Prostate adenoma — a benign tumor that develops from the stroma or the glandular epithelium of the prostate. By itself, the adenoma does not spread, but may over time degenerate into adenocarcinoma (prostate cancer).
In 30-40% of men older than 50 years and 75-90 %, over 65 years there is a change in the form of a proliferation of the glandular tissue in the neck of the bladder.
What is this disease, why it occurs in men after 40 years, what are the first symptoms that is prescribed as a treatment, will be discussed further.
What is BPH?
BPH is a benign neoplasm of paraurethral glands located around the urethra. The main symptom of BPH - a violation of urination due to the gradual compression of the urethra by one or multiple growing nodules.
If an adenoma is an increase in the body, which provokes a squeezing of the bladder and urethra. This violates the current urin and leads to the accumulation of residual urine. Additionally, men can develop a urinary tract infection, kidney stones, and cancer. The increase is painless, it's dangerous for rapid diagnosis of the disease.
Prostate gland: what is it?
The prostate, also known as the prostate is an organ located just below the bladder. The main purpose of the prostate – specific secret generation, which is part of semen. The secret of a prostate, determining the consistency of ejaculate (in particular, contributing to its dilution), contains vitamins, enzymes, immunoglobulin, zinc ions etc.
The main functions of the prostate include:
- thinning of semen, allowing sperm become active mobility and generally become a viable;
- the development of the secret lies in its composition, it has enzymes, proteins, fats and hormones, without which sexual system will not function normally;
- the emission of the seed the smooth muscle of the prostate gland is able to shrink, which ensures the supply of semen to the urethra, and in this way and happens ejaculation.
BPH develops and grows gradually. Although the disease occurs mainly among older males, the initial symptoms can be found in 30-40 years. Interestingly, the first nodules of cells are formed EN masse and only after a long time begin to grow in size.
Causes of development:
- The first group includes causes due to lifestyle that increase the possibility of spread of the prostate. For example, it can be a sedentary job or an active mental stress in the absence of physical. That is why the role of regular exercise cannot be overemphasized.
- The second group consists of objective reasons which do not depend on a person's lifestyle. It is proved that BPH occurs due to changes in hormonal men. If we consider that these changes inevitably occur in the elderly, it can be concluded that only some men are so fortunate as to avoid problems with the prostate gland.
There are a number of factors that can contribute to the development of the adenoma. These include:
- Weight (accumulation of adipose tissue promotes the production of female hormones);
- Hereditary factor;
- The abuse of Smoking and alcohol;
- Inflammatory processes in the kidney and urethra;
- Physical inactivity and poor diet;
- High blood pressure.
Kinds of benign prostatic hyperplasia
Structure and layout there are three types of adenomas:
- The tumor through the urethra penetrates the bladder, deforming the internal sphincter and disrupting its function.
- The tumor grows in the direction of the rectum, urination is disturbed slightly, but the loss of contractility of the prostatic urethra does not allow to fully empty the bladder.
- The uniform seal pressure prostate adenoma without its increase is not observed no urinary retention in the bladder or voiding. This is the most favorable view of the adenoma.
The symptoms of BPH in men
There are two groups of symptoms of BPH: obstructive and irritatio.
The first group of symptoms of BPH include:
- frequent urination,
- persistent (imperative) urge to urinate,
In the group of obstructive symptoms characteristic of BPH include:
- difficulty urinating,
- a delay at the beginning and increase the time of urination,
- a feeling of incomplete emptying,
- intermittent urination sluggish stream.
The first signs you should pay attention:
- The first signs of adenoma of the prostate, weak urine flow, frequent urination, which do not always result in emptying of the bladder.
- As the tumor acquires serious dimensions, the patient has no desire to find out what causes BPH, more worried about how to get rid of anxiety symptoms. Urination becomes difficult, you need to strain to urinate, to connect the abdominal muscles.
A complication of the prostate and its transition in the severe stage, all the symptoms will increase, which will adversely affect the patient's life. In complex cases, can help only operation that is why it is so important to pay attention to the symptoms. Even if they repeated 1-2 times, required to undergo a full inspection.
The most characteristic changes urination this stage:
- more frequent
- less free
- not the same intensity as before (stream of urine already is not a characteristic of a parabola, and falls almost vertically).
With the further growth of the prostate and the gain compression of the urethra appear the following symptoms:
- increased frequency of urination day
- the funding decreases urine volume
- an increase in cases of uncontrollable desire to urinate (so-called mandatory sneeze),
- participation of auxiliary muscles.
Subcompensated – enlarged prostate reached the levels when it began to affect the urinary bladder to withdraw urine from the body. Violations occur:
- the liberation of the bladder occurs portions,
- bladder wall increased in thickness,
- there is a delay part of the urine,
- when full, the bladder may occur involuntary release of urine,
- urine may be cloudy and contain blood.
Stage 3 BPH - decompensated
There is a drop of contractile ability of the bladder to the minimum limits, the increase of residual urine can be around two liters. Also important sudden stretching of the bladder, in which its outlines in the form of oval or spherical in shape, reaching to the navel, and in some cases rising much higher.
Meanwhile, at night, and later in the day, the urine is regularly or constantly stands out, it happens in an involuntary way, for drops of full bladder.
Associated symptoms of adenoma:
- nausea and lack of appetite,
- thirst and dry mouth.
Implications for men
Complications of BPH:
- Acute retention of urine. A complication appears in 2 or 3 stages of the disease due to compression of the urethra hypertrophied prostate gland.
- Inflammation of the urinary tract. Stagnant processes in the bladder lead to the growth of bacteria. They provoke the development of cystitis, urethritis, pyelonephritis.
- Urolithiasis. Incomplete emptying of the bladder leads to the appearance in it of microliths, stone, or mineral deposits. They can cause blockage of the bladder, urinary retention.
- Hematuria. The appearance in the urine of erythrocytes, the cause of which becomes varicose veins of the bladder neck.
It is no exaggeration if we say that the successful diagnosis of BPH is directly dependent on the patient. At the earliest stages namely poll can give you those indicators for which a specialist will be able to suspect the presence of disease.
Diagnostics consists of:
- The doctor performs a digital examination of the prostate.
- In order to assess the severity of symptoms of BPH, the patient is requested to complete a diary of urination.
- Perform a study of prostate secretion and smears from the urethra to rule out infectious complications.
- Conduct ultrasound of prostate, during which determine the volume of the prostate, identify rocks and areas with stagnant, estimate the amount of residual urine, of the kidneys and urinary tract.
Analysis of PSA with prostate adenoma – an important indicator in determining the degree of the disease and the treatment. Such a study is recommended to place every man older than 40 years, every year as it detects any deviations in simplicity and will help determine even cancer of the prostate.
Each gram of benign adenoma of the prostate raises the PSA level of 0.3 ng/l, and each gram of malignant tumor – 3, 5 ng/ml In the adenoma of the prostate level of prostate specific antigen almost never rises above 10 ng/ml. If this occurs, there is a suspicion of cancer.
Treatment of BPH
The standard treatment of BPH in men may be medicated efficiently and less invasive. The basic technique – a surgical procedure that is assigned to all patients with infravesical obstruction.
Treatment of BPH depending on the stage:
- The first stage can often manage the conservative treatment, which, however, does not exclude manifestations of acute and frequent of urinary retention, increased frequency of urination (up to 10 times), the formation of bleeding in the stagnant veins of the bladder or the emergence of large stones in it. This, in turn, leads to involuntary measures in the form of surgical intervention, even in the absence of residual urine.
- The second stage. The gold standard of assistance at this stage — removal of the adenoma with surgery using different minimally invasive and classic techniques.
- The third stage. Here the main task is to ensure good drainage of urine to remove toxicity. In this case, use percutaneous nephrostomy, cystostomy and etc. Next, normalize the condition of the liver, kidneys, cardiovascular system, and then decide on the possible further surgical treatment.
Medications while eliminating symptoms and manifestations of the disease refers to the gentle methods of therapy which make it possible to avoid surgery. How effective of a medicine depends on the severity of the adenoma.
- Alpha-blockers relax the muscles of the bladder and prostate, normalizes the process of urination.
- Inhibitors of 5-alpha reductase is needed to reduce the amount of glandular tissue tumors of the prostate, to monitor and adjust hormonal background.
- Antibiotics are necessary to reduce the activity of pathogenic flora, if the cause of adenomas is an infection and its rapid reproduction.
- Anti-inflammatory drugs men needed for the rapid elimination of inflammation of the prostate gland, reduce acute pain in the prostate adenoma.
- Antispasmodics man necessary, if the pain even after following a strict diet is not retreats, not weakened.
Surgical measures are applied with the ineffectiveness of conservative therapy, or when the extent of the disease. At an adenoma of a prostate operation is assigned with absolute indications:
- The inability to urinate;
- Massive hematuria;
- The stones in the bladder;
- Pathological processes in the prostate gland;
- The increase in the average share of the prostate;
- Kidney failure;
- A large number of residual urine.
Unscheduled (urgent) surgery is performed within days after the establishment of the development of complications: if severe bleeding that threatens the patient's life, and urinary retention in the acute form.
Identify different methods of surgical treatment of prostatic adenoma:
- Transurethral resection or TUR is a widespread method, since this operation is carried out through the urethra without cuts. However, it can only be applied when the weight of the adenoma up to 60 g and 150 mg of residual urine in the bladder. Also, this method may not use in renal failure patients.
- Adenomectomy (open prostatectomy) is a popular method of surgical treatment of benign prostatic hyperplasia because of the least number of contraindications. It is best to use with the weight of the prostate is over 40 g and the amount of residual urine 150 ml do Not interfere with the operation and various complications of the disease.
Diet with adenoma
The power mode is selected for each patient individually, taking into account the degree of neglect of the disease, General condition of the patient and his medical history, as well as gustatory propensities of the patient. But, as practice shows, without the regime change and the balance of power is not enough.
Special attention is given to foods rich in selenium (Se) and zinc (Zn), which have a positive effect on the tumor, reducing its size. During the disease the man needs to during the day 25 mg of zinc, and at least 5 mcg of selenium.
BPH is a serious disease that requires timely treatment, but only under the supervision of a specialist. No self-medication is not allowed here. Thank You and take care of your health!