What is prostate adenoma? Benign prostatic hyperplasia

Unfortunately, today many men of mature age face such an unpleasant problem as prostate adenoma. What it is? Why does such a disease develop? How much can it be dangerous? What methods of treatment exist? This information is of interest to many members of the stronger sex. After all, the earlier the disease is diagnosed, the easier it will be to get rid of it, avoiding dangerous and unpleasant consequences.

What is prostate adenoma?

According to statistics, approximately 50% of men over 50 years of age face a disease called prostate adenoma. What it is? Can I somehow avoid or slow the progression of the disease? These issues are extremely important and painful for men. Indeed, in fact, many patients are silent about their problems until the disease goes into a more serious form.

If you are interested in what an adenoma is, then for starters it is worth saying that this title is slightly outdated. In modern medicine, the term "benign prostatic hyperplasia" is increasingly used to refer to this disease. The process of the development of the disease begins with the formation in the tissues of the gland of a small nodule (sometimes it happens several at a time), which gradually (and sometimes fairly quickly) increases. Changing the size, the prostate gland squeezes the urinary tract, interfering with the normal outflow of urine - this phenomenon is not only unpleasant, but also extremely dangerous, as it affects the work of the entire excretory system. In fact, the tumor is a hyperplastic (enlarged) paraurethral glands.

By the way, adenoma is a benign neoplasm, which, despite the possible rapid growth, does not give metastases to other organs. Therefore, the disease, with the right approach, is perfectly amenable to therapy. The main thing here - in time to notice the alarming signs and seek help from a specialist.

The main causes of the disease

It should be noted right away that scientists are still studying the mechanism of development and the causes of this disease. The only thing that can be said for sure: the appearance of adenoma is associated with age-related changes in the body. For example, in adolescents, adenoma is very rarely diagnosed. But after 70 years, approximately 75% of men suffer from this or that stage of the disease.

Hyperplasia is associated with changes in the hormonal background, fluctuations in the level of sex hormones that inevitably occur in the aging process of the body. In favor of this theory is evidenced by the fact that among castrated or ososplennyh men cases of hyperplasia have not been recorded.

There are other, indirect factors that can provoke a disease called prostate adenoma. What are these reasons? First of all, doctors note that any lifestyle changes, as well as bad habits (smoking, alcohol abuse and drug addiction) increase the risk of hyperplasia. Risk factors include poor nutrition, persistent stress, severe psycho-emotional stress, and negative environmental effects. Naturally, these factors alone can not provoke the appearance of adenoma. Nevertheless, all of them somehow affect the endocrine system, affect the level of hormones, which, accordingly, can cause the appearance or accelerate the growth of the existing adenoma.

There are suggestions that there is some genetic heredity here. Unfortunately, there is no precise confirmation of this hypothesis, since it is difficult to determine whether hyperplasia is connected with heredity or arises with aging.

What symptoms are accompanied by the disease?

Despite the fact that the adenoma is a benign neoplasm, the course of the disease can be different. For example, in some men, hyperplasia can develop slowly, not making itself felt for 20-30 years. In other patients, on the contrary, the emerging tumor grows to critical sizes in 1-3 years. That's why every man needs to carefully monitor any changes in health.

Of course, there are certain symptoms that characterize prostate adenoma. What are these signs? In most cases, such a disease is accompanied by increasing problems with the process of urination, as well as violations of sexual function.

At the initial stages of the formation of hyperplasia, a decrease in the urine stream can be noted. Later, there are so-called "empty" desires, when a man has a desire to urinate, but nothing comes out. As the disease develops, the patient begins to wake up at night (sometimes up to 4 times) to empty the bladder. In the future, men begin to notice that they need to strain to empty out, use the abdominal muscles.

Often, on the background of hyperplasia, urine leakage is observed, when the bladder does not completely empty, and the urine remains passively leaving the stains on the underwear.

It should be noted that quite often adenoma is associated with chronic prostatitis (an inflammatory process in the tissues of the gland). In such cases, along with other symptoms, pain is also disturbed by urination, and during periods of exacerbation - weakness, fever. When such symptoms appear, it is better to immediately consult a specialist and get a diagnosis.

Possible complications of adenoma

Of course, in the absence of treatment, such diseases of the prostate can cause complications, and quite dangerous. Many men note the presence of blood impurities in the urine. The occurrence of such a symptom is associated with changes in the veins of the neck of the bladder, as well as an increase in blood pressure in the vessels of the small pelvis.

A large increase or swelling of the prostate gland can lead to a complete overlap of the urinary tract and the appearance of an acute retention of urination. This condition is extremely dangerous, as it can cause damage to the bladder, as well as disruption of the normal functioning of the kidneys. In addition, it is very painful.

To the most common complications of adenoma can be attributed and inflammatory diseases. By the way, the inflammatory process can develop not only in the gland tissues (prostatitis), but also affect any part of the excretory system. Patients often suffer from urethritis, cystitis, pyelonephritis, epididymitis, etc. By the way, chronic inflammation of the kidneys in the absence of timely treatment can lead to the development of renal failure.

Modern diagnostic methods

To begin with, the doctor will try to collect a complete history, hold a survey, take an interest in the symptoms present. In the future, as a rule, finger research of the prostate gland follows, which is by far the simplest and most accessible diagnostic method. After the prostate massage, samples of the secretion of the gland are taken for laboratory analysis.

In addition, a smear from the urethra is needed, which helps to determine the presence of infection. If you suspect an adenoma or any other disease of the gland, an ultrasound is performed that helps determine the exact size of the prostate, the presence of stones, and also determine whether there are stagnant phenomena.

To make an accurate diagnosis, uroflowmetry is also important - a comprehensive study that helps determine the speed of the urine stream, as well as the time of emptying the bladder and some other important indicators.

An important part of the diagnosis is PSA with prostate adenoma. This study helps to identify the so-called prostate-specific antigens in the blood, which are some sort of oncomarker. This analysis helps to detect the presence of malignant process. By the way, men aged 50 and older are recommended from time to time to take this analysis for preventive purposes.

How is the adenoma treated? The main types of therapy

To date, there are several ways to treat such a disease. By the way, the diagnostic process is necessary not only to detect the problem, but also to determine the most appropriate therapy for the disease "prostate adenoma." Methods of treatment can be both conservative and surgical.

In the early stages, the process of the development of the disease can be stopped or slowed down with the help of medications. But, again, conservative treatment will only help delay the operation for several years (or decades), but can not completely rid of the tumor that has already appeared.

The most effective is the surgical treatment of adenoma, as it helps to quickly eliminate all existing problems. Moreover, many men seek help at the stage of the disease, when conservative therapy does not make sense.

Medication

Again, it should be said that medication helps only in the early stages. Naturally, different drugs are used for any therapy, but more often - in conjunction with a surgical intervention.

First of all, patients are prescribed 5-alpha reductase inhibitors (for example, "Proscar"), as well as alpha-blockers (Okas, Omnik preparations are considered quite good). Positive on the condition of the prostate gland and the endocrine system affects immunostimulants (for example, "Reoferon" and "Pyrogenal"). In the presence of an inflammatory process or infection, it is mandatory to take antibacterial drugs, for example, antibiotics of the gentamicin group or cephalosporin.

Patients are also prescribed medications that improve blood circulation in the prostate gland and eliminate stagnant phenomena. The most popular drug to date is Trental.

Along with taking medications, patients are also recommended a proper diet, an active lifestyle, special exercises (Kegel complex for men).

Endoscopic methods of treatment

Unfortunately, in some cases, without operational intervention, it is impossible to manage. Surgical treatment of prostate adenoma is indicated in the following cases:

• Acute urinary retention ;
• Kidney failure, which occurred against the background of adenoma;
• Presence of stones in the bladder;
• Large diverticula of the bladder;
• Constant presence of blood in the urine;
• Repeated infections of excretory system.

Only the doctor decides which type of operation will be performed. In the presence of acute retention of urine , a cystostomy is first performed, in which the doctor surgically creates an external fistula of the bladder with an opening in the pubic region. Many patients oppose such an intervention. Nevertheless, it is necessary, since before the removal of the prostate or other manipulations it is extremely important to restore the normal outflow of urine and to prevent the infectious diseases. By the way, it is proved that complications of the postoperative period in patients who have undergone cystostomy are much less frequent.

To date, there are many minimally invasive procedures and endoscopic operations that are carried out through the urinary tract, leaving no serious injuries and scars. For example, some patients put so-called stents in the urethra, which prevent the narrowing of its lumen. This normalizes the outflow of urine, but, alas, does not stop the process of growth of the gland. By the way, these stents need to be changed quite often.

What are the ways to remove adenoma of the prostate? The operation of transurethral resection is now considered the gold standard. The doctor using the endoscopic instruments removes parts of the gland through the urethra. In addition, it is possible to transurethral dissection, in which the prostate is not removed, but only dissected in order to relieve pressure from the urinary tract.

A rather new procedure is laser surgery for prostate adenoma. Its price is slightly higher, but this technique has a number of important advantages. In particular, laser removal is much faster, less often accompanied by complications and minimizes the likelihood of infection of tissues.

In the presence of a small tumor, transurethral microwave therapy can be performed. During the procedure, the doctor enters a special device through the urinary canal, and then destroys the gland tissue with heat released by the electrodes. This technique is also quite popular and almost harmless, but, unfortunately, is not suitable for everyone.

The success of surgical intervention largely depends on the physiological characteristics of the patient and the stage of his illness, and on the qualification of the doctor. According to statistical data, approximately 25% of patients report the presence of the same symptoms (urine leakage, urination disruption, nocturnal urges) even after resection.

Adenoma of the prostate: surgery

In most cases, problems with the prostate can be solved with the help of minimally invasive methods. But in some cases, patients are shown a so-called radical prostatectomy. This operation is most often performed in the presence of a malignant tumor. With an adenoma, it is prescribed only in cases when the other methods do not work or can not be used for some reason.

Radical prostatectomy involves the complete removal of the prostate gland, and sometimes the surrounding tissue. The procedure requires a straight cut in the lower abdomen or in the perineal region. Naturally, this operation is more dangerous in terms of complications. For example, during removal, it is very easy to hook the nerve endings leading to the penis, which is fraught with impaired potency. In addition, the probability of developing infectious diseases is high.

Prevention of disease

Unfortunately, such diseases of the prostate gland are extremely common. That is why many men are interested in questions about whether it is possible to somehow protect themselves from the disease or at least reduce the likelihood of complications.

Prophylaxis of prostate adenoma is a healthy lifestyle. In particular, men in adulthood (and not only) need to monitor food more closely. For example, in the diet must be present fresh vegetables and fruits, but the number of animal proteins with age should be reduced. The abuse of spicy and spicy food often leads to constipation, which stimulates the growth of the tumor. Negative effects on health and fried foods. In addition, experts recommend to abandon alcohol and caffeine-containing products (coffee, chocolate, cola, energy). At least 1-2 times a year it is worth taking multivitamin complexes, as it is not always possible to get all the necessary nutrients together with food.

A very important part of prevention is physical activity. We must not forget about charging, if possible, to visit the gym. Suitable any physical exercise, even if it's just walking. Hypodinamy is a factor that negatively affects the body's work, hormonal background and, accordingly, can stimulate the development of the disease.