with urinating. Instrumental and laboratory diagnostics for BPH includes:

  • Ultrasound TRUS and transabdominal ultrasound of the prostate and bladder are complementary imaging modalities. An ultrasound scan is performed twice - with a filled bladder and after the act of urination, which allows you to determine the amount of residual urine. Asymmetry, density, heterogeneity of the structure, increased blood supply to the prostate indicate an adenoma.
  • Roentgenography. With x-ray diagnostics (excretory urography, cystography), you can not only determine the size of the prostate, but also evaluate kidney function, developmental abnormalities, diagnose pathologies of the bladder, urethra. The study involves the intravenous administration of a contrast agent.
  • Urodynamic studies. Uroflowmetry is a simple test for assessing urine flow, graphically showing bladder release rate and degree of obstruction. The study is performed to determine indications for surgical treatment and monitor the dynamics against the background of conservative therapy.
  • PSA study. Prostate-specific antigen is produced by organ capsule cells and periurethral glands. In patients with benign prostatic hyperplasia and prostatitis, PSA levels are elevated. The result is influenced by many factors, therefore, according to one analysis, the diagnosis cannot be established.
  • Urine tests. In men with prostate adenoma, concomitant inflammation of the bladder and kidneys is often diagnosed, so OAM pays attention to signs of inflammation - leukocyturia, proteinuria, bacteriuria. Blood in the urine may indicate varicose changes in the vessels of the neck of the bladder, their rupture when straining. With changes, urine is sown on nutrient media to clarify the composition of the microbial flora and sensitivity to antibiotics.

Differential diagnosis is carried out with the tumor process of the bladder or prostate, cystolithiasis, trauma, interstitial and post-radiation cystitis, neurogenic bladder, urethral stricture, prostate sclerosis, meatostenosis, urethral valves, phimosis, prostatitis.

Prostate BPH - causes

One of the most common factors in the development of adenoma is heredity. If the family has close relatives suffering from prostatitis, then the likelihood of illness increases significantly. This category of men is recommended to undergo an annual examination from the age of thirty to timely identify pathology. In addition to the genetic factor, risk sources also include:

  • hormonal imbalance (a change in the balance between female and male hormones),
  • inflammatory processes of the pelvic organs and urogenital area,
  • senile age
  • sedentary lifestyle, lack of physical activity,
  • frequent hypothermia,
  • bad habits (tobacco, alcohol),
  • improper nutrition (the predominance of fatty meat food and a lack of plant fiber),
  • transferred venereal diseases,
  • adverse environmental conditions and other environmental factors.

Prostate Hyperplasia - Diagnosis

Timely diagnosis, especially in the early stages, is very important for a quick and successful cure.As a rule, it involves a comprehensive examination and includes an examination of the patient, as well as a number of instrumental studies and laboratory tests. During a medical examination, a palpation method is used, which makes it possible to determine the condition of the prostate gland, soreness, densified areas, etc.

Diagnostic methods are selected individually for each patient, depending on complaints and the expressed clinical picture:

  • palpation examination,
  • analysis of urine for red blood cells, white blood cells, protein, glucose,
  • blood analysis,
  • Ultrasound
  • uroflowmetry (volume and speed of the stream during urination),
  • contrast urography (x-ray) is prescribed for suspected presence of stones in the bladder,
  • cystomanometry allows you to determine the pressure on the walls of the bladder,
  • urethrocystoscopy makes it possible to see the structure and condition of the urethra and the bladder.

Prostate Hyperplasia - Symptoms

The main feature of prostate adenoma is that it is almost asymptomatic for a long time. This is the danger, since the man does not even suspect the presence of a benign education in the body. Sensations and discomfort become pronounced only when pathological changes in the organ have occurred and the tumor has grown.

The following are the main signs of BPH that can manifest themselves at any stage of the disease:

  • frequent urination, sudden onset of urge,
  • emptying in small drops, low pressure,
  • intermittent urination,
  • pelvic muscles tighten when empty,
  • sensation of urine residue in the bladder,
  • pain when using the toilet
  • involuntary emptying
  • chronic urine retention resulting from narrowing of the canal,
  • blood in the urine.

If the patient has noticed at least one symptom, he should take it seriously and immediately consult a doctor. Do not take this lightly and self-medicate.

Stage of development of prostatitis

In the clinical picture of the development of pathology, 3 stages are distinguished.

Hyperplasia of the prostate gland of the 1st degree (compression) is characterized by problems with urination, mainly in the evening and at night. In this case, the urge to the toilet is frequent, and the stream is very sluggish. The duration of the stage can last up to 3 years, while the main symptoms are practically not expressed. At this stage, the neoplasm lends itself very well to drug therapy.

The second stage of hyperplasia (subcompensation) begins with serious disorders of the bladder, when its release presents serious difficulties. The patient feels constant urge to urinate and spontaneous excretion of turbid urine, often with an admixture of blood. At this stage of the disease, chronic renal failure can develop.

The third stage (decompensation) is the most difficult and dangerous, since there is a complete impossibility of independent emptying of the bladder. And this is fraught with a rupture of its walls. Urine is characterized by turbidity with an admixture of blood. A man in this period feels constant fatigue and a breakdown. He is tormented by constipation, his skin becomes pale, weight loss occurs. In people suffering from 2 and 3 degrees of prostatitis, a persistent smell of ammonia is felt from the mouth.

Forms of the disease

Depending on the growth direction of the neoplasm, hyperplasia has several forms:

  • subvesical (the tumor grows near the rectum). With this form, the patient often feels discomfort not when urinating, but with an act of defecation,
  • intravesical (education grows in the direction of the bladder). The growth of the prostate into the bottom of the bladder leads to deformation of the neck of the upper urethra,
  • prevesical - expansion of the lateral parts of the prostate adjacent to the bladder.

Types of adenomas by growth form

According to the form of tumor tissue growth, prostate adenoma is classified into 2 types.

Diffuse prostatic hyperplasia is characterized by a uniform increase in the organ during the development of the disease without pronounced foci. Adenomatous prostatic hyperplasia is noted by the formation of nodules inside the prostate. They can be from one to several, depending on the stage and course of the disease.

Prostate hyperplasia - treatment

The treatment regimen is selected by the doctor strictly individually after the diagnosis and history. There are currently 3 treatments for prostatitis.

  1. Drug (conservative) therapy. They usually resort to the help of drugs with a mild course of the disease, as well as with contraindications to surgical interventions.

At the disposal of specialists are several groups of drugs:

  • alpha1 - adrenergic blockers promote relaxation of smooth muscles and improve the outflow of urine,
  • 5 - alpha - reductase blockers stops the growth of prostate cells, which further leads to normalization of the gland,
  • phosphodiesterase blockers - 5 relax the muscles in the urogenital region, which greatly facilitates the outflow of urine,
  • herbal preparations contain natural extracts and extracts of medicinal plants (African plum bark, rye, nettle, pumpkin seeds, etc.).

  1. Surgical methods of treating prostatitis are indicated in cases where drug therapy does not bring the desired result. The following types of surgical intervention are used:
  • transurethral resection of the prostate is the most commonly used and standard method. A tube with a metal loop and a chamber is inserted into the urethra. Under the influence of electric current, the loop removes the overgrown formation layer by layer,
  • a transurethral notch of the prostate is used when the gland has not grown too much. Overgrown tissue is removed between the prostate and the neck of the bladder,
  • Holmium laser enucleation is the most progressive treatment for pathology. A laser is inserted into the urethra, which, under the influence of high power, gradually husks the tissue of a benign tumor,
  • open surgery is performed in advanced stages of the disease or in the presence of stones in the bladder. It is carried out through an incision in the bladder and is traumatic, but at the same time it guarantees complete cure.

  1. Benign prostatic hyperplasia - treatment with non-surgical methods:
  • the introduction of prostatic stents (spirals) into the urethra for a long or short time. Over time, stents should be removed, as untimely removal provokes worsening of symptoms,
  • microwave coagulation of the prostate - microwaves heat the tissue of the prostate to 70 degrees, resulting in its destruction,
  • prostate lifting with an implant - this method expands the diameter of the urethra and improves the quality of life of many patients,
  • cryodestruction, needle ablation, focused ultrasound, etc. are also performed.

Forecast

With timely access to medical help and following all the recommendations of the attending physician, the prognosis of cure is very favorable. Many men postpone a visit to the doctor for a long time, because they are afraid that due to surgical intervention they will have to forget about the pleasures of sexual life forever. But this is a common misconception - on average a month later, sexual function is fully restored.

Prevention

In order to stop the disease in the early stages, it is advisable for men to undergo an annual medical examination by a urologist, starting at the age of 40. Since the exact reason why the adenoma develops cannot be indicated, all preventive measures are exclusively general strengthening.

They consist in observing, first of all, proper and balanced nutrition - less fat and flour products, and more fiber and protein. It is also necessary to drink a large amount of clean water, and in the evening, its intake must be limited.

An active lifestyle, playing sports can normalize blood circulation in the pelvic organs, which helps prevent stagnant processes. At the same time, it is worthwhile to be careful about lifting weights and other increased loads.

To create a normal and comfortable psychological environment, stress and other conflict situations should be avoided. But it is better to refuse to take sedatives.

To provide a good state of sexual function and the prostate will help high-quality regular sex. But bed excesses and erratic relationships can negatively affect a man’s health.

If there is a malfunction in the prostate gland, doctors recommend a massage. It not only favorably affects sexual activity and the duration of sexual intercourse, but also removes harmful substances and pathogens.

What is prostate adenoma?

The prostate gland (prostate) is a small organ composed of muscles and glands. This gland performs important functions in the male body. It gives off a special secret (juice) that dilutes sperm during ejaculation.

The bladder is located above the prostate gland, the ureter passes through it. With an erection, the prostate blocks the entrance to the bladder. Iron is woven from tubules and alveoli.

Hyperplasia visually looks like an uneven or uniform growth of tissues. In this case, the lobes of the organ are usually clearly visible. Prostate adenoma in men can spread in all directions.

With the formation of adenoma (hyperplasia), different types of tissues undergo changes, so the nature of this benign tumor or its parts can be:

  • muscle (myomatous)
  • cicatricial (fibrous),
  • or glandular (adenomatous).

The prostate contains glands of three types, and all of them can undergo proliferation. Neoplasms are gradually replacing healthy tissue. Hyperplasia begins with small nodules, which gradually multiply and increase.

What are the names of this disease?

Changes in, characterized by benign proliferation of the prostate gland, has several names in Russian-language literature. “Prostate adenoma” and “prostate adenoma” are names more familiar to the patient’s hearing. Nevertheless, the new names - BPH (benign prostatic hyperplasia) or BPH (benign prostatic hyperplasia) more fully reflect the essence of this change.

In books and articles written by Russian urologists of the late 19th and early 20th centuries, the disease is called "prostatic hypertrophy." The term "hypertrophy" means an abnormal increase in something (organ, cells). At the beginning of the 20th century, the term in urology also appeared, “prostate adenoma,” which indicated that proliferating tissue was nothing more than a benign tumor of the prostate gland — an adenoma.

At the same time, a number of scientists began to use the term “hyperplasia” (with hypertrophy of the organ or cells, their size simply increases, and with hyperplasia the organ increases due to an increase in the number of cells).

Subsequently, discrepancies appeared in Russian-speaking and English medicine.

Already in the middle of the 20th century, in reference books and textbooks, the disease was called Benign prostatic hyperplasia - BPH, which can be translated into Russian as "benign prostatic hyperplasia."

Soviet surgeons used the terms "prostate adenoma" and "prostate adenoma", considering them true. Such terms are used to this day, they are more familiar to the hearing of patients. However, in the last 10-15 years, doctors of medical institutions in the patient’s cards did not call the disease “prostate adenoma”, but BPH (in another version, BPH).

Causes

The first complaints of frequent desires may appear at the age of 40-45 years. At this age, a diagnosis of BPH in urology is made in 20-27% of men.

What causes prostate adenoma in men? The older the man, the higher the risk of organ hyperplasia. The causes of prostate adenoma in men are associated with hormonal changes.

With reaching adulthood in men, the production of the male hormone testosterone decreases and the production of female hormones - estrogens increases.

Another reason for the insufficient production of testosterone is the malfunction of the pituitary and hypothalamus with prostate adenoma for a variety of reasons.

All men are at risk, regardless of place of residence, race, type of activity, or physical activity. No association was found between prostate hyperplasia and tobacco smoking or alcohol abuse. The main risk factor is the person’s age. There is also no connection between the formation of benign prostatic hyperplasia and acute or chronic prostatitis.

Features of the disease

The prostate is an organ of the urogenital system in men located under the bladder. Outwardly, the prostate resembles a nut. In the presence of adverse conditions, the proliferation of its tissues occurs, as a result of which the urinary canal is transmitted or even deformed, which leads to impaired movement of urine through it.

Therapist Elena Vasilievna Malysheva and interventional cardiologist German Shaevich Gandelman will talk about the features of the disease:

At the very beginning, benign prostatic hyperplasia may be asymptomatic. This can last for years. Her characteristic symptoms occur even when the pathology becomes chronic and is difficult to treat. Therefore, all men who are already 40 years old, urologists recommend an annual routine examination, which will reveal hyperplasia at the initial stage of development, when it is effectively treated.

The adenoma is benign in nature because it does not give metastases.

Pathology prevalence

The first changes in the prostate gland begin to occur in men after 35 years. But at this stage they are insignificant and do not pose any danger to the body. Only half of patients with a confirmed diagnosis of hyperplasia experience symptoms characteristic of it. In this case, not always an increase in the size of the gland leads to the appearance of signs of pathology.

Approximately half of men whose age is in the range of 50-60 years old has a histological adenoma. At the age of 80, the number of patients with this diagnosis reaches 90%. It is also worth noting that only every fourth patient at the age of 50 years and every second at the age of 70 years will experience characteristic symptoms of prostatic hyperplasia, which accompany a pathological increase in organ size.

BPH. What it is? Statistics

As mentioned above, BPH is a benign neoplasm. With it, small nodules form in the prostate (the abbreviated name of the prostate gland), which, as they grow, compress the urethra more and more.

Because of this, a man develops urination disorders. This disease has benign growth, and this is what distinguishes BPH from cancer.

BPH is one of the most common diseases in urology today. According to statistics, it appears in almost 80 percent of men in old age. In 20 percent of cases, instead of BPH, atrophy of the gland or its increase is observed.

BPH disease most often develops in men over 45 years of age.

More than half of men from 40 to 50 years old turn to a specialist with this ailment, and only in rare cases the disease can overtake the young.

Degrees of hyperplasia

During the enlargement of the prostate, various tissues are gradually involved in this process - glandular, muscle, etc. In urology, several degrees of BPH are distinguished, which are associated with the location of the formation.

Table 1. Degrees of hyperplasia

Degree of diseaseChanges Accompanying Hyperplasia
Stage 1 prostate hyperplasiaThere is a delay in urination, nightly urges become more frequent. Iron at this stage is slightly increased. Palpation of the prostate is painless. The average duration of a BPH period of 1 degree is 3 years, during which a man is not bothered by anything.
BPH 2 degreesThe man notes the frequent urges. At the same time, it seems to him that the emptying did not happen to the end. Urine becomes cloudy, blood impurities are possible. At this stage, the patient may suspect a disease. On average, this period lasts about 5 years.
BPH 3 degreesThere is a thickening of the walls of the bladder. Urination occurs drip. Additionally, there is a violation of the functioning of the kidneys. Blood appears in the urine. The patient complains of dry mucous membranes of the oral cavity. The smell of urine is clearly perceived from the mouth. A man is losing weight. Constipation worries him, his skin turns gray.
BPH 4 degreesAt this stage, the symptoms are the same as at the previous one, only they manifest themselves much brighter. Urination is difficult, and in some cases, obstruction of the urinary tract occurs. As a result of stagnation of urine, intoxication of the body occurs, so the patient complains of general weakness and its other manifestations.

Causes of BPH

To date, it is impossible to indicate the exact reasons for the development of prostate BPH, as they simply have not been fully clarified. It is believed that the disease is one of the signs of menopause in men.

The only risk factors are the level of androgens in the blood and the age of the person.

Usually, as a man ages, the balance between estrogen and androgen is gradually disturbed, which causes a violation of control over the growth and function of gland cells.

It is known that there is no connection between prostate BPH and sexual activity, orientation, bad habits, sexually transmitted and inflammatory venous diseases, and none of the above affects the onset of the disease.

Causes of the disease

Doctors cannot name the specific causes of prostatic hyperplasia. One of the main factors of its pathogenesis is the age of a man. This is due to the fact that over time various changes occur in the male body: the level of androgens decreases with a simultaneous increase in the amount of estrogen. Any hormonal changes always have a negative effect on the state of the genitourinary system.

More details about the causes and consequences of prostate adenoma tells Professor Igor Ivanovich Gorpinchenko:

Symptoms of Hyperplasia

For a long time, hyperplasia may not manifest itself in any way, and therefore a man may not be aware of its presence for a long time. The main signs of pathology are considered to be such symptoms:

  • Difficulty urinating. This is especially noticeable at the very beginning of the process.
  • The urine stream is weak, it can be interrupted.
  • The patient feels incomplete emptying of the bladder.
  • The urge to urinate increases and appears even at night.
  • There is a malfunction of the kidneys.

If the treatment of hyperplasia is not started in time, it can lead to various complications:

  1. Jade.
  2. Damage or even rupture of the bladder.
  3. The appearance of kidney stones.
  4. Inflammation of the urinary tract.

Over time, hyperplasia is able to become chronic. Sometimes benign prostatic hyperplasia can degenerate into malignant. In order not to miss the development of the negative consequences of the disease, it is important for a man to consult a doctor for any signs of urination disorders. Especially if there is an impurity of blood in the urine or if it becomes cloudy. This is due to the fact that various urological problems have similar symptoms, therefore, to make an accurate diagnosis, you need to see a doctor. Symptoms similar to the manifestation of hyperplasia also have different inflammatory processes, diabetes mellitus or a malignant tumor of the bladder.

BPH: symptoms

The signs of this disease directly depend on the location of the tumor, on its growth rate and size, as well as the degree of dysfunction of the bladder.

Prostate BPH can be divided into three stages:

  • Compensated, or the first stage. This form of the disease is manifested by delays in the onset of urination (frequent urge to empty, especially at night - a concomitant symptom). With BPH of the 1st degree, the prostate gland increases in size, has a dense-elastic consistency. Its borders are clearly defined, and in general, palpation of the gland (and its median sulcus) is painless. At this stage of the disease, the bladder is still completely empty and there is no residual urine at all. BPH of the 1st degree can last from one to three years.
  • Subcompensated, or second stage. As the tumor develops, it compresses the urethra more and more, and the bladder is no longer able to function normally and completely empty (its walls thicken at the same time). As a result, with grade 2 BPH, residual urine appears, due to which the patient feels incomplete emptying of the bladder. Due to squeezing of the urethra, patients urinate in small portions, and after a while the urine begins to stand out involuntarily (the cause is an overflowing bladder). BPH of the 2nd degree is sometimes accompanied by symptoms of chronic renal failure (developing against its background).
  • Decompensated, or third stage. The bladder is very distended due to residual urine, the urethra is still squeezed, and the urine is released literally dropwise, sometimes even with an admixture of blood. At this stage, BPH entails impaired renal function (renal failure). Weakness, severe weight loss, poor appetite, constipation, anemia, and dry mouth are also observed.

BPH treatment

At the moment, there are many ways to treat the disease, each of which is highly effective at a different stage of BPH. The treatment of this disease can be divided into three parts:

  • Drug treatment
  • Surgical treatment
  • Other non-surgical treatments

Medication is usually used at the first sign of BPH.

In the first stages of prostate BPH, treatment is aimed at reducing the growth rate of hyperplastic prostate tissue, improving blood circulation in adjacent organs, reducing inflammation of the prostate and bladder, eliminating stagnation of urine, eliminating constipation, and making urination easier.

In addition to the use of drugs, the patient is recommended to observe a mobile lifestyle, to give up alcohol and harmful (too greasy, spicy, spicy) food, smoking.

It is also worth reducing fluid intake in the afternoon, especially before bedtime.

In the presence of clinical and laboratory signs of androgen deficiency, androgen replacement therapy is also prescribed.

Often, in parallel with the treatment of hyperplasia, treatment of its complications is carried out - cystitis, prostatitis or pyelonephritis.

Sometimes (due to hypothermia or alcohol consumption), the patient may develop acute urinary retention. In this case, the patient urgently needs to be hospitalized and catheterized.

Let's take a closer look at each type of treatment.

Drug treatment

Most often, two types of drugs are used to treat BPH:

  • Alpha-1-blockers (e.g., tamsulosin, doxazosin or terazosin). Their action is aimed at relaxing the smooth muscles of the prostate and the neck of the bladder, which leads to easier passage of urine. The action of these drugs can be prolonged or short.
  • 5-alpha reductase inhibitors (blockers) (permixon, dutasteride or finasteride). These drugs do not allow dihydrotestosterone (a biologically active form of testosterone) to form in the body of a sick person, so the prostate gland decreases.

Surgical treatment

In especially severe cases, one medication cannot be dispensed with, and, as a rule, one has to resort to surgical intervention. This may be excision of hyperplastic tissue (adenomectomy) or total resection of the prostate gland (prostatectomy).

There are two types of surgical intervention:

  • Open surgery (transvesical adenomectomy). With this intervention, access to the gland tissue is obtained through the wall of the bladder. This type is the most traumatic, and is used only in advanced cases. An open operation provides a complete cure for BPH.
  • Minimally invasive surgery (in which there is practically no surgical intervention). They are carried out using modern video endoscopic technology, without an incision. Access to the prostate through the urethra.

There is another type of surgical intervention that cannot be compared with the above. Embolization of the prostate arteries is an operation performed by endovascular surgeons (the ones described above are performed by urologists) and consists in blocking the prostate arteries with small particles of a special medical polymer (through the femoral artery). Hospitalization is not required, the operation is performed under local anesthesia and is not traumatic.

After any type of surgery, there is little risk of complications, such as urinary incontinence, impotence, or urethral stricture.

Postoperative period

Alas, surgery is necessary at some stages of the disease. BPH is a serious disease, and even after surgery, you need to follow some rules to completely get rid of the disease and not provoke a reappearance. The three main points that you must observe after the operation are the correct diet, a healthy lifestyle, and regular visits to the doctor.

The diet in the postoperative period is extremely important for the patient, since he can significantly contribute to a speedy recovery. The diet after surgery completely eliminates fatty foods, spices, salty and spicy dishes and, of course, alcohol. It is recommended to eat low-fat foods rich in fiber.

As for work, if your profession does not imply frequent physical workloads, then you can return to your workplace a couple of weeks after the operation. When sedentary work every half hour is recommended to do a warm-up. A sedentary lifestyle can contribute to stagnation of blood in organs, from which the disease only worsens. The first few days after surgery do not even think about lifting weights!

Stop smoking at least in the postoperative period (two weeks after surgery) if you can’t quit addiction at all. Nicotine damages the walls of blood vessels, and this affects the blood circulation of the prostate, as a result of which an inflammatory process can occur.

Many people think that after the removal of BPH, you should forever forget about sexual activity. This opinion is erroneous, and the sexual function of a man is fully restored after some time. However, it is worth renewing sexual relations no earlier than 4 weeks after surgery.

Another tip that you should pay attention to: drive a car no earlier than a month after the removal of BPH.

In general, the postoperative period lasts about a month, after which the patient can already return to his usual life. However, experts strongly recommend leading a healthy lifestyle to prevent the re-emergence of the disease.

Urination after surgery

Almost immediately after the operation, the urine stream becomes stronger, and emptying the bladder is easier. After removal of the catheter, pain during urination may occur for some time, the reason for this is the passage of urine through a surgical wound.

Specialists do not exclude the occurrence of urinary incontinence or urgent urination in the postoperative period, these phenomena are completely normal. The more symptoms you have during your illness, the longer your recovery period will be. Over time, all problems will disappear and you will return to the normal rhythm of life.

There may be blood clots in the urine for some time. This phenomenon is associated with wound healing. It is recommended that you drink as much fluid as possible in order to properly flush the bladder. But with severe bleeding, you should immediately consult a specialist.

Video - Prostate BPH: what it is, causes, treatment and prevention

Given the timely detection of BPH and a competent approach to treatment, the prognosis of this disease is usually favorable. But delaying a visit to the doctor can lead to the development of a malignant form of the tumor, which is much more difficult to cure. How prostate cancer manifests itself and how effective its treatment is can be found on our website.

What does benign prostatic hyperplasia (BPH) look like?

A healthy prostate looks like a symmetrical, rounded organ of triangular section, light pink in color. In a section it is possible to see equal shares. Hyperplasia, the proliferation of tissues, makes the organ oval, round, or gives it an irregular shape and heterogeneity of structure.

The increase can be significant, and the shape of the lobes and gland as a whole - completely asymmetric. These changes are clearly visible on the screen of the ultrasound machine (in the pictures you can also see the deformation of the bladder and the amount of residual urine).

A healthy prostate has the shape of a smoothed, down-facing triangle. The size of a healthy prostate in diameter is on average 4 cm, in the longitudinal - from 3.5 to 4 cm. The volume of a healthy prostate is approximately 20 cubic cm.

What does prostate adenoma look like - a photo for your attention:


Symptoms and signs

A sign and symptom of the disease can be repeated urge to urinate during the day, with incomplete emptying of the bladder.

Another sign of an enlarged prostate is the problem of the urination process itself:

  • weak, not tense jet,
  • the need to strain the abdominal muscles when urinating,
  • after the patient has urinated, there is a feeling that the bladder is still full,
  • the allocation of drops of urine after the act of urination,
  • pain in the suprapubic region after urination.

The following are symptoms of different stages of the disease.

  1. The first stage - the jet has no pressure, while there are strong, rapid urges (especially at night), urination is difficult.
  2. The second stage - the jet has no pressure, while there are strong, rapid urges.

Incomplete emptying of the bladder and the formation of residual urine. Acute urinary retention is possible, as a result - a violation of the kidneys.

  • The third stage - due to the closure of the urethra, the patient urinates with great difficulty. Acute urinary retention is possible, requiring a visit to the surgeon. Urine oozes spontaneously drop by drop. Renal function is impaired.
  • What can and cannot be done?

    With prostate adenoma, the contraindications are as follows:

    • lift weights
    • supercool, swim in the hole,
    • sunbathing in the sun, overheating, including in a bath,
    • eat red meat, spicy foods, margarine, animal fats, flour foods, other foods prohibited by the diet,
    • drink sparkling alcohol and carbonated drinks,
    • ride a bicycle with the wrong saddle,
    • smoking (smoking narrows blood vessels and is incompatible with treatment with a number of drugs),
    • abuse alcohol.

    With prostatic hyperplasia, you can and should:

    • lead an active lifestyle, walk a lot,
    • to engage in sports not related to weight lifting, to improve blood circulation in the pelvic area,
    • engage in physical therapy and yoga,
    • take a bath at a certain temperature after consulting a doctor. All about water procedures for prostate adenoma can be found here,
    • have sex or masturbate after consulting a urologist,
    • follow a diet
    • Be sure to eat tomatoes and tomato pastes that contain lycopene,
    • bring back weight
    • after 45 years, visit a urologist once a year,
    • Do not forget about the prevention of the disease.

    The field of medicine dealing with prostate adenoma is called "urology". Diseases of the prostate are treated by a urologist. If a man lives in an area where there are no narrow specialists, he should contact a therapist who will give a referral to a urological doctor. The urologist is also a specialist in diseases of the kidneys and organs of the urinary system.

    Hyperplasia treatment

    After confirming the diagnosis, the doctor will prescribe treatment for benign prostatic hyperplasia. To do this, you must:

    1. Observation of adenoma in dynamics.
    2. Drug treatment.
    3. The operation.

    At the very beginning, urologists prefer not to take emergency measures and recommend that the patient is monitored. For this, a man should undergo regular examinations, during which you need to tell the doctor about all the medications that were taken during this period. This is due to the fact that some drugs can enhance the manifestations of pathology and cause a violation of urination. These drugs include tranquilizers or drugs for the treatment of sinusitis.

    From the video with the urologist Igor Mikhailovich Rokhlikov you will learn about the treatment of the disease:

    Benign hyperplasia may not progress and in men, even after a while, its symptoms do not appear. In this case, the patient must comply with all the instructions of the attending physician and monitor their health and well-being. It is very important to give up bad habits and lead an active lifestyle. This will help delay the pathological changes in the prostate.

    There is evidence that hyperplasia can decrease on its own if a man adheres to certain rules:

    • Avoid the use of antidepressants and drugs that have a sedative effect. This is due to the fact that such medications can reduce muscle tone and interfere with normal emptying of the bladder.
    • Does not take decongestants. They are often prescribed for the treatment of colds and SARS. However, along with this, they increase the tone of the sphincter.
    • Limits caffeinated drinks and alcohol, especially after dinner.

    Surgery

    In those situations where drug therapy of hyperplasia did not lead to the desired result and the disease continues to progress, the doctor prescribes surgery.

    Open surgery can save a man from hyperplasia. But this method is too traumatic, so they resort to it only in the most extreme cases, when the weight of the prostate is more than 80 g.

    About how transurethral resection of the prostate is performed, tells the immunologist Gennady Alexandrovich Ermakov:

    Mostly they use a special tool inserted into the bladder through the urethra. It is equipped with a loop that conducts electric current. Thus, they make an excision of the damaged area of ​​the prostate gland. At the same time, a catheter is inserted, through which urination will be carried out over the next 3 days. In approximately 90% of patients, after such an operation, the condition improves. However, such an intervention can cause complications, such as urinary incontinence, erectile dysfunction, which requires repeated surgery.

    Phytotherapy

    It is impossible to cure prostatic hyperplasia using folk remedies. But supplementing them with traditional treatment will help increase the body's defenses and restore health, which, of course, will speed up recovery.

    Today you can find an advertisement for herbal remedies that promise to quickly and effectively rid a man of prostate hyperplasia. One such remedy is the dwarf palm extract. But, this drug did not pass the necessary research, so its effect has not been proven by doctors. There is an assumption that this medicine relieves swelling, reduces the size of the prostate gland and normalizes hormone levels. However, until now this has not been precisely determined, so the positive result of its use is considered to be the "placebo effect".

    Recovery period

    After medication or other treatment, the patient must regularly visit a urologist to monitor the condition of the prostate gland. After the operation, he is forbidden to lift weights for at least 1 month. If a man is engaged in sedentary work, he needs to periodically take breaks during which to take small walks or do warm-ups. This is due to the fact that with a sedentary lifestyle, in the pelvic area, stagnant processes begin to occur that adversely affect the state of the prostate.

    It is very important at the first urge to urinate, go to the toilet immediately. A delay in emptying the bladder also negatively affects the condition of the organ and the genitourinary system in particular.

    The duration of the recovery period after treatment of adenoma should not be less than 30 days. This is the minimum period for which the patient should completely abandon bad habits. After the course of treatment, men usually feel significant relief and consider themselves completely healthy, but this is not so. The body needs time to recover.

    After surgery, the man will feel pain for a while while urinating. This is due to irritation of the wound, which remained after the operation and is considered completely normal.

    Surgical intervention

    There are several methods of surgical treatment. The doctor can offer the patient to conduct a gentle operation using modern equipment. In extreme cases, the patient's prostate is removed. Methods of surgical treatment can be invasive (large-scale abdominal operations) and minimally invasive (gentle methods in which the opening of the cavity is performed pointwise or not at all). The following types of operations are available:

    Invasive:

    Endoscopic:

    • transurethral needle ablation,
    • transurethral resection,
    • transurethral incision,
    • transurethral electrovaporization.

    Minimally invasive (not endoscopic):

    • cryodestruction
    • focused ultrasound treatment,
    • balloon division
    • ethyl alcohol injections
    • microwave hyperthermia,
    • microwave transurethral therapy,
    • urethral stent placement.

    Sometimes the patient is prescribed vascular embolization. This procedure is designed to reduce blood flow to the prostate, which leads to a decrease in its size.

    Possible complications

    If untreated, patients at stage 2 and especially stage 3 of the disease may experience complications of prostate adenoma.

    Blood may appear in the patient's bladder due to damage to blood vessels from excessive urine pressure.

    What else is dangerous prostate adenoma in men? Blood vessels can damage bladder stones.

    Stones form from residual urine, especially if an inflammatory process (cystitis) occurs in the bladder.

    The muscles of the bladder can undergo stretching and dystrophy, throwing urine into the kidneys can lead to pyelonephritis and the development of renal failure. A prostate adenoma tumor can cause chronic prostatitis.

    Thanks to this article, you found out what are the causes of prostate adenoma in men, and you have also got acquainted with pictures of benign prostatic hyperplasia and found out what complications a disease may have.

    Watch the video: Medical Management of Benign Prostatic Hyperplasia BPH. UCLA Urology (February 2020).

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