Prostate adenoma. Treatment of large adenomas. Symptoms of prostate adenoma

Instruction

Don't delay your visit to the doctor. The more you put off going to the hospital, the further the adenoma develops. The disease is successful at an early stage and only by taking pills. In the later stages, surgery is required.

Limit your intake of spicy foods. Spices cause swelling of the prostate gland and make it difficult to urinate.

Do not overheat, do not visit, for example, baths or saunas. Heat causes a rush of blood to the pelvic organs, which increases the formation of urine. The more urine is produced, the more often you feel the urge to urinate.

Take your medications prescribed by your urologist regularly. They will help slow down the process and improve your condition. With irregular medication, the adenoma increases in size, and it will be impossible to cure it.

If you do not want to be operated on, and the drugs are no longer effective, remove prostate adenoma using modern methods with minimal intervention in the body. These include the removal of an adenoma by radio waves, a laser, and exposure to high temperatures. There are no incisions on the skin, because. instruments are inserted through the urethra.

After prescribing medications by a doctor, removing an adenoma, regularly undergo preventive examinations, donate blood to detect changes in the prostate.

note

In the case when a benign prostatic hyperplasia begins in a man, prostate adenoma begins to form, and gene predisposition plays an important role in this process. How to cure prostate adenoma with a surgical method is known to surgeons and they carry out such treatment with the help of transurethral incision of the prostate and this makes it possible to reduce pressure on the urethra.

Useful advice

It is possible to cure prostate adenoma! Adenoma, or benign prostatic hyperplasia (BPH), develops in men in advanced or old age due to the onset of menopause, changes in hormonal levels. It is characterized by frequent urination, weakening of erection, pain in the perineum. The tumor is determined by palpation and ultrasound of the prostate. For the treatment of the disease, traditional medicine offers many effective recipes.

Related article

Sources:

• how to cure prostate

Adenoma is a benign tumor that can appear in any organ containing glandular tissue. This is mostly due to hormonal changes. Adenomas are found on the salivary, thyroid, and mammary glands, as well as on the prostate, bronchi, and mucous membrane of the gastrointestinal tract. Most often, physicians have to deal with similar tumors of the prostate, thyroid gland and breast.

Instruction

Adenoma manifests itself in different ways, depending on its location. In the initial stage, it is almost impossible to recognize it, because. It does not cause any discomfort or pain. It can be detected already when it grows to a certain size and begins to compress nerves, blood vessels, some neighboring organs, etc.

Prostate adenoma usually appears over the age of 50. If you suspect its development, pay attention to the following signs:

1. More frequent nighttime urination.
2. Frequent urge to urinate during the day (more than 5-7 times), but the process itself is difficult.
3. Weak, sluggish stream during urination, sometimes taking on a different shape and direction.
4. Feeling that the bladder is not emptying completely.
5. Violation of sexual function.
6. Absence of pain in the initial period (they are - inflammation of the prostate gland).
7. In a later stage - urinary incontinence or her.

A urologist can recognize an adenoma when examining the prostate gland through the rectum or after an ultrasound examination, as a result of which the size and shape of the nodes are determined, as well as the severity of this disease.

Thyroid adenoma most often appears over the age of 55 years. You can recognize this disease by the following symptoms:

1. A person experiences a feeling of squeezing in the neck, it is difficult for him to swallow, shortness of breath is felt.
2. With the help of your fingers, you can find in the neck area either a dense or soft, elastic and mobile body that is not connected with the surrounding tissues.

Since such an adenoma is difficult from other diseases of the thyroid gland, doctors use a hardware examination to diagnose it - scanning, echothyroidography, x-rays, biopsy, etc.

Breast adenoma is a disease that occurs most often in young people aged 15 to 30 years, and especially in. It is almost non-existent in older women. You can detect it yourself when examining the chest and probing it. This formation is smooth, round, soft, to the touch something similar to rubber.

To make an accurate diagnosis, doctors most often use ultrasound. On the images obtained with its help, adenoma as a dark round or oval spot. If after the ultrasound there are doubts about the nature of this spot, then the patient is sent a magnetic resonance tomogram or a biopsy to examine it under a microscope.

Related videos

Advice 3: How to treat prostatitis with traditional medicine

The main cause of prostatitis is a combination of infectious diseases, age-related changes in the prostate gland and an unhealthy lifestyle. According to statistics, most men over the age of 45 experience prostatitis. Traditional medicine offers a number of recipes to combat this disease.

You will need

• - establishment of a healthy lifestyle;
• - recipes of traditional medicine.

Instruction

Prepare juice from asparagus, cucumbers, beets and carrots. Half of the total volume should be asparagus juice, the remaining 50% in equal shares fall on the rest of the ingredients. The resulting juice should be taken in the treatment of chronic prostatitis, a quarter cup three times a day before meals. Treatment to continue alone. Then you should take a two-week break and, if necessary, repeat the course.

For the treatment of chronic prostatitis, prepare the following composition: grate 300 g of onion, add 100 g of honey and 0.5 liters of wine. The resulting composition must be kept in a dark, cool place for about a week, then strain. Take 2-3 tablespoons before meals.

Prostate adenoma is one of the most common diseases in men over the age of 50 years. According to statistics, every second man older than this age has symptoms of this disease, while there are studies that confirm that adenoma can develop in 85% of men.

Symptoms of the disease

Adenoma is a complex disease that is a benign tumor resulting from an increase in tissue volume and hypertrophy in the prostate. The organ itself produces a secretory fluid that supports and develops their resistance to adverse conditions. During adenoma, the prostate puts pressure on the urinary canal, which leads to stagnation of urine and the appearance of urolithiasis, pyelonephritis, prostatitis, etc.

If you notice any of the symptoms, you should see a doctor as soon as possible. This will help stop the progression of the disease.

To date, this disease has not been sufficiently studied, however, among the factors influencing the appearance of the problem, there are hormonal disorders that can be caused by lifestyle, amount of stress and environmental factors. Doctors classify the disease as an age-related disease and associate it with a change in the production of testosterone levels by the body.

During the duration of urination increases and it becomes necessary to strain the abdominal press to empty the bladder. In the later stages, there is a need for several times, incontinence, constant leakage, painful sensations during ejaculation.

With adenoma, a special diet is often prescribed, which helps to speed up recovery.

Therapy and treatment

To confirm the diagnosis, many doctors rely on the examination of the patient. A digital rectal examination, prostate ultrasound, uroflowmetry, cystography, cystoscopy, urinalysis and blood tests are often prescribed to exclude prostate cancer from the list of possible diseases. In some cases, a biopsy is done.

In the treatment, additional methods are often used: prostate massage and the use of special candles.

After confirming the diagnosis is assigned. In the early stages of the disease, special medications are used, which are prescribed individually based on the results of all examinations. In more serious cases of adenoma, surgical treatment is prescribed to reduce the size of the gland and restore its function. There are 3 types of treatment for the disease: prostatectomy, transurethral resection and vaporization of the prostate, which are selected by the attending physician after medical research.

Related videos

Advice 5: How to cure BPH at home

Prostate adenoma is a common disease in men over 50 years of age. As a rule, pathological changes in the gland occur at this age. Their benign nature, diagnosed at an early stage, allows the use of treatment at home.

Instruction

Despite the fact that the symptoms of prostate adenoma have characteristic features, even doctors can find it difficult to make an accurate diagnosis. Therefore, before treatment, be sure to undergo a comprehensive examination. It will help to identify not only the presence of prostatitis, but also the stage of its development. The main symptoms of this disease include a decrease in potency, difficulty urinating, pain during intercourse, a significant weakening of the flow of urine produced.

There is no exact way of prostate adenoma in. There are several methods that help eliminate symptoms or manage prostatitis at a very early stage. Otherwise, the methods described below are aimed at keeping the prostate gland in proper shape for proper treatment in the hospital. They help reduce swelling of the tissues that make up

The method for treatment depends on various factors, in each case. The choice will depend on the size of the benign tumor, as well as the patient's age and general health. For example, for the treatment of adenoma without surgery at the age of 45, drugs and remedies can be used that will not work for a similar problem at 70 or simply will be ineffective. The older the patient, the more often treatment is used without surgery, with the use of medications. If the patient is younger, a minimally invasive treatment may be used.

It is necessary to carefully approach the method of treatment during the treatment of prostate adenoma, and additionally discuss with the urologist all possible methods. For example, the beginning may be the use of medications, and if there are no results from pills or injections, then a minimally invasive course should already be taken.

If complications or severe symptoms of adenoma occur, it is better to omit the use of medications. The minimally invasive method differs significantly from the surgical method, since the patient will have a minimum period for recovery and complete recovery. However, there is a high risk that the adenoma will occur in the future and the procedure will need to be repeated. Sometimes there may be a side effect in the form of problems with erection, urinary incontinence.

Only a specialist can say for sure whether the patient can be cured by conservative methods or surgical intervention is required.

Observations as Therapy

This method of treating adenoma may be suitable if the general symptoms do not greatly disturb the patient, and also do not cause any complications. The doctor will need to be consulted and examined annually, if complications or deterioration begin, then the visit becomes more frequent.

It will be possible to reduce prostate adenoma without surgery if you completely abandon alcohol and coffee consumption, reduce the amount of water you drink before bed. It is necessary to be careful during colds and taking medicines for illnesses that contain decongestants.

Drug treatment

During the use of medications as a treatment, two types of drugs can be used:

• Alpha blockers - relax the muscles, resulting in a reduction in the severity of symptoms.
• 5-alpha reductase inhibitors - lead to a decrease in the diseased gland, and also stop its further development in growth.

Alpha blockers work quite quickly, which means that the patient can feel relief during the first two days. It is very effective to use this remedy if the tumor is normal, medium in size, or only slightly enlarged. Such agents do not affect the size of a benign tumor itself. There are also side effects, which include a runny nose, headache and dizziness.

When using inhibitors, the patient will experience a decrease in the hormone dihydrotestosterone, which is responsible for the growth of the prostate. Such substances act not very quickly. Urine outflow improvement will only improve for 3 months. Side effects include a decrease in sexual desire, erection problems may occur, and the amount of sperm released will be reduced.

If the patient has a large prostate, then it is possible to use combination therapy. In such a case side effects will be taken from both remedies.

Minimally invasive way

This procedure for prostate adenoma reduces parts of the damaged organ. For this, various thermal energies are used, which can only be used in hospitals and clinics.

Adenoma reduction may be carried out using laser therapy. The essence of this treatment is that the patient is introduced into the urethra a small tube with a laser. After that, the energy is activated and the tissues that affect the urethra are removed. As a result of this method, the prostate becomes smaller. This method is carried out exclusively under anesthesia, and the recovery period is quite short.

The method of transurethral microwave thermotherapy is also used. This technology is used if the disease is with mild or moderate symptoms. The method reduces the frequency of urine outflow, but does not affect the difficulty of emptying the bladder itself. The treatment is carried out by adjusting the microwaves on the computer, heat comes out of them directly to the affected areas of the gland. The walls of the urethra during such an operation are protected by a cooling system.

Thermotherapy is carried out only in medical institutions, and the patient during its treatment of adenoma is under anesthesia. Side effects include possible pain attacks during the outflow of urine, which lasts for several weeks. It is possible to reduce the amount of sperm.

Folk methods

Treatment of prostate adenoma by non-traditional methods can be carried out only with the permission of the doctor. If this treatment is not controlled, then all methods may be ineffective or lead to deterioration. Among the effective recipes for the treatment of adenoma are the following:

• Consumption of fresh juices, especially beet, cucumber or carrot. Such a product allows several times to speed up recovery. The patient will need to drink about 0.5 liters of juice per day.
• Pumpkin seeds contain a lot of zinc, which is necessary for any man. To obtain a daily dose, you need to eat 30 grams of seeds in a fried form.
• Chestnut peel will also help cure prostate adenoma without surgery. To prepare an effective medicine, you will need to collect chestnuts in the fall, peel them, and then grind them into powder. Received 3 tbsp. powder, pour boiling water and leave to infuse for a day. Next, you need to evaporate the medicine in a water bath and drink 3 drops daily.
• Propolis is a very strong active substance in adenoma and can show incredible results. It is allowed to use the remedy for prostatitis, which occurs in a chronic form. You can get an extract if you evaporate 50 mg of propolis with 100 ml of alcohol. Further, at 0.2 gr. the resulting substance is added 4 gr. cocoa butter. A candle is made from the ingredients, which is injected into the rectum at night.
• Elderberry juice will need to drink at least 1 tbsp. per day. An hour before taking such a medicine, 200 ml of water is drunk. If the patient's temperature then rises, then the recovery mechanism is running.
• With adenoma, you need to eat as much fresh onion as possible. This plant has the strongest effective properties for the prevention of pathology.
• Perfectly helps to cope with adenoma ordinary celandine, in the form of infusion. To create an active substance, 1 tbsp is enough. crushed dry plant pour 200 ml of boiling water. After a couple of hours, you will need to strain the liquid through cheesecloth and drink 1 tbsp. 3 times a day, 30 minutes before meals. The course of treatment is 1 month.
• Treatment without surgery is allowed using microclysters, which will be based on water and fir. For an enema, 50 ml of fir water should be heated to 40 degrees, and then injected into the rectum. The main thing is to empty it before starting therapy. The procedure must be repeated every day for 1.5 months. Additionally, fir oil is rubbed into the perineum.

Many urologists recommend doing simple physical activity as a prevention of adenoma. This exercise can speed up recovery. Every morning, immediately after sleep, you need to massage the perineum to eliminate the stagnation of the gland. After that, the patient stands up to his full height, bends his legs slightly and makes circular movements with his knees. Movement must alternate. Such charging is carried out for 10 minutes, and in the evening you can conduct a second session.

Possible drugs

There are different drugs for the treatment of prostate adenoma without surgery. Commonly used types include:

• Candles, which are more effective in adenoma, unlike tablets. To get the result, the candles will need to dissolve, then the active ingredients will penetrate directly to the affected gland. The candles contain cocoa butter and antispasmodics. They can be made independently, according to the described recipe, or bought at a pharmacy. In any case, the effectiveness of the treatment of adenoma is to eliminate the growth of pathology, relieve inflammation, and remove intermittent urination.
• Androgenic drugs are excellent help in the early stages of the development of prostate adenoma. Specific medications can only be prescribed by a doctor. It is worth noting that an overdose leads to complications. The course of treatment is not more than 30 days, but if necessary, the treatment is repeated.
• "Progesterone". This substance is included in the group of antiadrogens, but unlike them, it directly affects the development of a benign tumor. With favorable treatment, potency may decrease. The product is sold in ampoules, and the analogue of the product is Phonophoresis. The substance is administered weekly, in a course of 3 months.
• Diuretics are often used as an adenoma therapy without surgery. Such substances are prescribed so that the patient can empty the bladder without pain syndromes. Means can only reduce the symptoms, but it is not suitable for the entire course of treatment of adenoma. Often, diuretics are prescribed by urologists so that the patient receives an anti-inflammatory effect.

Alternative Views

Since it is rather difficult and not always effective to treat prostate adenoma without surgery, scientists and doctors are conducting research for new types of adenoma therapy. The main task is to improve the lives of patients, as well as reduce side effects.

Such an alternative as water induction for adenoma has proven itself well. During treatment, under the influence of heated water and air, excess tissues begin to break down. The procedure is done by patients under local anesthesia, and the result will appear only after 3-4 months.

Among the alternative types for the treatment of prostate adenoma, beta-cytosterol is used. But to date, there is still no reliable information that confirms the effectiveness of this type.

Choice of method

Before deciding how to cure an adenoma, it is necessary to think through everything well and put on the scales all the possible risks, advantages and disadvantages of a particular type of treatment. It is recommended that you answer a few questions yourself:

• How much does the quality of life suffer from an adenoma?
• Will it be possible to achieve results from the chosen type of treatment and how long will the effect be?
• Are complications possible?

If you do not want to be exposed to the side effects of drugs, then you can use observation as a treatment for adenoma. But it will be necessary to take into account that improvements in this case are possible only in 30-50% of patients.

The use of drugs is possible if the symptoms are moderate, but bring some inconvenience and discomfort. In addition, drugs are used when the observation has already been carried out, but the pathology has remained.

Many people know that adenoma can appear with age and will be difficult to get rid of, so they try to take preventive measures. In practice, there are no effective preventive measures for pathology. In old age, it is recommended to review your diet and eat right. Do not eat spicy, smoked or spicy foods. It is better to give up alcohol and smoking, play sports and normalize the water regime, then treatment may not be required.

Found an error? Select it and press Ctrl + Enter

Problems of the sexual sphere affect both the somatic health of a person and his psychological state. Actual disease for men is prostate adenoma. It is this pathology that occurs most often in men in old age, but, according to recent studies, adenoma is getting younger and significantly affects the sexual function of the stronger sex. How to treat prostate adenoma, whether there are conservative methods of therapy and what are the results of surgical treatment - these are the questions that concern patients with such a diagnosis.

Medical treatment

It is possible to cure prostate adenoma without surgery only if the patient does not have a risk of progression of the pathology. In this case, surgery is indicated. To determine the possibility of drug therapy, doctors rely on the following research data:

• determination of the residual volume of urine;
• urine stream speed;
• severity of pathological symptoms;
• data on the volume of benign prostatic hyperplasia (BPH) according to the results of ultrasound examination of the organ;
• the level of prostate specific antigen.

If these indicators are stable and allow us to talk about the relief of the process, then conservative treatment of the pathology can be carried out. First of all, drug treatment fights the manifestations of BPH - problems with urination. At the initial stage of the pathology, only the bladder suffers, since unextracted urine remains in the organ and threatens it with the development of cystitis. For each individual patient, their medications are selected.

The objectives of conservative treatment of prostate adenoma are as follows:

• eliminate the severity of pathological symptoms;
• improve the quality of life of a man;
• prevent further progression of the pathology;
• reduce the risk of acute urinary retention, promote the establishment of the most complete emptying of the bladder.

In the complex, the tasks performed can completely save the patient from the need for surgical intervention. With proper therapy, it is possible to restrain the progression of the pathology with medication and postpone the operation for many years.

Pathological processes in prostate adenoma are accompanied by increased activity of nerve fibers. They increase the tone of the smooth muscles of the prostate. If you take alpha-blockers, then these drugs have a beneficial effect on the muscle fibers of both the gland itself and the bladder. When the gland is relaxed, the process of urination occurs unhindered, especially in the part where there is an effect of the prostate on the urethra.

Drugs for the treatment of BPH can achieve results in a few weeks

When taking alpha-blockers, improvements can be seen as early as two weeks after the start of treatment, and in some cases, positive changes occur by the end of the first month of therapy. Drugs in this group are usually well tolerated by patients, but some men experience such a side effect as lowering blood pressure, headaches, dizziness, and retrograde ejaculation occurs due to muscle tone.

For the treatment of prostate adenoma, patients are prescribed the following drugs:

• doxazosin,
• Alfuzosin,
• Terazosin
• Silodosin,
• Tamsulosin.

These drugs are used all over the world, and specialists from various clinics note the high effectiveness of drugs. The choice of a specific drug from the list presented is carried out taking into account the indicators of the patient's somatic health - blood pressure, the state of the heart and blood vessels, the presence of concomitant complications from the urinary organs, taking into account the drugs that the patient is already taking.

The second group of drugs that are actively used in prostate adenoma are 5 alpha reductase inhibitors. This enzyme in the body is responsible for the activation of the main male sex hormone testosterone. Under the influence of the enzyme, the tissue of the prostate gland increases and grows. Therefore, using inhibitors of this enzyme, there are high chances to stop hyperplastic processes in the organ, stop the pathological growth of its tissues and pressure on the urethra.

The peculiarity of the use of inhibitors is the need for long-term therapy. In some patients, results appear after three months, while others need to be treated for at least six months to get a positive trend. Typically, inhibitors are prescribed to patients with an organ volume greater than 40 ml.

The drugs do their job well, but they are not without side effects. Patients during treatment note such negative reactions as a decrease in sexual desire, problems with ejaculation, erectile dysfunction. The most popular drugs are dutasteride and finasteride. The drug Dutasteride has the ability to block all types of inhibitors, and this, in turn, contributes to a significant decrease in the level of prostate-specific antigen.

The drug is able to eliminate the pathological growth of tissues, but its effect appears after a few months.

Since both groups of drugs have significant differences in the effect and timing of a positive result, doctors resort to combination therapy. To obtain rapid improvements, alpha-blockers are prescribed, and then patients continue treatment with 5 alpha reductase inhibitors. The scheme is drawn up by a doctor depending on the stage of the disease.

Recent studies have shown high efficacy against prostate adenoma Tadalafil. Initially, this drug was used in the treatment of erectile dysfunction, but observations of patients found that Tadalafil also reduces the level of BPH, so this drug is also included in the pathology treatment regimen.

Patients who are worried about whether prostate adenoma can be cured without surgery should understand that drug treatment has its own characteristics:

• drugs show the greatest effectiveness when seeking help early;
• you need to take medicines for a long time, until the patient receives a positive effect;
• with conservative treatment of pathology, there is always a risk of worsening the situation and the need for urgent surgery (for example, with acute urinary retention).

Based on these features, doctors offer patients to solve the problem in an operative way in order to permanently get rid of prostate adenoma.

Surgical care

To date, there are several surgical methods for the treatment of prostate adenoma, allowing you to remove overgrown tissue without problems. Each intervention is different. There are several methods of surgical treatment of the prostate:

• open adenomectomy with transcystic or retropubic access;
• transurethral resection of the prostate;
• holmium enucleation of the prostate;
• photoselective laser vaporization.

The choice of surgical technique is carried out not only according to indications, but also based on the patient's condition. If surgery is not possible to perform in full, then doctors resort to a minimally invasive stenting technique. The purpose of such an intervention is to expand the urethra in the place where it is compressed by overgrown prostate tissues. Usually, stenting is not difficult, but in rare cases, the attending physician must create a cystostomy or place a urethral catheter to remove urine.

Until recently, open adenomectomy was most often used to remove overgrown prostate tissue.

Open adenomectomy consists in exfoliation of hyperplastic nodes and suturing of the glandular bed. The advantages of this operation are obvious. It does not require the use of expensive equipment, is performed from the technical side and is more simple than other interventions. An open operation can remove a prostate adenoma of any size, so this operation is still practiced in any clinics, public or private.

The key disadvantage of such an operation is a large blood loss in patients after the intervention.

In addition, the recovery period after adenoma is the longest compared to other removal methods. In men, a scar remains after the operation, and complications can also occur. It should be understood that such operations are carried out quite often and doctors have enough experience to avoid the negative consequences of their implementation. There is no need to be afraid to treat prostate adenoma in men by open adenomectomy, since most of these operations are without complications.

Transurethral resection of the prostate is currently recognized as the gold standard in the surgical treatment of pathology. The technique for performing surgical intervention is to remove prostate tissue using special surgical instruments inserted into the urethra. Direct removal of tissues occurs with the help of electroresection through a special loop.

Resectoscope for TUR of the prostate - a low-traumatic instrument for gentle tissue removal

Surgery has a number of undeniable advantages:

• the urinary canal is fully visualized, if necessary, treatment of concomitant pathologies can be carried out;
• blood loss during surgery is much less;
• there are no incisions on the skin;
• the recovery period is shortened;
• the possibility of removing the catheter already on the second day after the operation.

The only inconvenience of the operation is the inability to remove large volumes of overgrown tissue. It is also worth noting that the operation requires special equipment, which makes the operation more expensive compared to the open method of tissue removal.

Holmium enucleation of the prostate is a new technique. It is not used in all clinics, but where there are special laser installations. To date, holmium enucleation is being actively introduced into surgical practice, but it has not yet replaced transurethral resection of the prostate in its popularity.

The advantages of the intervention are that the adenoma tissues are completely removed, the blood loss during the intervention is minimal, and the operation can be performed with any size of the adenoma. Operations are carried out in single clinics, where specialists with sufficient experience in the treatment of the disease work.

Laser vaporization is also new and is not used as often. During the intervention, prostate tissue is burned out with a laser beam. When carrying out laser vaporization, it is possible to remove all pathologically altered prostate tissues at a time. Blood loss during vaporization is minimal. This method can also remove an adenoma of any size.

Folk methods of treatment

It is necessary to treat prostate adenoma with folk remedies extremely carefully so as not to delay the pathological process, when it will be possible to remove overgrown tissues only by a traumatic surgical method.

For the treatment of the disease, there are several effective recipes. Good results are obtained by treatment with onions, sunflowers and walnuts. Treatment should be carried out as follows: on the first day it is recommended to eat a whole head of raw onions before going to bed, on the second day - 100-150 g of raw seeds, and on the third day - half a glass of walnuts. It is best to eat nuts either immediately before bedtime or two hours after dinner. Thus, the therapy is alternated for three consecutive months and the results of treatment are evaluated.

Another effective remedy is rosin, wax and vegetable oil. It is necessary to prepare an ointment from the following components:

• rosin - 100 g;
• wax - 50 g;
• vegetable oil - 50 g.

All components are mixed to obtain a thick mass for application. It is applied to the pubic area with a layer of 1-2 cm thick. You need to wear a bandage with an application for three days, and then change the product to a new one. In total, 10 such applications will be made in the first 30 days. After the end of therapy, it is advisable to consult a doctor to evaluate the effectiveness of treatment, because you need to get rid of not only the symptoms of the pathology, but also its cause.

When the first signs of pathology are detected, it is not necessary to wait for deterioration. If you consult a doctor earlier, you can treat the pathology with a conservative method. With the ineffectiveness of such therapy, adenoma is successfully treated surgically.

Prostate adenoma - benign growths of the glandular structures of the prostate, leading to difficulty in the outflow of urine from the bladder.

At the same time, there is difficulty urinating and frequent trips to the toilet. In addition, the urine stream becomes weaker, possibly involuntary discharge. In the later stages of the development of the disease, chronic urinary retention develops. It leads to general intoxication of the body and chronic renal failure.

It is important to consult a doctor in a timely manner to start treatment, since the absence of such treatment in the early stages, when the problem can still be solved with the help of pharmacotherapy, leads to the need for surgical intervention when the pathology passes to later stages of development.

The reasons

The reasons for the development of prostate adenoma are not fully established. But it has been established that the main factor predisposing to this pathology is the age of the man. The older he gets, the higher the likelihood of this disease.

First of all, this is due to age-related changes in the regulatory function of the endocrine system, which is responsible for the functioning of the genital area. It is noteworthy that no cases of prostate adenoma have been recorded in castrated or castrated men. It is also known that smoking, sexual orientation, sexual activity and other factors do not affect the appearance of pathology.

Adenoma is a disease that develops with the growth of a benign tumor of the glands surrounding the urethra, and located in the prostatic urethra under the bladder.

In men older than 50 years, the probability of developing pathology is 50%, and in older people it is even higher. Patients after 70% in 75% of cases are faced with this disease.

What is the difference between prostate adenoma and prostatitis?

And prostate adenoma are completely different concepts, which, however, many people confuse with each other.

Prostate adenoma is called hyperplasia (enlargement) of prostate tissue. Prostatitis is an inflammatory process that affects this gland.

Symptoms and first signs of prostate adenoma

Prostate adenoma in all patients manifests itself the same way. The main symptoms may be irritative or obstructive.

The first form is characterized by an increase in the process of urination. In addition, the patient suffers from frequent urge to empty the bladder, urinary incontinence and nocturia.

With obstructive prostate adenoma, the process of urination is difficult, and the time for emptying the bladder increases. In addition, the man feels discomfort associated with the feeling of incomplete emptying of the MP. In parallel, there is intermittency and weakening of the urine stream, and straining during urination.

In modern urology, prostate adenoma is divided into 3 stages.

First stage

In the initial phase of the development of the disease, the dynamics of urination changes. Urges become frequent, but the process itself becomes sluggish, less intense. The patient begins to feel the need to visit the restroom at night.

As a rule, at the first stage, prostate adenoma does not cause a feeling of particular discomfort in the patient. As for nocturnal awakenings, men often associate them with age-related insomnia.

During the daytime, the number of urination acts remains the same, but many men note the appearance of the so-called waiting period. It is especially pronounced in the morning hours.

Gradually, the number of urges to urinate will increase, and the amount of urine excreted, on the contrary, will decrease. Next, imperative urges to empty the bladder will begin to arise. It is noteworthy that if earlier the urine stream in a man formed a parabolic curve, then at the first stage of the development of prostate adenoma, it becomes sluggish, and is characterized by a vertical fall.

Since hypertrophy of the bladder muscles occurs at the first stage, the effectiveness of its emptying remains the same. At the same time, there is no urine left in its cavity. The functional state of the kidneys and upper urinary tract also does not change.

Second stage (or subcompensated stage)

The second stage of the development of prostate adenoma is characterized by an increase in the size of the bladder. At the same time, dystrophic changes begin to occur in its walls. Residual urine gradually accumulates in the bladder. At first, its volume is 200 ml, but over time it increases.

During urination, a man has to tighten the abdominal muscles, which causes a sharp increase in intravesical pressure. Urination at this stage becomes multi-phase, intermittent and undulating.

As the pathology progresses, there may be a failure in the passage of urine in the upper urinary tract. The muscles lose their elasticity and the urinary tract begins to dilate. Against this background, the functioning of the kidneys is disrupted.

Patients begin to suffer from constant thirst, polyuria and other symptoms of CRF. If the compensation mechanism is violated, stage 3 of the disease occurs.

Third stage (decompensated stage)

This stage of prostate adenoma is characterized by an increase in the patient's bladder due to the large amount of urine accumulated in it. It is not difficult to detect this deviation. This can be done visually, or during palpation.

The upper border of the bladder can reach the navel, or reach a higher point. Even with intense tension of the press muscles, urination becomes impossible. In this case, the patient experiences a constant desire to empty the bladder. Due to the inability to do this, he suffers from pain in the lower abdomen, and urine is excreted in the form of drops, or in small portions.

Over time, the increased urge to urinate and pain subside somewhat. Instead, the so-called paradoxical urinary retention begins to occur. It is characterized by the fact that the bladder overflows with urine, but it is excreted only in the form of drops.

At the last stage of the development of the disease, the upper urinary tract expands, and there is a violation of the renal parenchyma. This failure occurs due to obstruction of the urinary tract, under the influence of which pressure increases in the area of ​​the pelvicalyceal system.

In the third stage, the symptoms of CRF increase, and in the absence of timely treatment, death can even occur.

Consequences and complications

With untreated prostate adenoma, complications can develop in the form of:

1. Acute urinary retention. This is a serious complication of the pathology, accompanied by the impossibility of emptying the bladder. Often such a deviation is observed at the 2-3 stage of adenoma development. Often, acute urinary retention is observed with hypothermia, overwork, or prolonged sitting in a sitting position. Only catheterization of the bladder can correct the situation.
2. Inflammatory processes - cystitis or pyelonephritis. These pathologies can be avoided only if the prostate adenoma is treated in a timely manner.
3. The formation of stones in the bladder. With incomplete emptying of the organ, mineral deposits - stones - begin to form in it. Their appearance can be prevented only if the urinary function is restored. If the calculi have already formed, surgical treatment of prostate adenoma is performed, during which the stones are also removed.
4. Hematuria is blood in the urine. With varicose veins of the bladder neck, a certain amount of red blood cells enter the urine. Erythrocyturia can be macroscopic, in which the urine becomes red, and microscopic. In the latter case, it is possible to detect red blood cells in the urine only with its laboratory study. Hematuria requires additional diagnostics aimed at excluding the presence of tumors or calculi in the bladder.

Diagnostics

To begin with, a digital examination of the prostate is performed, after which a swab is taken from the urethra, and a study of the secretion of the prostate gland is also performed. This is necessary to exclude bacterial complications of pathology.

It is also mandatory to perform:

1. Ultrasound examination, which allows you to determine the size of the prostate gland, detect calculi and congestive processes in the bladder. In addition, the volume of urine remaining in the bladder is determined, and the functioning of the stoves and urinary tract is also evaluated.
2. Uroflowmetry is a procedure during which the bladder emptying time and the rate of urine flow are measured. Manipulation is carried out using a special sensor.
3. Determination of the level of prostate-specific antigen (abbreviated as PSA). This diagnostic procedure is necessary to exclude the development of cancerous tumors in the tissues of the prostate gland. The value of the indicators in the norm should not exceed the mark of 4 ng / ml of blood. If there is doubt about the reliability of the data, a prostate biopsy is performed.
4. Cystography and excretory urography. However, these manipulations have been performed less frequently in recent years due to the emergence of new, minimally invasive methods of ultrasound diagnostics.

In some cases, in order to differentiate prostate adenoma from other pathologies with similar symptoms, cystoscopy is performed.

Treatment of prostate adenoma

Treatment of prostate adenoma can be both conservative and surgical. The choice of therapeutic technique depends on the stage of the pathology:

1. So, at the first stage of the development of the disease, medications are prescribed to patients, and a regimen of physical activity is also being developed. In parallel, recommendations are given regarding the general lifestyle and nutrition. A prerequisite is the cessation of smoking and alcohol, as well as the exclusion from the coffee menu. Problems with urination may require additional transurethral electroresection.
2. At the second stage of the development of pathology, surgical removal of the adenoma is recommended. As a rule, they resort to minimally invasive surgical approaches, or classical techniques.
3. The main task of treating the third stage of prostate adenoma is to ensure a full outflow of urine and eliminate the symptoms of azotemichesky intoxication. In this situation, percutaneous puncture nephrostomy, cystostomy or other manipulations are performed. After that, all efforts are directed to the normalization of the work of the kidneys, liver, CCC. Only after that the question of surgical intervention is considered.

Important! Pharmacotherapy cannot completely cure the disease. Its main task is to slow down or completely stop the progression of the pathological process.

Pharmaceuticals

With prostate adenoma resort to the use of:

1. Alpha blockers, which contribute to the expansion of the urethra. This, in turn, improves the outflow of urine. To achieve a stable therapeutic effect, treatment should be carried out for at least six months. The first signs of positive dynamics are noted already after 2-4 weeks from the date of the start of taking the drugs. Basically, drugs such as Prazosin (daily dosage - from 4 to 5 mg), Doxazosin (from 2 to 8 mg per day), Alfuzosin (from 5 to 7.5 mg / day), etc. are prescribed. If after 3- 4 months of treatment does not give the expected results, the doctor should reconsider the therapy regimen.
2. 5-alpha reductase inhibitors, which reduce the size of the prostate and stop its further growth. The drugs of this group act directly on testosterone, transforming it into dihydrotestosterone. The use of Finasteride at a dose of 5 mg per day, or Duasteride, helps to cope with the pathology. These drugs are not associated with hormonal receptors, so they do not have the side effects characteristic of hormonal medications. After 3 months of treatment, the prostate decreases by 20%, after six months - by 30%.

Surgery

Surgery is the most effective treatment for prostate adenoma today. Surgical intervention is indicated in the development of complications of the disease in the form of acute urinary retention, impaired renal function, secondary infection, etc.

In addition, the operation is prescribed for patients suffering from subjective symptoms that significantly reduce the quality of life - incontinence, frequent urge to empty the bladder, etc. To date, the following methods of surgical treatment of prostate adenoma are the most effective.

Open prostatectomy

Manipulation is performed under general anesthesia. During the operation, a resection of the prostate lobes is performed.

This surgical technique is resorted to if a large part of the prostate gland is affected, and the volume of residual urine is at least 150 ml.

In order to avoid postoperative complications, the intervention in most cases is carried out in 2 approaches. At the first stage, resection of certain areas of the prostate is performed, after which a fistula is formed, through which urine freely enters the urinal. At the second stage, the full outflow of urine is restored completely.

Transurethral resection (TUR)

This surgical method of treating prostate adenoma is more gentle, since no incisions are made to the patient during the procedure. Manipulation is carried out through the urethra.

Indications for such an operation are the mass of the urethra is not more than 60 g and the amount of residual urine is less than 150 ml. During the procedure, only certain sections of the prostate are removed. After that, the patient is prescribed medications that will prevent its re-growth.

Despite the fact that TURP is considered a minimally invasive surgical technique, it causes postoperative complications more often than open prostatectomy. Thus, patients may experience bleeding, urinary incontinence, sclerosis of the bladder neck and other adverse effects of such an intervention.

Transurethral Microwave Therapy

The essence of this procedure is the introduction of a catheter into the urethra, through which microwaves are supplied. Under their influence, heating and coagulation of the tissues of the prostate occurs.

This technique is effective only for small adenomas. After the operation, there may be a slight swelling, so a catheter is inserted to remove urine from the patient.

Transurethral laser vaporization

A catheter is inserted through the urethra, after which a laser beam is applied to the tumor. Under its influence, water from overgrown tissues begins to actively evaporate, as a result of which they die. Due to this, the prostate decreases in size.

Transurethral laser vaporization is used only for small growths of the gland.

Transurethral needle ablation

The procedure is performed using a cystoscope, through which the doctor inserts needles into the tissues of the prostate gland. Radiofrequency waves are delivered through these needles, under the influence of which the tumor is heated and destroyed.

The technique is used for small neoplasms. Complications may be the same as with transurethral microwave therapy.

FUVI

High Intensity Focused Ultrasound is a procedure during which a small camera and a device that emits ultrasound waves are inserted using a special probe.

Ultrasound has a thermal effect, destroying pathological tissues. After such treatment, patients may develop impotence (in 1-7% of cases).

Balloon dilatation

A balloon is inserted through the cystoscope into the urethra, with the help of which the lumen of the urethra expands. This technique is used when conservative treatment of pathology is ineffective, as well as when it is impossible to perform an operation.

Stenting

The method is a bit similar to the previous one, but in this case a special stent is inserted into the urethra, which ensures a normal outflow of urine.

Cryodestruction

During the manipulation, liquid nitrogen is used, which freezes the tissues of the neoplasm, as a result of which they are destroyed. In order not to damage the healthy tissues of the urethra, a special heating element is placed in its zone.

Embolization of the arteries of the prostate

The procedure uses small plastic balls that are inserted into the arteries of the prostate through a special catheter. Together with the blood flow, they reach small arterioles and clog them tightly. Due to the lack of blood supply, pathological tissues stop growing and then die.

What are the consequences of surgery for prostate adenoma?

Surgical treatment of prostate adenoma can cause complications in the patient in the form of:

1. Bleeding during surgery. They occur in 2-3% of cases, and are the most serious consequence of surgical treatment. Many patients require a blood transfusion procedure.
2. Bleeding after surgery, accompanied by the formation of blood clots, which subsequently disrupt the normal outflow of urine. It is possible to eliminate such consequences only through repeated intervention performed by the endoscopic or laparotomy method.
3. Stagnation of urine due to its delay. It, in turn, occurs against the background of dysfunction of the muscular layer of the bladder.
4. Infection of the organs of the genitourinary system (inflammatory processes in the testicles and their appendages, prostate, renal calyces and pelvis, etc.). A similar complication is observed in 5-22% of cases.
5. Violations of the process of urination, provoking even greater difficulties than were observed in the patient before. This complication is due to incorrectly performed excision of pathological prostate tissues. This problem is solved only by re-resection.
6. Retrograde ejaculation, in which there is difficulty in ejecting seminal fluid outward due to its reflux into the bladder.
7. erectile dysfunction. Occurs in 10% of patients, but is not always the result of surgical treatment of prostate adenoma.
8. Narrowing of the urethral canal, which occurs in 3% of cases, and requires microinvasive intervention using endoscopic techniques.

Very rarely, patients may experience urinary incontinence, which may go away on its own. But only if it was caused by a malfunction of the muscles of the bladder.

Forecast and prevention

In order to avoid the development of prostate adenoma, men are recommended:

• avoid hypodynamia, which leads to stagnation of blood in the pelvic organs;
• adjust the diet to include easily digestible foods;
• avoid obesity;
• refuse to wear tight jeans, trousers and underwear that squeezes the genitals;
• avoid casual sex to prevent the development of STDs;
• after reaching the age of 40, regularly undergo preventive examinations by a urologist, and take a blood test for PSA for early detection and timely initiation of therapy for prostate adenoma.

The maximum restriction of the use of harmful products and the inclusion of food enriched with vegetable fiber in the daily menu significantly reduces the risk of developing this disease. It is better to refuse strong tea and coffee in favor of natural juices, teas or decoctions of medicinal plants - mint, lemon balm, chamomile, hibiscus, tea rose petals, etc. If adenoma has already begun to develop, it is necessary to give preference to dairy products, legumes, boiled , steam or baked lean meat.

When the disease was detected, the prognosis for recovery also depends. If the pathology was detected at an early stage of development, and treatment began immediately, the prognosis is considered the most favorable. But they worsen sharply when ignoring the symptoms and postponing a visit to the doctor.

In severe cases, the development of chronic renal failure occurs, as well as malignancy of the adenoma, which leads to prostate cancer. The process of malignancy of the prostate gland is observed in the later stages of the disease, as well as when the patient ignores the recommendations of the attending physician regarding the treatment and prevention of prostate adenoma.

BPH- a disease that begins in men in adulthood and is characterized by benign enlargement (hyperplasia) of the paraurethral glands.

Prostate adenoma can appear already at the age of 40-50 years. According to the WHO (World Health Organization), there is an increase in the disease, starting from 12% in men aged 40-49 years to 82% in 80 years. After 80 years, prostate adenoma occurs in 96% of cases.

The conducted studies have led to the result that prostate adenoma in the Negroid race is more common, and less common among the inhabitants of Japan and China. This is due to the dietary habits of Asian countries, which contains a large number of phytosterols that have preventive properties.

Anatomy of the prostate

The urethra passes through the prostate gland. It enters the gland at the base and exits it anterior to the apex. The prostate gland is supplied with blood from the inferior cystic and rectal arteries. The veins of the prostate form a plexus around it.

Why does prostate adenoma occur?

There are a number of factors that increase the risk of developing prostate adenoma:

• Genetic predisposition (one of the relatives had this disease)
• Excess weight (leads to impaired metabolism and endocrine regulation)
• Unbalanced diet (eating excess salty, spicy, fatty foods).

Symptoms of prostate adenoma

There are three stages of the disease
1 stage	characterized by the occurrence of complaints with complete emptying of the bladder (compensation stage).
2 stage	characterized by a significant disruption of the bladder in which, after urination, a significant amount of urine remains (subcompensation stage).
3 stage	complete dysfunction of the bladder develops with the phenomenon of paradoxical ischuria (droplet excretion of urine from an overflowing bladder).

Obstructive symptoms:

• Sluggish urine stream- the rate at which urine is excreted is reduced.
• Initial (primary) urinary retention- urination does not occur immediately after relaxation of the sphincter, but after a certain delay.
• It is necessary to strain the abdominal muscles- to carry out urination, the patient has to significantly strain the abdominal muscles.
• Intermittent urination- that is, urination in parts (normally, urination occurs without interruption until the bladder is completely empty).
• Drops of urine at the end of urination(normally this does not happen)
• Feeling of incomplete emptying of the bladder(normally, after urination, men feel that the bladder has completely emptied).

Daytime pollakiuria- Increased urination during the day. Normally, the number of urination is from 4 to 6 per day, if a person drinks no more than 2.5 liters of fluid per day and is not treated with diuretics. Pollakiuria can reach up to 15-20 urination per day.

Nocturnal pollakiuria or nocturia- Increased urination at night. Normally, a person can sleep at night without emptying the bladder. Nocturia appears up to 3 times or more.

False urge to urinate- conditions in which the urge is present, but urination does not occur.
An important role in the onset of symptoms is played by impaired detrusor function (the bladder muscle that expels urine). Normally, detrusor contraction occurs when the bladder neck is fully open. With prostate adenoma, detrusor instability occurs. This is due to an increase in detrusor activity in relation to adrenergic influence. This phenomenon occurs, as a rule, against the background of a weakening of the contractility of the detrusor.

Hyperplastic nodes of the prostate cause a violation of the blood supply to the bladder neck, which, along with a reduced threshold of excitability of the detrusor, leads to its dysfunction.

Why is prostate adenoma dangerous?

• Acute urinary retention a severe complication of a disease characterized by the inability to urinate. This complication most often appears in the second or third stage of the disease. Usually, acute urinary retention develops after hypothermia, overwork or prolonged sitting. This complication is treated with bladder catheterization.
• Inflammatory processes that developed against the background of prostate adenoma. Most often, cystitis (inflammation of the bladder) and pyelonephritis (an infectious disease affecting the pelvicalyceal system and kidney parenchyma) can develop. Prevention of these complications is the timely treatment of prostate adenoma.
• Bladder stones - mineral deposits that appear due to incomplete emptying of the bladder. Prevention of this complication is the elimination of incomplete emptying of the bladder. If the stones nevertheless appeared, it is necessary to carry out surgical treatment of prostate adenoma with the associated removal of stones.
• Hematuria - the appearance of red blood cells in the urine. Hematuria appears due to varicose veins of the bladder neck. Hematuria can be macroscopic (urine red) and microscopic (can only be established in the laboratory). When this complication occurs, it is necessary to exclude stones and tumors of the bladder.

Diagnosis of prostate adenoma

This algorithm also includes filling out a urination diary (frequency and volume), palpation (finger examination) of the prostate and various instrumental diagnostic methods.

Palpation of the prostate(digital rectal examination of the prostate)
Palpation of the prostate allows you to determine the size, consistency, pain of the prostate (in the presence of chronic prostatitis).

ultrasound. With the help of ultrasound, the degree of enlargement of the prostate is determined. Evaluate the direction of growth of nodes, the presence of calcifications. Ultrasound also allows you to assess the size of the kidneys, the presence of various changes in them, concomitant urological pathologies.

TRUS- transrectal ultrasound. This study allows you to study in detail the structure of the prostate, get its exact dimensions, and also identify signs of chronic prostatitis or prostate cancer. TRUS allows you to determine the development of prostate adenoma at a very early stage.

Quite often, in patients with severe prostatic hyperplasia, foci of calcification are determined. The presence of calcifications in the central zone of the prostate indicates the final (5) stage of the development of the disease.

Uroflowmetry - a method that is used to measure various characteristics of the urine stream. This method must be carried out at least 2 times in conditions of bladder filling (150-350 milliliters) and when a natural urge to urinate occurs. To evaluate the results, a uroflowmetric curve is used, on which the maximum urine flow rate is noted. Flow rates greater than 15 milliliters / second is considered normal. The total urination time is also estimated. Normally, for a volume of urine of 100 milliliters - 10 seconds, for 400 milliliters - 23 seconds.

Studies have shown that there is a dependence of urination parameters on age. Normally, the flow rate is considered to decrease by 2 milliliters/second every 10 years. This decrease in speed is explained by the aging of the bladder wall.

Determination of residual urine after urination is of great importance for determining the stage of the disease, as well as for determining indications for surgical treatment. Residual urine is determined by ultrasound immediately after urination. Recently, uroflowmetry has been combined with the determination of residual urine.

Cystomanometry- a method by which the pressure inside the bladder is determined. This method allows you to measure intravesical pressure at different stages of filling the bladder, as well as during urination.

In a healthy person, the initial urge to urinate occurs when there is 100-150 milliliters of urine in the bladder, while the pressure is 7-10 centimeters of the water column. When the volume of the bladder is filled up to 250-350 milliliters, the urge to urinate sharply increases. In this case, normal intravesical pressure is 20-35 centimeters of the water column. This reaction of the bladder is called normoreflex.
Increased intravesical pressure (above 30 centimeters of water column) with a bladder volume of 100-150 milliliters indicates hyperreflexogenicity (increased detrusor reflex). Conversely, reduced pressure (by 10-15 centimeters of the water column) when the bladder is filled to 600-800 milliliters indicates detrusor hyporeflexia. The reflexogenicity of the detrusor makes it possible to assess its reserve function, and the relationship between volume and pressure characterizes the elastic properties of the detrusor.

Cystomanometry performed during urination, allows you to determine the vesicourethral patency and contractility of the detrusor. Normally, the maximum intravesical pressure during urination is 45-50 centimeters of water column. If the pressure is increased, this indicates the presence of an obstacle when emptying the bladder.

Cystography- method of examination of the bladder with the use of contrast. There is a descending and ascending cystography. Descending cystography suggests the movement of contrast from top to bottom. This method allows you to determine the filling defect in the neck of the bladder. In the picture, this filling defect is visible as a tubercle. Ascending cystography allows you to determine the deformation of the urethra in the prostate.

Computed tomography and magnetic nuclear resonance- these studies provide more detailed information (correlation with neighboring organs) about prostate adenoma.

Treatment of prostate adenoma

Medical treatment

• Prazosin 4-5 milligrams per day in 2 divided doses
• Alfuzosin 5-7.5 milligrams per day in 2 divided doses
• Doxazosin 2-8 milligrams once a day
• Terazosin 5-10 milligrams daily once

Treatment with herbal remedies

Treatment with herbal medicines has been used by people since ancient times. Recently, these drugs have become very popular in Europe, Japan and the United States.

Permixon- French drug from the fruits of the American dwarf palm, which has an inhibitory effect on 5 alpha reductase. It also has a local antiproliferative and anti-inflammatory effect.
Conducted surveys have shown that prolonged use of the drug (for 5 years) leads to a significant decrease in the volume of the prostate and the volume of residual urine, and also relieves the symptoms of the disease. Permixon is well tolerated and has no side effects.

Prostamol Uno- a preparation made from the fruits of the Sabal palm tree. The drug has anti-inflammatory, antiexudative (prevents the accumulation of pathological fluid), antiandrogenic action (due to inhibition of 5 alpha reductase). The drug does not affect the level of sex hormones, does not change the level of blood pressure, does not affect sexual function.

Treatment with phyto drugs is carried out with prostatic hyperplasia of the first and second degree.

Surgical treatment of prostate adenoma

Surgical treatment can be carried out according to emergency indications or in a planned manner. A planned operation is carried out only after a complete examination of the patient.
Surgical treatment (elective surgery) is carried out only if there are absolute indications:

• Urinary retention (inability to urinate even after a single bladder catheterization)
• Massive and recurring hematuria (the presence of red blood cells in the urine), which is due to prostate adenoma
• Kidney failure that develops due to prostate adenoma
• Bladder stones due to prostate adenoma
• Urinary tract infection that recurs many times due to an enlarged prostate
• The presence of a large diverticulum in the bladder

• If there is bleeding in a life-threatening patient
• For acute urinary retention

• A general blood test is carried out to determine anemia (a reduced amount of hemoglobin and red blood cells), leukocytosis (indicates some kind of inflammatory process).
• Before the operation, it is necessary to check the kidney function with a biochemical blood test. In the presence of impaired renal function, creatinine and urea in the blood will be increased.
• Blood clotting studies are necessary to exclude the risk of thromboembolism or bleeding, both during and after surgery.
• ECG (electrocardiogram) - in order to exclude possible complications from the heart during surgery.

Methods of surgical treatment:

Transurethral endourological treatment of the prostate- a method of operation in which special endoscopic equipment is used. The operation is performed transurethral (that is, in the urethral cavity). An endoscope is passed through the urethra directly to the prostate, then the hypertrophied portion of the prostate is removed. This method of surgical intervention has several advantages over open surgery:

• The absence of soft tissue damage when accessing the prostate, which speeds up recovery time after surgery.

• Well-controlled hemostasis (stop bleeding), which significantly reduces the risk of bleeding after surgery.

• Enables surgery for patients with comorbidities

Transurethral electrovaporization (electroevaporation) of the prostate - this method of treatment is similar to the endourological method and differs from it only in the use of a roller electrode. When the electrode touches the tissues of the prostate, tissue is burned with drying and coagulation. This treatment method significantly reduces the risk of bleeding during surgery. This method of treatment is most effective for small and medium-sized prostates.

Electroincision of prostate adenoma - this method of treatment differs from other methods in that in this case, the prostate tissue is not removed, but only a longitudinal dissection of the tissues of the prostate and bladder neck is performed.
Most often, this method of treatment is used in the following cases:

• Young age of the patient
• small prostate
• Intravesical (into the lumen of the bladder) growth of prostate adenoma

• Laser vaporization
• Laser coagulation

The advantage of evaporation over coagulation is the ability to remove the prostate under visual control. The evaporation procedure can take from 20 to 110 minutes.

There is also a method of interstitial laser coagulation of the prostate. This method involves placing the tip directly into the prostate tissue. During the operation, change the location of the tip several times. The average operation time is 30 minutes.

Transurethral microwave thermotherapy – a method in which the effect of high temperatures on prostate tissue is used. The threshold of temperature tolerance (tolerance) of prostate cells is 45 degrees Celsius. This method involves the use of temperatures from 55 to 80 degrees Celsius. This temperature is generated using unfocused electromagnetic energy, which is conducted to the prostate using a transurethral antenna.

Transurethral radiofrequency thermal destruction - this method involves the use of hard temperature exposure (70-82 degrees Celsius). This method also uses electromagnetic energy.

The main advantage of thermal destruction is its high efficiency in the treatment of prostate adenoma with severe sclerotic changes and prostate calcification. This procedure takes about an hour on average.

Balloon dilatation - the method is based on the mechanical expansion of the prostatic urethra.

Urethral stents (internal drainage systems)
By implanting a urethral stent, the problem of bladder drainage is solved. Most often, stents are used in the second or third degree of the disease (when obstructive symptoms are severe).

Prevention of prostate adenoma

• Daily mobility and sports (but without excessive exertion). Physical activity reduces the risk of developing stagnant processes in the pelvis.
• Healthy eating, which involves the exclusion from the diet of sour, salty, spicy smoked foods. Mandatory presence in the diet of fruits and vegetables, as well as vitamins of all groups.
• Fighting excess weight (improves metabolism throughout the body).
• Avoid wearing tight-fitting things in the crotch area: panties, pants.
• Exclude casual sexual contacts as a means of preventing sexual infections.

Is it possible to apply any physiotherapeutic methods for the treatment of prostate adenoma?

• Any kind of heating of the prostate gland
• Electromagnetic waves
• Ultrasound
• Various vibration treatments

Can massage be used as a treatment method?

What foods should be eaten?

Are there exercises that should be done with prostate adenoma?

• In the supine position with the buttocks torn off the floor, you need to retract the anus.
• In a position on all fours, take turns stretching your legs back, then to the side. Simultaneously with stretching the legs, you need to stretch opposite arms forward (that is, if you stretch your left leg back, then at the same time you need to stretch your right arm forward).
• Lying on your back, pull up your legs bent at the knees, and then lower them in turn to the right, then to the left of the body.

What is the difference between prostate adenoma and prostatitis?

What are the PSA norms for prostate adenoma?

With benign prostatic hyperplasia, PSA is produced in an increased amount, with malignant tumors, its level in the blood rises even more.

PSA levels for men of different ages:

• up to 50 years -
• 50-60 years old -
• 60-70 years old -
• over 70 years old - 6.5 ng / ml.

With prostate adenoma, the level of PSA in the blood annually rises by no more than 0.75 ng / ml. Faster growth is typical for malignant tumors.

Prostate-specific antigen can circulate in the blood in free form ( free PSA), or be associated with other proteins ( associated PSA). Usually, the laboratory determines the level of free and total prostate-specific antigen. If free is less than 15% of the total, there is a risk of a malignant tumor.

Another important indicator is the density of PSA. In order to get it, divide the indicator of the level of prostate-specific antigen in the blood by the volume of the prostate gland. If the PSA density is greater than 0.15 ng/ml/cm 3 , there is a risk of cancer.

In all cases when prostate cancer is suspected after a PSA blood test, the doctor prescribes a biopsy.

What is the cost of surgery for prostate adenoma?

The operation is performed under anesthesia - its type also affects the total cost. Not the last role is played by the pricing policy of the clinic. Management can set the price at its discretion.

What are the consequences of surgery for prostate adenoma?

• Bleeding during surgery is the most severe complication. According to statistics, it occurs in 2-3 men out of 100. A blood transfusion may be required.
• Bleeding after surgery. In this case, blood clots form in the bladder, which disrupt the outflow of urine. It is necessary to perform a second operation, open or endoscopic.
• Urinary retention. It occurs as a result of a malfunction of the bladder muscle or due to surgery.
• Infections of the genitourinary system:acute prostatitis(inflammation of the prostate) acute pyelonephritis(inflammation of the renal calyces, pelvis and tubular system), acute orchiepididymitis (inflammation of the testicle and its epididymis). They occur in 5-22 men out of 100.
• Insufficient removal of prostate tissue during surgery. The remaining tissue can act as a valve and lead to urination disorders that do not go away for a long time, sometimes causing a man even more anxiety than before the operation. The complication occurs in 2-10 men out of 100, and a second operation helps to cope with it.
• retrograde ejaculation- a condition in which sperm does not come out during intercourse, but is thrown in the opposite direction, into the bladder. This complication is very common.
• erectile dysfunction. Erection problems occur in every tenth man who has undergone surgery for benign prostatic hyperplasia. Many scientists believe that the operation has nothing to do with it - in non-operated men, violations occur just as often.
• Narrowing of the urethra. Develops after surgery in about 3 out of 100 men. Requires endoscopic intervention.
• Urinary incontinence. This complication occurs in some men. If it is associated with a violation of the muscles of the bladder, then it can go away on its own.

What is prostate embolization?

Embolization is often a good alternative to surgery for benign prostatic hyperplasia. But far from all hospitals can perform it - this requires special equipment and trained medical specialists - endovascular surgeons.

After embolization, the prostate may shrink by half or more. At the same time, the procedure avoids complications that may occur during and after surgical interventions.

How is prostate embolization performed?:

• The procedure is carried out in a special room ( X-ray operating room) under X-ray control.
• Due to the use of anesthesia, the procedure is almost painless. A man experiences sensations, as during an injection into a vein.
• The doctor makes a small incision in the area of ​​​​the radial or elbow joint and inserts a catheter, respectively, into the radial or brachial artery.
• Under X-ray control, the catheter is passed into the aorta, the internal iliac artery, and finally into the vessel that feeds the prostate adenoma.
• The doctor injects emboli through the catheter - small particles that block the lumen of the vessel and disrupt blood flow to the adenoma.
• In general, the procedure can take up to several hours. After embolization, many men can return home the same day and go about their daily activities.

Is there a malignant prostate adenoma?

However, over time, prostate adenoma can become malignant. Prostate cancer develops. Usually, the “first bell” signaling the development of a malignant tumor is an increase in the level of prostate-specific antigen in the blood. Helps definitively confirm the diagnosis biopsy.

Prostate cancer, unlike adenoma, is able to grow into neighboring tissues and metastasize. The success of treatment is highly dependent on how early it was started.