Recommend
Official site Prostaline

Diagnosis and treatment of prostate adenoma

The most common urological pathology, which is directed to the urologist, men over 45, is the adenoma of prostate.The presence of this pathology significantly worsens the quality of life of men.One of the most formidable possible consequences of the pathological process is the degeneration of the Benign prostate hyperplasia in a malignant tumor.

To combat prostate adenoma, surgical and drug treatment methods are used.Hospital specialists select the most effective medicines or methods of surgical intervention taking into account the stage of the disease, the general condition and age of the patient, as well as the presence of related pathologies.In the surgery clinic, comfortable conditions for the treatment of patients have been created.

Prostatitis in a man

The causes of disease development

The adenoma appearance is more frequently associated with changes related to age in the prostate, namely a change in its structure and an increase in size.As a result of such changes, the urethra is gradually compressed, which is found in the thickness of the prostate gland and violations of the urine process appear.

The adenoma of prostate in men develops due to the hormonal restructuring of the body associated with age -related changes.The testosterone level (male hormone) is gradually decreasing with age, while the concentration of female sexual hormone (estrogen), on the contrary, increases.This phenomenon is called male menopause.

Prostate adenoma development may be due to the following risk factors:

  • The patient's age: the increase in the iron of the prostate is extremely weird in men under forty years old, and after sixty years it is diagnosed in almost every second;
  • Hereditary predisposition: If the adenoma of the prostate was diagnosed in close blood relatives of a man, he has a great risk of inheriting this disease in adulthood;
  • Diabetes mellitus, cardiovascular diseases: a benign tumor (adenoma) of the prostate can occur as a result not only of these diseases itself, but also by the harmful effects of medications for their treatment (for example, beta blockers);
  • The wrong way of life: the risk of developing prostate adenoma increases in men with obesity, insufficient physical activity.

Symptoms

The adenoma of the prostate can be suspected when a man appears in the following symptoms that are more typical for this disease:

  • urine duties;
  • the appearance of the need for the tension of the abdominal muscles for urine;
  • the presence of pain, burning, slow urine current;
  • discomfort and insufficient emptying of the bladder;
  • Increasing the duration of the urine process.

The adenoma of the prostate leads not only to a decrease in the quality of life of a man, but also to an acute delay in the urine, which requires the use of surgical treatment methods.To avoid surgical intervention, many patients use special medications for the treatment of prostate adenoma, eliminating symptoms and restoring the normal activity of the prostate.However, only a qualified specialist can suggest the best remedy for prostatitis and prostate adenoma.It is necessary to contact it when the first symptoms of the disease appear.

Prostate adenoma treatment individually for each patient.Preparations for the treatment of prostate adenoma, their dose and duration of use are prescribed by the treating doctor.Taking prostatitis products and prostate adenoma may not be only an ineffective measure, but also a dangerous measure.Due to the presence in men of the previous generation of some "personal" chronic diseases, medications for the treatment of prostate adenoma should be selected taking into account the accompanying pathologies.

Stages of disease development

Prostate adenoma is characterized by gradual development, which can be divided into three stages.

  • The first stage of the disease continues with minimal urination disorders.You can see your insignificant increase, especially at night, and a slow flow of urine.The first stage can last from one year to 12 years or more.
  • The second stage of the prostate adenoma is characterized by more pronounced urine disorders: the intermittency of urine current, the appearance of the need to tighten during urination and a sensation of incomplete emptying of the bladder.The residual urine, which remains in the bladder and urinary tract, causes an inflammatory process accompanied by pain, ardor feeling during urination, pain in the lower back and above the pubis.
  • The third stage is characterized by the release of periodic or constant involuntary urine, which forces the patient to use the ureter.

Complications

In some men in the prostate adenoma, the quality of life does not worsen and proceeds without the development of complications.However, in some cases, the disease can cause the following negative consequences:

  • The acute delay of urine: is characterized by a sudden impossibility of emptying the bladder and pain in the right region.With a similar condition, the patient needs emergency medical care with catheterization or a small operation;
  • The appearance of infections in the urinary tract is the stagnation of the urine, which creates favorable conditions for the reproduction of pathogens, leads to the development of cystitis and pyelonephritis;
  • The formation of stones in the bladder is also a consequence of the urine stagnation;
  • Damage to the bladder: with the irregular emptying of the bladder, it stretches, the formation of bumps (pockets) on the walls of the organ, in which the urine stagnates;
  • Damage to the kidneys: increased pressure on ureters and bladder has a direct harmful effect on the kidneys, as a result of which renal failure develops.

Prostate and power adenoma

The adenoma of the prostate and the power are closely interconnected.The adenoma interrupts the structure of the tissue of the gland, which, in turn, leads to the defeat of another organ no less important: the testicles responsible for the androgen products.Therefore, the adenoma of the prostate can cause helplessness that requires prolonged and complex therapy.

Diagnosis

A simple and effective way to establish a preliminary diagnosis is the patient by maintaining a urine diary with the fixation of quantitative and qualitative parameters: dedicated urine volumes, characteristics of the liquid consumed, called imperative, night urgency.The main physical exam method in case of suspicion of the adenomics of the prostate is a rectal examination of the prostate fingers to identify its increase and exclude other pathologies.

The diagnosis of prostate adenoma in the hospital is carried out using the following laboratory and instrumental methods:

  • General blood and urine tests;
  • Biochemical blood analysis for markers of the condition of the kidneys, urea and creatinine;
  • Analysis for dog level (to exclude prostate cancer);
  • Transortal ultrasound exam (ultrasound);
  • Uroofloometry (to determine the speed of urine current);
  • Determination of the volume of residual urine (using ultrasound);
  • Electromyography of the pelvic background;
  • Urethrocystoscopy;
  • Excretory Urography.
Prostate adenoma diagnosis using instrumental methods

Treatment

The treatment of the prostate adenoma aims to facilitate the symptoms of the lower urinary tract, improve the quality of the patient and prevent the development of disease complications.Patients with poorly exposed symptoms who do not worsen the quality of life, often recipe the tactics of dynamic observation with regular exams with a urologist, who controls the course of the disease and gives recommendations on how to stop the growth of the prostate adenoma.During this period, attention focuses on therapy that is not funds.Hérica methods can be an addition to conservative treatment, which is the intake of the following drugs:

  • Alpha blockers (tamsulosin, alfuzosina);
  • 5-Inhibitors of the Alfa Redtase (Finsteride);
  • Type 5 phosphodesterase inhibitors (sildenafil);
  • Combinations of inhibitors 5-Alpha reductase and alpha blockers;
  • Muscarine or m-colinolithic receptor blockers.

Patients with prostate adenoma are recommended in an advanced stage to perform surgical treatment, which can be performed through various methods: transureral split, transureral resection and prostate elimination.

There are certain indications for the use of surgical treatment:

  • Repeated urine delay;
  • Renal failure caused by the adenoma of prostate;
  • Stones in the bladder;
  • Recurring infections of the urinary tract;
  • Hematuria repetition.

In addition, surgery is necessary for patients in the absence of effectiveness of pharmacological treatment.

In the course of conservative therapy or in the postoperative period, patients need constant medical control with standard studies (determining the urine current rate, ultrasound, PSA level analysis).

Drugs

There is a certain scheme according to which specific medications are prescribed for the treatment of prostatitis and prostate adenoma.A high treatment effectiveness is achieved thanks to the use of drugs from the Alpha Reduase inhibitors and alpha blockers.These medications for the treatment of prostate adenoma in men help eliminate the main symptoms of the disease, as well as to restore enough urination.

What are the most effective and widely used tablets of prostate adenoma?The list is headed by alpha1-adrenergic receptor blockers.In addition, this list includes inhibitors of 5 ALFA reductase, vitamins and minerals.

The pharmacological therapy complex includes not only drugs.With prostate adenoma, conservative treatment can be complemented with biologically active additives, dietary supplements that improve the therapeutic effect of medications and provide early recovery.Some of them include zinc.This macro element is directly involved in spermatogenesis and testosterone synthesis.Vegetable phytosterols normalize urination.

Treatment with medications from the alpha1-adoreceptors antagonistic group

These medications for the treatment of prostatitis and the adenoma of the prostate provide relaxation of the smooth muscles of the urinary system and improving the urine process.Tamsulosin with the same name of the active substance, which is part of other medications (alfuzosina, silodines, etc.), is a highly sequential drug that has a selective effect on alpha1-adrenergic receptors of the prostate muscles, the prostate of the urethra and the bladder.Thanks to a decrease in muscle tone, the output flow and urine is facilitated.Tamsulosin, like all selective medications, has a minimum number of side effects, does not affect the tone of blood vessels and can be prescribed to patients with chronic hypertension.

Alfreergic receptor antagonists should be constantly used, so that it can achieve a gradual reduction of irritation and obstruction with the prostate adenoma.Tamsulosin drug in the treatment of prostate adenoma occupies a well -deserved priority in the purpose of urologists.

The shape of the drug tablet is considered more progressive, since due to the controlled release of tamsulosin, the active substance is in the body in constant concentration.The medicine enters the bloodstream uniformly, thus ensuring a decrease in the probability of developing the main side effects of the drugs of the Adrenaehobocators group, a strong decrease in blood pressure.

An equally effective drug with the active substance tamsulosin is a lesson.Taking this medicine is not accompanied by the following undesirable effects: Orthostatic Hypotension, Tachycardia, an increase in angina attacks in patients with coronary heart disease, so it can be prescribed for men with cardiac pathologies.The dose and compliance properly selected with all the rules on the use of medicines of the alpha-blocker group allow it to achieve a good therapeutic effect on the almost complete absence of side effects.

Group of the inhibitors (blockers) reductase

The drugs of this pharmacological group (Finsteride, Dutteride) contribute to relieve the output of the urine and, therefore, to the elimination of the main symptoms of the disease.A stable therapeutic effect already occurs two or three weeks after the start of the course.All symptoms stop completely after three months.According to the results of clinical studies, maximum efficiency is achieved after six months of therapy with these medications.

Finasteride and Dutterida are specific inhibitors of the 5-Alpha reductase of the second type (cellular enzyme responsible for the transformation of testosterone into dihydrotestosterone).The growth of the prostate with prostate adenoma is directly related to a similar transformation of testosterone.Thanks to the inhibitors of the 5 ALFA reductase, the products of the intra -industrial dihydrotestosterone are blocked and their blood concentration is significantly reduced.

Finsteride and Dutteride are used for the following purposes:

  • Treatment and control of prostate hyperplasia;
  • Improve urine output and eliminate symptoms of prostate adenoma;
  • Reduction of the risk of developing acute urinary retention and the need to perform surgical intervention.

Finasteride and Dutterida have a pronounced antiandrogenic effect, that is, they contribute to a decrease in the level of male blood hormones.In addition, these medications have a teratogenic effect, so they must be taken with caution.With the help of modern drugs, you can stop the growth of the prostate and prevent the need for surgical treatment.

Antispasmodics and analgesic tablets with exacerbation of the disease

The main prescription of antispasmodic and analgesics effects with exacerbation of prostate adenoma is to relieve the general condition of the patient and eliminate pain syndrome.The anti -inflammatory and analgesic effect is exercised by non -steroidal anti -inflammatory drugs (diclofenac, ibuprofen).They help fight not only with painful sensations that occur in the urine process, but also with constant pain in groin and perineum.Due to the action of non -steroid anti -inflammatory medications, the inflammatory process decreases, the swelling of the prostate gland decreases, body temperature is normalized and eliminated by unpleasant symptoms.

Neopioid analgesics produced in the form of tablets or candles help to stop pain syndrome with prostate adenoma exacerbation.The most affordable of them is sodium metamizol.However, this drug is intended for the use of a time, since it can only affect a weak pain syndrome.In addition, analgesics with lidocaine, benzocaine, anesthesine and novocaine (ichtammol, benzocaine, tribenosido + lidocaine) are effective.

Vitamin E 400

Tocoferol acetate or vitamin E is often part of the complex treatment of prostate adenoma as an antioxidant radioprotective agent and an indispensable link in reproductive processes.Vitamin E in a dose of 400 mg of urologists is prescribed to patients with erectile function disorders and spermatogenesis associated with the adenoma of the prostate gland.

The treatment of a chronic disease as serious as a prostate adenoma should be prescribed and controlled by a urologist.It is strictly forbidden to take certain drugs independently, without a preliminary consultation with the attending physician, since the self -medication in this case can not only be ineffective, but also dangerous to male health.Only a qualified specialist can suggest which prostate adenoma tablets are the most effective in each case, and which of them can cause negative consequences.

Patient with prostatitis on an appointment with the doctor

Operations

Hospital urologists masterfully perform classical and minimally invasive surgical interventions, use innovative methods of surgical treatment of prostate adenoma.Each patient is selected that operation that suits it more.

The generally recognized standard in the surgical treatment of the adenoma of the prostate is the transureral resection of the prostate.The operation is highly effective.After the intervention, patients get rid of the infravizia obstruction (narrowing of the urethra) and the associated symptoms.The rehabilitation period is short.During or after surgery, bleeding can be developed, "water poisoning" syndrome.

Alternative methods to treat the adenoma of the prostate include the following surgical interventions:

  • Stent;
  • Globe dilation;
  • Hyperthermia;
  • Thermotherapy;
  • Ultrasonic ablation, laser and needle;
  • Interstitial Coagulation.

After them, complications arise less frequently, but these methods are lower than transurethral resection in terms of effectiveness, both in clinically and economically.

The laparoscopic elimination of the adenoma of the prostate is used when the tumor has grown significantly, and it is problematic to eliminate it using transurethral resection.This operation is more complicated, performed under anesthesia.Through small incisions, the surgeon introduces special tools in the body's cavity, which performs the adenoma of prostate.The operation is carried out according to the image of the video cameras, shown on the screen.The main advantages of intervention are the minimum volume of blood loss, a small probability of complications.After surgery, the patient does not need long -term rehabilitation.

When there are signs of prostate adenoma in men, doctors use a high -tech method to treat laser enucleation.The intervention is carried out with large sizes of neoplasia.Excess fabrics are eliminated with a laser.The operation is carried out through the urethra.The tumor is separated, divided into small parts and then shows.The method is considered minimally invasive.It has a series of significant advantages: it does not violate the integrity of the cavities, it does not cause unnecessary damage.

Laser vaporization is to destroy adenoma by laser evaporation.Through the urethra, the urologist introduces a special device, takes to neoplasm and promptly affects it with a strong green laser.The depth of laser penetration and the precision of their blow can avoid damage to neighboring areas.The method is minimal, without blood, fast and effective.His only disadvantage is the inability to take a tumor fabric for the histological examination.

In some situations, the inevitable method to treat the adenoma of the prostate is abdominal surgery: adenomectomy.It is performed in the case when other methods cannot help the patient.During surgery, the surgeon with scalpel has access to the prostate gland and manually, using surgical instruments, eliminates adenoma.As a result of the operation, a significant loss of blood can occur, complications are developed.After surgery, the patient needs prolonged rehabilitation.

The elimination of the adenoma of the prostate by the method of adenomectomy of custody (transluccal) consists of the radical split of the hyperplace tissues of the prostate through the longitudinal incision of the anterior abdominal wall and the bladder.The operation is carried out in the advanced stages of the disease, when the tumor reaches large sizes, the bladder becomes overturned due to its accumulated urine overflow and renal failure develops.

The bladder is pre -cateterized and is filled with a sterile solution of furathsiline or other substance.Then it is assigned and taken in two places to special properties, for which they lift the wall of the organ.The surgeon dissects the fold formed and opens the bladder.

In the internal end of the established urinary catheter, it determines the bladder neck area and around the urethra holes that appeared in the field of vision, withdrawing at 0.5-1 cm from it, it makes the mucous membrane of the mucous membrane.After that, the operational urologist penetrates a finger into the thickness of the prostate, enters between the tumor capsule and the adenomatous nodes, and we have the latter.At the same time, the doctor gives the gland at the head of the patient in the patient's rectum in the rectum on the front abdominal wall.It becomes more affordable for manipulation.Thanks to this technique, operating time is reduced and blood loss is reduced.

Then, the surgeon performs hemostasis (stopping the bleeding) of the bed of the remote adenoma and the bladder, leaving a thin drain in the wound.It is designed to wash its resulting blood clots.The urinary catheter, introduced before the start of the operation, is not eliminated for 7-10 days.Around it, a new section of the urethra is formed instead of those accompanied in the course of the prostate part of the urethra.

Cuspular adenomectomy refers to the most traumatic of all methods used for the adenoma of the prostate gland.It is accompanied by the risk of developing the following complications:

  • Bleeding of the neoplasm lodge;
  • Stagnant pneumonia;
  • Deteriorated motor evacuation function of the intestine, manifested by constipation.

To avoid complications, after hospital surgery, the patient performs early activation.The following undesirable consequences of operations can occur to eliminate the adenoma of the prostate:

  • Insufficient bladder drainage;
  • Narrowing of his neck;
  • Urinary infiltration of tissue near the pussia;
  • The formation of the "prenatal" (the residual cavity in the place where the adenoma of the prostate) was eliminated;
  • The formation of narrowing of the light of the urethra;
  • Urine incontinence.

This negatively affects the quality of life of patients and extends the restoration of proper urination.

The consequences of the operation are less pronounced when the intervention is performed using a laparoscope.The laparoscopic operation to eliminate the adenoma of the prostate is one of the least invasive options for surgical interventions in the prostate gland.Hospital urologists use this technique if the patient has a sufficiently large adenoma of the prostate.

If the patient's prostate gland with an adenoma does not exceed 120 cm3, it is recommended for transureral resection of the prostate adenoma.But 10% to patients who need surgery, this option is not adequate, since iron reaches more than 120 cm3.The laparoscopic operation is not performed to eliminate the adenoma of the prostate during uarolithiasis, inguinal hernia, the fun of the bladder and the anchyose joints of the lower extremities.In this case, the decision on the possibility of performing an operation is collegially taken by a urologist, an andrologist, an abdominal surgeon and other hospital specialists.