Benign prostatic hyperplasia (BPH) or adenoma is a growth of the stromal component or epithelium of the prostate.The disease mostly affects men over the age of 40, and is less common in younger people.According to statistics, the probability of developing the disease after the age of 50 is about 40%, and after the age of 65, it is more than 75%.In fact, 90% of men will encounter this disease sooner or later, so it is necessary to understand the causes, risk factors, symptoms and modern treatments of prostate adenoma in advance.
Danger
Adenomas are benign formations and therefore do not cause harm to the body.However, as the tissues grow, they block the lumen of the urethra, preventing urine from passing through.This is associated with many unpleasant complications and painful feelings, especially in the later stages.The resulting congestion can lead to infection, bladder stones, bladder damage, and serious interference with kidney function, including the development of failure.Therefore, as soon as the slightest symptoms appear, you must immediately make an appointment with a urologist for a thorough examination and, based on the results, choose the most effective treatment for prostate adenoma.
Stages and symptoms
The course of the disease can be divided into three main stages, accompanied by various symptoms:
- I – Characterized by more frequent urges, nocturia (increased diuresis at night), the first signs of incontinence, and a slower urine flow.The disease may persist in this stage for several years without progressing to a more severe form;
- II – More severe symptoms.The flow of urine may be interrupted and you must frequently strain to urinate, which often leads to hernias and rectal prolapse.After using the toilet, there is still a feeling of dissatisfaction and incomplete emptying.The disease develops more actively and the transition to the next form takes a relatively short time;
- III – Due to the cumulative effect, the bladder stretches, its elasticity decreases, infections develop, kidney stones appear, urinary incontinence worsens.General symptoms of poisoning may also occur - weakness, loss of appetite, nausea, constipation, persistent dry mouth.
It’s worth understanding that similar symptoms are also associated with certain types of neurological disorders and cancer.An accurate diagnosis can only be made in the clinic after proper research.
disease treatment
Prostatic adenomatous hyperplasia is currently a well-studied disease.Its treatment is not particularly difficult and can be done in a variety of ways, depending on the severity, type, speed and stage of development of the disease, the patient's age, general health and other factors.
In general, all methods are conventionally divided into pharmacological, non-pharmacological and surgical.There are also many recipes from alternative (traditional) medicine, including the use of various herbal preparations, but their effectiveness has not been proven by clinical trials, and in some cases this method of treating prostate adenoma only complicates the course of the disease and has a negative impact on the patient's condition.
non-pharmacological methods
For mild disease symptoms or more serious symptoms that do not affect quality of life, watchful waiting, also known as active waiting, can be used.It involves regular monitoring of the condition without the use of medications.Behavioral therapy is also provided, including:
- Refusal to take anticholinesterase and diuretic medications without additional instructions from the attending physician;
- Force complete emptying of the bladder before bed;
- Physical therapy, Kegel exercises, and other activities designed to train the pelvic muscles;
- Reduce consumption of diuretic products and fluids, especially three hours before bed.
The technology can be used either independently or as a complement to medical treatments.
drug treatment
For severe to moderate symptoms, patients may be prescribed a variety of medications, including:
- Alfuzosin, tamsulosin, and other alpha-blockers;
- Solifenacin, M-anticholinergics, muscarinic blockers - symptoms due to congestion are clearly predominant;
- Type V phosphodiesterase inhibitors - commonly used to treat impotence and its causes, but have also been shown to be effective in treating hyperplasia;
- Finasteride and other 5-alpha reductase inhibitors - reduce the rate of proliferation and reduce the size of prostate tissue.
These and other medications are often used before surgery or if they are contraindicated for some reason.
Operation
Surgery is currently considered the “gold standard” and most effective treatment for prostate adenomas.With their help, you can completely remove the prostate adenoma with minimal impact on the body and maintain normal urination and erections.Their main advantage is that they can be used at any stage of the disease.There are several main types of surgical procedures performed at our clinic.How to treat prostate adenoma is decided by the attending physician together with the patient after a thorough examination and examination.
open adenoma resection
Open adenomaectomy is a classic surgery that involves making an incision in the perineum or lower abdomen and using various instruments to remove inflamed glandular tissue.The main advantages of this method are that it is well-studied and does not require special equipment, so it can be used in almost any clinic.However, due to the open nature of the surgery, it is often accompanied by heavy bleeding.Additionally, due to the proximity of the prostate to nerve nodes, there is always a risk of damage to the nerve nodes, leading to disruption of sexual and urinary function.
transurethral resection
Prostatic adenoma TUR is a procedure that uses an electrical resection ring to remove part of the prostate.Today, it has become one of the most popular and frequently performed surgeries due to its less invasive nature.All instruments are formed through the urethra without any incisions, no blood loss, no scarring on the skin, and a recovery period of only a few days.In addition, during the surgery, complete information about the state of the urinary system is collected and any abnormalities discovered are eliminated.
New treatment method for prostate adenoma
Minimally invasive approaches using advanced technology and equipment are considered the most promising.These include:
- Holmium laser enucleation of the prostate (HoLEP) - Surgery is performed through a small incision (up to 2 cm).Using a laparoscope, a laser fiber is inserted into the bladder and through its neck to reach the gland.Using an ultra-precise and safe holmium crystal laser, careful incisions are made to remove the adenoma tissue and then pulverize it.This approach ensures almost complete immunity to healthy tissue and minimal blood loss;
- Transurethral Photoselective Vaporization - This method involves using focused laser radiation to completely burn away damaged tissue without damaging healthy cells.Intervention is performed through the urethra, eliminating any incisions and scars, minimizing the number of recurrences and reducing recovery time to just a few days;
- Robot-assisted laparoscopy - performed using an advanced da Vinci robotic complex equipped with necessary video recording tools and equipment.Controlled by experienced surgeons on a dedicated terminal, the camera's images are displayed on a large screen with high resolution, significantly expanding the surgical field of view.Special robotic algorithms smooth out all sudden, random movements of the operator, completely eliminating human factors such as tremors.Using this complex allows you to perform surgery as accurately as possible through small incisions of a few millimeters.
All of these methods have a significant disadvantage - the equipment is expensive and requires experienced, qualified personnel to use it.Therefore, this technology cannot be used in every hospital.