Diagnosis and treatment of prostate adenoma

The most common urological pathology is addressed to the urologist, men over 45, is prostate adenoma.The presence of this pathology significantly worsens the quality of life of men.One of the most frightening consequences of the pathological process is the degeneration of benign prostate hyperplasia into malignant tumors.

Surgery and medication methods are used to combat prostate adenoma.Hospital experts choose the most effective drugs or methods of surgical intervention, taking into account the disease, general condition and the age of the patient, and the presence of related pathologies.At the surgical clinic, the treatment of patients was a comfortable condition.

Causes of the development of the disease

The occurrence of adenoma is most often associated with changes in the age of prostate, namely its structure changes and increasing size.As a result of such changes, the urethra is gradually compressed, which is located in the thickness of the prostate and the urinary process appears.

In men, the adenoma prostate develops due to the hormonal restructuring of the body due to age -related changes.Testosterone (male hormone) levels gradually decrease with age, while the concentration of female sex hormone (estrogen) is increasing on the contrary.This phenomenon is called male menopause.

The development of prostate adenoma is due to the following risk factors:

• The age of the patient - increased prostate iron is extremely rare for men under the age of forty and is diagnosed in almost every second after sixty years;
• Hereditary predisposition - if adenoma is diagnosed with a person's close blood relatives, there is a huge risk of inherit this disease in adulthood;
• Diabetes mellitus, cardiovascular disease-prostate benign tumors (adenoma) are not only the result of the disease themselves, but also the harmful effects of medicines on their treatment (such as beta-blockers);
• Poor Lifestyle - The risk of developing prostate adenoma increases in men with obesity, with insufficient physical activity.

Symptoms

Prostate adenoma is suspected when a person appears on the following symptoms that are most common for this disease:

• urinating obligations;
• appearance of the need for tension in the abdominal muscles;
• presence of pain, burning, slow urine flow;
• discomfort and inadequate emptying of the bladder;
• Increase the duration of the urination process.

The adenoma prostate not only leads to a decrease in human quality of life, but also to an acute delay in urination, which requires the use of surgical treatment methods.To avoid surgery, many patients use special drugs to treat prostate adenoma, eliminate symptoms and restore normal prostate activity.However, only one qualified specialist can recommend the best cure for prostatitis and prostate adenoma.When the first symptoms of the disease appear.

Treatment of prostate adenoma in each patient.The attending physician prescribes the treatment, dosage and duration of the prostate adenoma.It is not only ineffective but also dangerous to buy products from prostatitis and prostate adenoma.Because it is present in people of older generations of "personal" chronic diseases, medicines used to treat prostate adenoma should be chosen, taking into account the accompanying pathologies.

Stages of the development of the disease

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

• The first stage of the disease has minimal urinary disorders.Significant growth, especially at night and slow urine flow, is observed.The first phase can last from one year to 12 years.
• The second phase of the prostate adenoma is characterized by highlighted urinary disorders: the period of urine, the need for tension during urination and the feeling of incomplete bladder emptying.The residual urine in the bladder and the urinary tract causes an inflammatory procedure accompanied by pain, burning sensation during urination, lower back and pain above the pub.
• The third stage is characterized by periodic or constant involuntary urine emissions, which causes the patient to use the use of the urethra.

Complication

In some people of the Adenoma prostate, the quality of life does not deteriorate and continues without complications.However, in some cases, the disease can cause the following negative consequences:

• Acute delay in urine - it is characterized by a sudden impossibility of emptying the bladder and pain in the right -handled region.In a similar condition, the patient needs emergency medical care with catheterization or small operation;
• The incidence of urinary tract infections is the stagnation of urine, which creates favorable conditions for reproduction of pathogens, to the development of cystitis and pyelonephritis;
• Formation of stones in the bladder - also a result of urine stagnation;
• Damage to the bladder - provided by irregular emptying of the bladder, formation of protrusions (pockets) in the walls of the organ in which urine stagnates;
• Damage of kidneys - increased pressure in the urethra and bladder has a direct adverse effect on the kidneys, which results in kidney failure.

Prostate adenoma and efficiency

Prostate adenoma and efficiency are closely linked.Adenoma disrupts the structure of the glandular tissue, which in turn leads to the defeat of another, no less important organ - the testicles responsible for the products of androgens.Thus, adenoma can cause prostate impotence, which requires longer and complex therapy.

Diagnosis

A simple and effective way to create a preliminary diagnosis The patient by keeping the urination log by capturing quantitative and qualitative parameters: the amount of dedicated urine, the characteristics of the fluid consumed, compulsory calls, and night urgency.In the event of a suspicion of prostate adenoma, the main test method is the main test method in the case of a prostate suspicion to identify its growth and exclude other pathologies.

Diagnosis of adenoma prostate in the hospital is performed by the following laboratory and instrumental methods:

• General blood and urine tests;
• Biochemical blood test for markers of kidneys, urea and creatinine;
• Analysis of the dog level (to exclude prostate cancer);
• Transrectal ultrasound (ultrasound);
• Urofloometry (to determine the speed of urine flow);
• Determination of residual urine volume (ultrasound);
• Lower electromiography in the pelvis;
• Urethra;
• Empty urography.

Treatment

The aim of the treatment of prostate adenoma is to facilitate lower urinary symptoms, improve the quality of the patient and prevent the development of complications of the disease.Patients with poorly exposed symptoms who do not exacerbate quality of life often require dynamic observation tactics with regular examinations with a urologist that regulates the course of the disease and gives recommendations to stop prostate adenoma growth.During this period, attention is focused on non -drug therapy.Hertic methods can complement conservative treatment, which is to take the following drugs:

• Alpha blockers (tamsulosin, alfuzosin);
• 5-alpha reductase inhibitors (Finsteride);
• Type 5 phosphodesterrase inhibitors (sildenafil);
• Combinations of 5-alpha-reductase inhibitors and alpha blockers;
• Muscarine receptor blockers or m-choline policy.

Patients with prostate adenoma are advised to perform surgical treatment at advanced stages, which can be done in several methods: transuretral cutting, transuretral resection and removal of prostate.

There are some indications for the use of surgical treatment:

• Delay of repeated urine;
• Renal failure provoked by prostate adenoma;
• Stones in the bladder;
• Recurring urinary tract infections;
• Repetition of hematuria.

In addition, surgery is needed for patients due to the lack of drug treatment.

During the conservative therapy or postoperative period, patients need constant medical examination with standard examinations (determining urine current, ultrasound, PSA levels).

Drugs

There is a certain schema that prescribes specific drugs to treat prostatitis and prostate adenoma.The high efficiency of the treatment is achieved through the use of alpha-reductase inhibitors and alpha blockers.These drugs in men to treat prostate adenoma help to eliminate the main symptoms of the disease and to restore proper urination.

What are the most effective and widely used tablets from prostate adenoma?The list is guided by alpha1-adrenergic receptors blockers.In addition, this list contains the inhibitors of 5-alpha reductase, vitamins and minerals.

The complex of medication not only includes drugs.In the case of adenoma prostate, conservative treatment can be complemented by biologically active additives - dietary supplements that improve the therapeutic effect of drugs and provide early healing.Some of them contain the zinc.This macro element is directly involved in spermatogenesis and testosterone synthesis.Plant phytosterols normalize urine.

Treatment with Antagonists Medicines is a group of Alfa1-Adrenoceptors

These drugs for the treatment of prostatitis and prostate adenoma provide relaxation of the smooth muscles of the urine system and improve the urine process.Tamsulosin with the same name, which is part of other drugs (alfuzosin, silodinos, etc.), is a very sequential drug that has a selective effect on the prostate muscles alpha1-adrenergic receptor, the urethra and bladder prostate.Due to the decrease in muscle tone, it is facilitated by outflow and urinary emissions.Tamsulosin, like all selective drugs, has a minimal number of side effects, does not affect the sound of blood vessels and can be prescribed for patients with chronic hypertension.

Antagonists of alpha-adrenergic receptors should be continuously used to gradually reduce irritation and obstruction for prostate adenoma.Tamsulosin is a well -known priority in the treatment of prostate adenoma for urologists.

The form of tablet is considered to be more progressive because, due to the controlled release of Tamsulosin, the active substance is constantly concentrated in the body.The drug enters the bloodstream evenly, thus ensuring the likelihood of the main side effects of the Adrenaehobocators group - a sudden reduction in blood pressure.

The same effective drug with tamsulosin active ingredient.This drug is not accompanied by the following undesirable effects: orthostatic hypotension, tachicardia, growth of angina attacks in patients with coronary artery disease, so it can be prescribed for men with cardiac catology.Properly selected dosage and adherence to the use of alpha-blockers groups allows you to achieve a good therapeutic effect in almost complete lack of side effects.

Drugs of reductase of inhibitors group (blockers)

The drugs of this pharmacological group (Finsteride, Dutasteride) contribute to the relief of urine outflow and, therefore, to eliminate the main symptoms of the disease.The stable therapeutic effect occurs two to three weeks after the start of the course.All symptoms will stop completely after three months.Clinical trials show that maximum efficiency is achieved with these drugs after six months of treatment.

Finasteride and dutasteride are the specific inhibitor of type 2 5-alpha reductase (an enzyme responsible for the transformation of testosterone to dihydrotestosterone).The growth of the prostate with prostate adenoma is directly related to similar transformation of testosterone.Thanks to the 5-alpha reductase inhibitors, intra -industrial dihydrotestosterone products are blocked and blood concentrations are significantly reduced.

Finsteride and Dutasteride are used for the following purposes:

• Treatment and control of prostate hyperplasia;
• Improving urine outflow and eliminating the symptoms of prostate adenoma;
• Reducing the development of acute urinary tract retention and the need for surgical intervention.

Finasteride and Dutasteride have a pronounced antiandrogen effect, ie contributes to a decrease in male hormones in the blood.In addition, these drugs have a teratogenic effect and should be taken carefully.Modern drugs allow you to stop prostate growth and prevent the need for surgical treatment.

Malipsmodes and analgesic tablets with the worsening of the disease

With the worsening of the adenoma prostate, the main recipe for inhibition and analgesic effects is to relieve the patient's general condition and eliminate pain syndrome.The anti -inflammatory and analgesic effects are not expressed by -steroid anti -inflammatory drugs (Diclofenac, ibuprofen).They help with painful feelings during the urination process, but also with continuous pain in the groin and perineum.Due to the effect of non -steroid anti -inflammatory drugs, the inflammatory process is reduced, the swelling of the prostate gland is reduced, the body temperature is normalized and the unpleasant symptoms are eliminated.

Neopioid analgesics produced in the form of tablets or candles help stop the pain syndrome by worsening the prostate adenoma.The cheapest of these is sodium -metamizole.However, this drug is intended for simultaneous use, as it can only affect weak pain syndrome.In addition, lidocaine, benzocaine, anesthine and novocaine painkillers (ichtamol, benzocaine, tribenoside + lidocaine) are effective.

Vitamin E 400

Tocopherol or vitamin E is often part of the treatment of the prostate adenoma as an antioxidant, radioprotective agent, and indispensable in reproductive processes.Vitamin E is prescribed in the dose of 400 mg urologist for erectional disorders and spermatogenesis related to the adenoma of the prostate gland.

Treatment of such a serious chronic disease such as prostate adenoma should be prescribed and controlled.It is strictly forbidden to take certain medications independently without prior consultation with your doctor, as in this case, the medicine alone is not only ineffective but also dangerous to men's health.Only one qualified specialist can recommend which prostate adenoma tablets are most effective in each case, which can cause negative consequences.

Surgery

Hospital urologists perform classic and minimally invasive surgical interventions and use innovative methods to treat prostate adenoma.We select all patients that are better suited to him.

In the surgical treatment of prostate adenoma, the generally recognized standard is a transuretral resection of prostate.The operation is extremely effective.After the intervention, patients get rid of infraviral obstruction (reduction of the urethra) and related symptoms.The rehabilitation period is short.During or after surgery, bleeding may develop the "water intoxication" syndrome.

Alternative methods for treating prostate adenoma are the following surgical interventions:

• Stenting;
• Balloon expansion;
• Hyperthermia;
• Thermotherapy;
• Ultrasonic, laser and needle ablation;
• Interstitial coagulation.

After them, complications are less frequent, but these methods are lower than transuretral resection in terms of efficiency, both clinical and economic.

The laparoscopic removal of the prostate adenoma is used when the tumor is significantly increased and the removal of transuretral resection is problematic.This operation is more complex and is performed under anesthesia.Through a small incision, the surgeon introduces special tools into the body cavity, which performs the removal of prostate adenoma.The operation is performed according to the video cameras on the screen.The main benefits of the intervention are the minimal amount of blood loss and a low probability of complications.After surgery, the patient does not need long -term rehabilitation.

If there are signs of prostate adenoma in men, doctors use a high tech method to treat adenoma - laser -enollation.The intervention is performed with large tumors.Excess tissues are removed with a laser.The operation is performed through the urethra.The tumor is separated, divided into small parts and then appeared.The method is considered minimally invasive.It has many significant benefits: it does not violate the integrity of the cavities and does not cause unnecessary damage.

The laser evaporation consists of destroying adenoma laser evaporation.Through the urethra, the urologist introduces a special device, enters the tumor and affects it with a heavily green laser.The depth of the laser penetration and the accuracy of the hit can avoid damage to adjacent areas.The method is minimal, bloodless, fast and effective.The only disadvantage is that they are incapable of histological examination of tumor tissue.

In some situations, the treatment of prostate adenoma is an inevitable method of abdominal surgery - adenomectomy.This is done if other methods cannot help the patient.During surgery, surgeon with scalpels gives access to the prostate gland and manually removes adenoma by surgical means.As a result of the operation, significant blood loss may occur and complications may occur.After surgery, the patient needs longer rehabilitation.

Removal of prostate adenoma by care (trans temporary) adenomectomy consists of radical cutting of prostate hyperplashed tissues, through longitudinal incision of the abdominal abdominal and bladder.The surgery is performed at the advanced stage of the disease, when the tumor is large, the bladder is upset as the accumulated urine is overflowing and kidney failure develops.

The bladder is set to a preliminary sector and filled with sterile solution of furatsilin or other substance.It is then divided and taken to the special farms to which the organ wall is raised.The surgeon opens the shaped drive and performs the bladder opening.

It determines the inner end of the formed urethra around the bladder's neck and urethra holes that appear in the field of vision and retract from 0.5-1 cm.The operating urologist then penetrates the finger into the thickness of the prostate, enters the tumor capsule and adenomatous nodes, and seizes the latter.At the same time, the doctor gives the gland in the anterior part of the patient in the rectum in the first abdominal wall.It becomes more affordable than manipulation.Thanks to this technique, functioning time decreases and blood loss is reduced.

The surgeon then the hemostasis of the distant adenoma bed (stops bleeding) and sews the bladder and leaves thin drainage in the wound.It is designed to wash its cavity from the resulting blood clots.The urinary catheter introduced before the start of the operation is not removed for 7-10 days.About a new section of the urethra develops in the part of the urethra prostate.

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

• Bleeding from the tumor house;
• Stagnant pneumonia;
• The intestinal-damaged engine-e-e-emacious function of the intestine, manifested by constipation.

After surgery in the hospital to avoid complications, the patient is performed early activation.The following unwanted consequences for removal of prostate adenoma may occur:

• Insufficient drainage of the bladder;
• Narrowing of his neck;
• Urinary infiltration of nearby tissue tissue;
• The formation of the "prenatal" (the remaining cavity at the place where the adenoma has been removed);
• Narrowing of the urethra lumen;
• Urine incontinence.

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

The consequences of the operation are less highlighted when the intervention is performed with a laparoscope.A laparoscopic operation for the removal of prostate adenoma is one of the less invasive options for prostate surgical interventions.Hospital urologists use this technology if the patient has a large enough adenoma for the prostate.

If the prostate gland of the patient with adenoma does not exceed 120 cm3, it is recommended for the transuretral resection of adenoma prostate.But 10% of patients in need of surgery, this option is inadequate as iron reaches more than 120 cm3.They do not perform a laparoscopic operation to remove adenoma during uarolose hernia, the blistering diverticulum and the anchilose joints of the lower limbs.In this case, the decision on the possibility of implementing the operation is collegially made by a urologist, andrologist, abdominal surgeon and other hospital experts.