Adenoma of the prostate — a benign tumor that develops from the stroma or the epithelium glandular prostate. By itself, the adenoma does not spread, but it is possible that with time degenerate into adenocarcinoma (prostate cancer).
In 30-40% of men over the age of 50 years and 75-90 %, more than 65 years there has been a change in the form of a proliferation of tissue glandular in the neck of the bladder.
What is this disease, why it occurs in men after 40 years, what are the first symptoms that is prescribed as a treatment, consider forward.
What is BPH?
BPH is a benign neoplasm of paraurethral glands located around the urethra. The main symptom of BPH - a violation of urination due to the progressive compression of the urethra by one or multiple growing nodules.
If an adenoma is an increase in the body, which causes a compression of the bladder and the urethra. This breaks the flow of the urine and leads to the accumulation of urine residual. In addition, men can develop a urinary tract infection, kidney stones, and cancer. The increase is painless, which is dangerous for the rapid diagnosis of the disease.
The gland of the prostate: what is it?
The prostate, also known as the prostate is an organ situated slightly below the bladder. The main goal of the prostate-specific secret generation, which is part of semen. The secret of the prostate, the determination of the consistency of the ejaculation (in particular, contributing to its dilution), it contains vitamins, enzymes, immunoglobulin, zinc, ions, etc.
The main functions of the prostate are:
- thinning of semen, allowing sperm to be active mobility and, in general, become a viable alternative;
- the development of the secret lies in its composition, it has enzymes, proteins, fats, and hormones, without which sexual system do not function normally;
- the emission of the seed of the smooth muscle of the gland of the prostate is able to reduce, which ensures the supply of semen to the urethra, and in this way, and happens ejaculation.
BPH develops and grows slowly. Although this disease occurs mainly among older men, initial symptoms can reveal is of 30-40 years. Interestingly, the first appearance of nodules of cells form too much and only after a long period of time they begin to grow in size.
Causes of development:
- The first group includes causes due to the style of life that increase the possibility of spread of prostate cancer. For example, it can be a work sedentary or an active mental stress in the absence of physical. It is for this reason that the role of regular exercise cannot be overemphasized.
- The second group includes the objective reasons, independent of the person, the style of life. It is shown that BPH occurs due to the hormonal changes men. If we take into account that these changes that inevitably occur in the elderly, it can be concluded that only some men are so fortunate as to avoid problems with the gland of the prostate.
There are a number of factors that can contribute to the development of the adenoma. These include:
- Weight (accumulation of adipose tissue promotes the production of female hormones);
- Hereditary Factor;
- The abuse of tobacco and alcohol;
- Inflammatory processes in the kidney and urethra;
- Physical inactivity and poor diet;
- The high blood pressure.
Type of benign prostatic hyperplasia
Design and structure there are three types of adenomas:
- The tumour through the urethra enters the bladder, deforming the sphincter internal and the interruption of its function.
- The tumor grows in the direction of the rectum, urination is disturbed slightly, but the loss of contractility of the urethra prostatic't allow completely empty the bladder.
- The uniform seal pressure adenoma of the prostate, but the increase is not observed any retention urinary in the bladder or cancellation. This is the most favorable view of the adenoma.
The symptoms of BPH in men
There are two groups of symptoms of BPH: obstructive and irritatio.
The first group of symptoms of BPH include:
- frequent need to urinate,
- persistent (imperative) urge to urinate,
In the group of obstructive symptoms characteristic of BPH include:
- difficulties when urinating,
- a delay in the beginning and increase the time of urination,
- a feeling of emptying incomplete,
- intermittent urination sluggish stream.
The first signs you should pay attention:
- The first signs of the adenoma of the prostate, weak flow of urine, frequent urination, that does not always result in the emptying of the bladder.
- As the tumor acquires serious dimensions, that the patient does not have any desire to find out the causes of the BPH, more than he cares about how to get rid of disturbing symptoms. Urination becomes difficult, you need to make an effort to urinate, to connect the abdominal muscles.
A complication of the prostate and its transition in the severe stage, all the symptoms will increase, which adversely affect the life of the patient. In difficult cases, to help can only operation that is why it is so important to pay attention to is the symptoms. Even if it is repeated 1-2 times, forced to undergo a full inspection.
Compensated the form
The most characteristic changes of the urination this stage:
- the most frequent
- less free
- not with the same intensity as before (stream of urine, as it is not a characteristic of a parabola, and falls almost vertically).
With the growth of the prostate and the gain compression of the urethra appear the following symptoms:
- the highest frequency of urination day
- the funding decreases the volume of urine
- an increase in cases of uncontrollable desire to urinate (so-called mandatory sneeze),
- participation of auxiliary muscles.
Subcompensated – enlargement of the prostate reached the levels when it began to affect the bladder urinary to remove the urine from the body. Violations occur:
- the release of the bladder occurs portions,
- the wall of the bladder to increase in thickness,
- there is a delay part of the urine,
- when full, the bladder may produce involuntary release of urine,
- the urine may be cloudy and contain blood.
Stage 3 BPH - icc
There is a decrease in the capacity of contractile bladder to the minimum limits, the increase of the urine residual can be around two liters. It is also important to sudden stretching of the bladder, in which its outlines in the form of oval or spherical in shape, get to the navel, and in some cases the increase much higher.
Meanwhile, in the night, and later in the day, the urine is periodically or constantly stands out, it happens involuntary way, through the drops of a full bladder.
Associated symptoms of adenoma:
- nausea and lack of appetite,
- thirst and dryness of mouth.
Implications for men
Complications of BPH:
- Acute retention of urine. A complication appears in 2 or 3 stages of the disease due to the compression of the urethra hypertrophy of the gland of the prostate.
- Inflammation of the urinary tract. Stagnant processes in the bladder lead to the growth of bacteria. Cause the development of cystitis, urethritis, pyelonephritis.
- Urolithiasis. Incomplete emptying of the bladder leads to the appearance of microliths, stone, or mineral deposits. They can cause obstruction of the bladder urinary retention.
- Hematuria. The appearance in the urine of erythrocytes, the cause of which is converted into veins of the neck of the bladder.
It is no exaggeration if we say that the success of the diagnosis of BPH is directly dependent of the patient. In the early stages is to say, the survey can be given that the indicators for which a specialist will be able to suspect the presence of the disease.
Diagnosis consists of:
- The doctor performed a digital examination of the prostate.
- In order to assess the severity of symptoms of BPH, the patient is requested to complete a diary of urination.
- Carry out a study of prostate secretion and smears from the urethra to rule out complications infectious.
- Conduct ultrasound of prostate, during which we determine the volume of the prostate, identify the rocks and areas with stagnant, estimation of the amount of urine residual, of the kidneys and the urinary tract.
Analysis of PSA with adenoma of the prostate – an important indicator in the determination of the degree of the disease and the treatment. This study is recommended to place all men over the age of 40 years, every year, because they diagnose any abnormalities in the prostate and will help you to determine and even cancer of the prostate.
Each gram of benign adenoma of the prostate increases the level of PSA of 0.3 ng/l, and each gram of cancer on 3.5 ng/ml In the adenoma of the prostate level of prostate specific antigen almost never rises above 10 ng/ml. If this happens, there is a suspicion of cancer.
Treatment of BPH
The standard treatment of BPH in men may be medicated efficiently and less invasive. The basic technique – a surgical procedure that is assigned to all patients with infravesical obstruction.
Treatment of BPH depending on the stage:
- The first stage often can be managed by conservative treatment, which, however, does not exclude manifestations of severe and frequent retention urinary, increased frequency of urination (up to 10 times), the formation of the indentation in the stagnant veins of the bladder or the appearance of large stones. This, in turn, leads to a forced measure in the form of operative intervention, even in the absence of urine residual.
- In the second stage. The gold standard of the assistance in this stage — the removal of the adenoma with surgery using different minimally invasive and classic techniques.
- In the third stage. Here the main task is to ensure a good drainage of the urine to remove the toxicity. In this case, the use of percutaneous nephrostomy, cystostomy, etc normalize the condition of the liver, kidneys, cardiovascular system, and then decide on the possible subsequent surgical treatment.
Medicines, while eliminating symptoms and manifestations of the disease refers to the gentle methods of therapy, making it possible to avoid the surgery. The effectiveness of a drug depends on the severity of the adenoma.
- Alpha-blockers relax the muscles of the bladder and prostate, normalizes the process of urination.
- Inhibitors of 5-alpha-reductase is necessary to reduce the amount of tissue glandular tumors of the prostate, to monitor and adjust hormonal background.
- Antibiotics are needed to reduce the activity of pathogenic flora, if the cause of adenomas is an infection and its rapid reproduction.
- Anti-inflammatory drugs men necessary for the rapid removal of the inflammation of the gland of the prostate, reduce the acute pain in the adenoma of the prostate.
- Antispasmodics man necessary, if the pain, even after following a strict diet is not retreats, not of weakness.
Surgical measures are applied with the ineffectiveness of therapy is conservative, or when the extent of the disease. In an adenoma of the prostate operation is assigned with absolute indications:
- The inability of the urination;
- Massive hematuria;
- The stones in the bladder;
- Pathological processes in the gland of the prostate;
- The increase in the average share of the prostate;
- Renal failure;
- Large number of urine residual.
Unplanned (emergency) surgery is performed in the days after the establishment of the development of complications: if bleeding severe, which puts in danger the life of the patient, and the retention urinary in the acute form.
There are different methods of surgical treatment of adenoma prostatic:
- Transurethral resection or TUR is a method widespread, since this operation is performed through the urethra without cuts. However, can only be applied when the weight of the adenoma up to 60 g and 150 mg of waste from the urine in the bladder. In addition, this method can not be used in patients with renal failure.
- Adenomectomy (open prostatectomy) is a popular method of surgical treatment of the benign prostatic hyperplasia, because of the lesser number of contraindications. It is best to use with the weight of the prostate is over 40 g and the amount of urine residual 150 ml. Not hinder the operation and the complications of the disease.
The diet with adenoma
The power mode is selected for each patient individually, taking into account the degree of neglect of the disease, General condition of the patient and their history, and the tastes of the patient. But, as practice shows, without the regime change and the balance of power is not enough.
Special attention is given to foods rich in selenium (Se) and zinc (Zn), which have a positive effect on the tumor, reducing its size. During the disease the man needs to during the day 25 mg of zinc, and at least 5 mcg of selenium.
BPH is a serious condition that requires timely treatment, but only under the supervision of a specialist. No self-medication is not allowed here. Thank you and take care of your health!