Diagnosis and treatment of prostate adenoma

The most common urological pathology, aimed at urologists, men over 45, is prostate adenoma.The presence of this pathology significantly exacerbates the quality of human life.One of the most likely consequences of the pathological process is the deterioration of benign prostate hyperplasia into malignant tumors.

To combat prostate adenoma, surgical methods and treatment drugs are used.Hospital experts choose the most effective surgical medication or method of surgery taking into account the level of disease, general condition and age of the patient, and the presence of related pathology.At the surgical clinic, a comfortable condition for the patient's treatment was made.

The cause of the development of a disease

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

Prostate adenoma in men develops due to restructuring of the body's hormones related to age -related changes.The level of testosterone (male hormones) gradually decreases with age, while female sex hormone concentration (estrogen), in turn, increases.This phenomenon is called menopause.

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

• Patient age - increased prostate iron is extremely rare in men under the age of forty, and after sixty years of diagnosis almost every second;
• Predit of heredity - if the prostate adenoma is diagnosed in a man's close blood, he is at risk of inheriting the disease in adulthood;
• Diabetes mellitus, benign cardiovascular disease (adenoma) prostate can occur as a result of the disease itself, but also the harmful effects of drugs for their treatment (for example, beta-blockers);
• The wrong way of life - the risk of developing prostate adenomas in men with obesity, inadequate physical activity.

Symptom

Prostate adenoma can be suspected when a man appears in the following symptoms most typical for the disease:

• urine tasks;
• the appearance of the need for abdominal muscle tension;
• presence of pain, burning, moist flow of urine;
• discomfort and inadequate bladder emptying;
• Increase the duration of the urinary process.

Prostate adenoma brings not only to the decrease in the quality of life of a man, but also for acute delays in the urine, which requires the use of surgical treatment methods.To prevent surgical intervention, many patients use special drugs for the treatment of prostate adenoma, eliminate symptoms and restore normal prostate activity.However, only qualified experts can recommend the best remedies for prostatitis and prostate adenoma.It needs to contact it when the first symptom of the disease appears.

Individual prostate adenoma treatment for each patient.Preparation for the treatment of prostate adenoma, dosage and duration of use is prescribed by the attending physician.Taking products from prostatitis and adenoma prostate can be free not only ineffective, but also dangerous measures.Due to the presence of men of older generations of some "personal" chronic diseases, medications for the treatment of prostate adenoma should be selected taking into account the accompanying pathology.

Stage of development of disease

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

• The first stage of the disease continues with minimal urinary tract disorders.Increased improvements, especially at night, and moisturizing urine flow, can be observed.The first stage can last from one year to 12 years or more.
• The second stage of the prostate adenoma is characterized by a more significant urinary tract: urine strain, appearance of the need to sink during urination and incomplete emptying of the bladder.Urine waste, which persists in the bladder and urinary tract, causes inflammation accompanied by pain, burning sensation during urination, lower back pain and above the pubis.
• The third stage is characterized by regular or continuous urine discharge, which forces the patient to use the ureter.

Complication

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

• Acute urine delay - it is characterized by a sudden disadvantage - Suddenly emptying the bladder and pain in the right region.In the same condition, patients need emergency medical treatment with catheterization or small operation;
• The occurrence of infection in the urinary tract is a stagnation of urine, which creates favorable conditions for pathogenic reproduction, leading to the development of cystitis and pyelonephritis;
• The formation of stones in the bladder - also as a result of urine;
• Damage to the bladder - with irregular emptying of the bladder, it is stretched, the formation of protrusions (pockets) on the wall of the organ, where the urine is stagnated;
• Damage to the kidneys - increased pressure on the ureter and bladder has a direct damage to the kidneys, resulting in kidney failure.

Prostate adenoma and potential

Prostate adenoma and interconnected potential.The adenoma disrupts the structure of the gland tissue, which in turn leads to another defeat, the organs are less important - the penis responsible for androgen products.Therefore, prostate adenoma can cause impotence that requires prolonged and complex therapy.

Diagnostics

A simple and effective way to create an early diagnosis is patients by maintaining a diary of urine by setting quantitative and qualitative parameters: dedicated urine amounts, fluid features used, important calls, night encouragement.The main method of physical examination in the case of suspicion of prostate adenoms is the prostate finger rectal examination to identify its improvement and exclude several other pathologies.

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

• General blood and urine tests;
• Biochemical blood tests for markers of kidney conditions, urea and creatinine;
• Analysis for dog level (to exclude prostate cancer);
• Ultrasound Transrectal Examination (Ultrasound);
• Urofloometry (to determine the speed of urine current);
• Determination of wastewater (using ultrasound);
• Electromilography under the pelvis;
• Urethrocystoscopy;
• Urography excretory.

Treatment

Prostate adenoma treatment aims to facilitate lower urinary tract symptoms, improve the quality of the patient and prevent the development of disease complications.Patients with less exposed symptoms that do not exacerbate the quality of life, often prescribe dynamic observation tactics with regular examinations with urologists, which control the disease and suggests on how to stop the growth of prostate adenoma.During this time, attention is focused on non -Drug therapy.Thehestic methods can be in addition to conservative treatment, which is the following medication:

• Alpha barrier (tamsulosin, alfuzosin);
• 5-alpha reductase inhibitors (finsteride);
• Type 5 inhibitors phosphodesterase (sildenafil);
• A combination of 5-alpha redukitor inhibitors and alpha barriers;
• Muscarine or m-cholinolytics receptor blockers.

Patients with prostate adenomas in advanced stages are recommended to perform surgical treatment, which can be done by several methods: transurethral isolation, transurethral resection and prostate removal.

There are certain indications for the use of surgical treatment:

• Repeated urine delay;
• Kidney failure provoked by prostate adenoma;
• Stones in the bladder;
• Recurrent urinary tract infections;
• Repeat hematuria.

In addition, surgery is required for patients without the effectiveness of drug treatment.

During the conservative therapy period or during the postoperative period, patients need continuous medical control with standard studies (determining current urine rate, ultrasound, PSA level analysis).

Drug

There are specific schemes according to certain drugs prescribed for the treatment of prostatitis and prostate adenoma.The effectiveness of high treatment is achieved thanks to the use of redukitase alpha inhibitors and alpha barriers.These drugs for the treatment of prostate adenoma in men help eliminate the main symptoms of the disease, as well as to restore urination.

What is the most effective and widely used tablet from prostate adenoma?The list is led by Alpha1-Adrenergic receptor blockers.In addition, these lists include 5-alpha reductase inhibitors, vitamins and minerals.

Drug therapy complexes include not only drugs.With prostate adenoma, conservative treatment can be supplemented by biological active additives - supplements that enhance the therapeutic effects of drugs and provide early recovery.Some of them include zinc.This macro element is directly involved in spermatogenesis and testosterone synthesis.Plant phytosterols normalize urine.

Treatment with Alpha1-Adrenoceptors Antagonist Group Drugs

These drugs for the treatment of prostatitis and prostate adenoma provide a smooth muscle of the urinary system and improve the urine process.Tamsulosin under the name of the same active ingredient, which is part of other drugs (alfuzosin, silodino, etc.), is a very sequential drug that has selective effects on alpha1-adrenergic receptors of the prostate muscle, prostatic urethra and bladder.Thanks to the decrease in muscle tone, flow and urine emission are facilitated.Tamsulosin, like all selected drugs, has little side effects, does not affect blood vessels and can be prescribed to patients with chronic hypertension.

Alpha-adrenergic receptor antagonists must be used continuously, so that you can achieve a gradual reduction in irritation and obstruction with prostate adenoma.Tamsulosin drugs in the treatment of prostate adenomas occupy good priority in the purpose of urologists.

The shape of the drug tablet is considered more progressive, due to the controlled tamsulosin release, the active ingredient is in the body in a fixed concentration.The drug enters the bloodstream evenly, thus ensuring a decrease in the possibility of developing the main side effects of the adrenehobocators group - a sharp decrease in blood pressure.

The same medicine is effective with tamsulosin Material acting is a lesson.Taking this drug is not accompanied by unwanted effects: orthostatic hypotension, tachycardia, increased angina attacks in patients with coronary heart disease, can be prescribed for men with heart pathology.The dosage selected and compliance with all the rules on the use of alpha-blockers group drugs allow you to achieve good therapeutic effects in the absence of almost complete side effects.

A group of inhibitors (blockers) reductase

Medications of these pharmacological groups (Finsteride, Dutasteride) contribute to reducing urine flow, and, therefore, the elimination of the main symptoms of the disease.The stable therapeutic effect occurs two to three weeks after the start of the course.All symptoms are completely stopped after three months.According to clinical studies, maximum efficiency is achieved after six months of therapy with these drugs.

Finasteride and Dutasteride are the 2nd Specific Inhibitors of 5-Alpha Reductase (the cell enzyme responsible for the transformation of testosterone to dihydrotestosterone).Prostate growth with prostate adenoma is directly related to the same testosterone transformation.Thanks to the 5-alpha redukitor inhibitor, the intra-industrial dihydrotestosterone product is blocked and its concentration in the blood is significantly reduced.

Finsteride and Dutasteride are used for the following purposes:

• Treatment and control of prostate hyperplasia;
• Increase urine flow and eliminate symptoms of prostate adenoma;
• Reduces the risk of developing acute urinary retention and the need for surgical intervention.

Finasteride and dutasteride have a clear antiandrogenic effect, which contributes to the decrease in male hormone levels in the blood.In addition, these medicines have a teratogenic effect, so they need to be taken carefully.With the help of modern medicine, you can stop prostate growth and prevent the need for surgical treatment.

Antispasmodic and analgesic tablets with increased disease

The main prescription of antispasmodic and analgesic effects with the severity of prostate adenoma is to relieve the general condition of the patient and eliminate the pain syndrome.Anti -anti -anti -analgesic effects are applied by anti -non -—steroid (Diclofenac, Ibuprofen) drugs.They help to fight not only with the painful sensations that occur in the urinary process, but also with persistent pain in the thighs and perineum.Due to the action of the anti -anti -inflammatory drug, the process of inflammation decreases, the swelling of the prostate gland decreases, the body temperature is normalized, and unpleasant symptoms are eliminated.

Neopioid analgesics produced in the form of tablets or candles help stop the pain syndrome with the severity of the prostate adenoma.The most affordable is Metamizole sodium.However, this drug is more intended for one -time use, as it can only affect poor pain syndrome.In addition, analgesics with lidocaine, benzocaine, anesthesin and novocaine (ichtammol, benzocaine, tribenoside + lidocaine) are effective.

Vitamin E 400

Tocopherol acetate or vitamin E is often part of the complex treatment of prostate adenoma as an antioxidant, radioprotective and much needed link in the reproductive process.Vitamin E in 400 mg of urology is prescribed to patients with disruption of erection and spermatogenesis associated with prostate gland adenoma.

Treatment of serious chronic diseases such as prostate adenoma should be prescribed and controlled by urologists.It is strictly prohibited from taking certain medications independently, without early consultation with the attending physician, as the medication in this case is not only ineffective, but also dangerous to men's health.Only qualified specialists can recommend tablets from the most effective prostate adenomas in each case, and which they can cause negative consequences.

Operation

Hospital urologists by mastering classical and minimally invasive surgical interventions, using the innovative method of prostate adenoma surgery.Each patient is selected that the operation is more appropriate.

The most commonly recognized standard in the treatment of prostate adenoma surgery is the prostate transurethral resection.This operation is very effective.After intervention, the patient removes infrarvyzical obstruction (narrowing the urethra) and related symptoms.The recovery period is short.During or after surgery, bleeding can develop, "water intoxication" syndrome.

Alternative methods for treating prostate adenomas include the following surgical interventions:

• Stenting;
• Balloon dilatation;
• Hyperthermia;
• Thermotherapy;
• Ultrasonic, laser and needle ablation;
• Interstitial freezing.

After them, complications arise less frequently, but this method is lower than the transurethral resection in terms of effectiveness, both in clinical and economic.

The removal of laparoscopy prostate adenoma is used when the tumor has developed significantly, and it has a problem to eliminate it using transurethral resection.This operation is more complicated, carried out under anesthesia.Through a small incision, the surgeon introduces a special device into the body cavity, which performs the removal of the prostate adenoma.The operation is carried out according to the image from the video camera, which is displayed on the screen.The main advantage of intervention is the minimum amount of blood loss, a small probability of complications.After surgery, the patient does not need long recovery.

When there are signs of prostate adenoma in men, doctors use high technology methods to treat adenomas - laser enucleases.Interventions are done in large sizes of neoplasms.Excess fabric is removed using a laser.This operation is performed through the urethra.The tumor is separated, divided into small portions, and then displayed.This method is considered slightly invasive.It has several significant advantages: it does not violate the integrity of the cavity, does not cause unnecessary damage.

Laser vaporization consists of destroying adenoma by laser evaporation.Through the urethra, the urologist introduces a special device, brought to the neoplasm and affects the strong green laser.The depth of laser penetration and the accuracy of the hit can prevent damage to the neighboring area.This method is minimal, not bleeding, fast and effective.The only weakness is the inability to take tumor tissue for histological examination.

In some cases, the inevitable method for treating prostate adenomas is stomach surgery - adenomectomy.It is done in cases where other methods cannot help the patient.During surgery, surgeons with a knife carry access to the prostate gland and manually, using surgical instruments, eliminating adenomas.As a result of surgical, significant blood loss may occur, complications develop.After surgery, the patient needs prolonged recovery.

The removal of prostate adenoma with Transluccal (Transluccal) adenomectomy consists of radical isolation of tissue -tisis hyperplashed prostate through the longitudinal slices of anterior abdominal wall and bladder.The surgery is carried out at the advanced stage of the disease, when the tumor reaches a large size, the bladder is reverse due to the overflow of the urine, and the failure of the kidney develops.

The bladder is pre -installed and filled with fursilin sterile solution or other material.Then it is allocated and taken in two places for special holdings, where they raise the wall of the organ.The surgeon disseminates the folds formed and performs the opening of the bladder.

By the end of the urinary tract, it determines the bladder area and around the urethra hole that appears in the field of view, backing 0.5-1 cm from it, making the mucous membranes of the mucous membrane.Subsequently, the operating urologist penetrated the finger into the prostate thickness, entering it between the tumor capsule and the adenomatous node, and he was the last.At the same time, the doctor gives the gland ahead of the patient in the rectum in the rectum on the front abdominal wall.It becomes cheaper for manipulation.Thanks to this technique, the operation time is reduced and blood loss is reduced.

Then the surgeon performs hemostasis (stopping bleeding) from the remote adenoma bed and bladder stitches, leaving thin drainage in the wound.It is designed to wash the cavity from the resulting blood clots.The urinary catheter, introduced before the start of the operation, is not taken for 7-10 days.Around it, the new section of the urethra is formed rather than that surrounded by the prostate part of the urethra.

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

• Bleeding from neoplasmic cottages;
• Stagnan pneumonia;
• The function of the motorcycle assessment is affected by the intestine, which is indicated by constipation.

To prevent complications, after surgery in the hospital, the patient is performed early activation.The following unwanted operations to eliminate prostate adenomas may occur:

• Insufficient drainage of the bladder;
• Narrowing his neck;
• Infiltration of urine near -pussy;
• "Prenatal" formation (residual cavity where prostate adenoma is removed);
• The formation of narrowing of the urethra lumen;
• Incontinence urine.

This negatively affects the quality of life of the patient and prolongs adequate urination recovery.

The result of the operation is less clear when intervention is performed using laparoscopy.Laparoscopic operation to eliminate prostate adenoma is one of the less invasive options for surgical intervention in the prostate gland.Hospital urologists use this technique if the patient has a large adenoma of the prostate.

If the prostate gland of the patient with adenoma does not exceed 120 cm3, it is recommended for transurethral resection of prostate adenoma.But 10% of patients in need of surgery, this option is not appropriate, as iron reaches more than 120 cm3.Laparoscopic operation to eliminate prostate adenoma during utarolitiasis, inguinal hernia, bladder diverticulum, and ankylose joints from the lower leg is not performed.In this case, the decision on the possibility of conducting operations was collected by urologists, andrologists, abdominal surgeons and other hospital experts.