Effective treatment of prostate adenoma

Benign prostatic hyperplasia (BPH) or adenoma is an enlargement of the stromal component or epithelium of the prostate. The disease occurs in men over 40, less often at an early age. According to statistics, the probability of its development after 50 years is about 40%, and more than 75% - after 65. In fact, 90% of all men sooner or later face the disease, so it is necessary to know inadvance the causes, risk factors, symptoms and modern treatment of prostate adenoma.

Dangers

Adenoma is a benign formation, therefore, in itself, it does not harm the body. However, as they grow, the tissues of the formation block the lumen of the urinary tract, which prevents the passage of urine. This is due to a number of unpleasant complications and painful sensations, especially in the later stages. Emerging congestion leads to the formation of infections, stones in the bladder, damage to it, as well as severe disturbances in the work of the kidneys, up to the development of failure. Therefore, at the slightest manifestation of symptoms, it is necessary to immediately make an appointment with a urologist, undergo a thorough examination and, based on its results, choose the most effective method of treating prostate adenoma.

Stages and symptoms

The course of the disease can be roughly divided into three main stages, accompanied by various symptoms:

  • I - characterized by more frequent imperative impulses, nocturia (an increase in the volume of nocturnal urine output), the first signs of incontinence, slower flow. At this stage, the disease can persist for several years without developing into a more severe form;
  • II - more pronounced symptoms. Urine flow can be disrupted, you need to push frequently to urinate, which often leads to hernias and prolapse of the rectum. After visiting the toilet, there is a feeling of dissatisfaction, incomplete emptying. The disease develops more actively, the transition to the next form takes relatively little time;
  • III - due to the cumulative effect, the bladder stretches, its elasticity decreases, infections develop, kidney stones appear, and incontinence increases. General symptoms of poisoning may also appear: weakness, lack of appetite, nausea, constipation, persistent dry mouth.

It should be understood that similar symptoms are accompanied by some types of nerve disorders and cancer. An accurate diagnosis can only be made in the clinic after conducting appropriate research.

Treatment of the disease

treatment of prostatitis in men

At the moment, prostatic hyperplasia is a fairly well-studied disease. Its treatment does not cause particular difficulties and can be carried out in various ways, depending on the severity of the disease, the type, speed and stage of development, the age of the patient, his general state of health and other factors.

In general, all methods are conventionally divided into pharmacological, non-pharmacological and surgical. There are also many recipes of alternative (traditional) medicine, including with the help of various herbal preparations, but their effectiveness has not been proven by clinical studies, and in some cases, such methods of treating prostate adenoma complicateonly the course of the disease, negatively affecting the patient's condition.

Non-pharmacological techniques

For mild symptoms or more severe symptoms that do not affect quality of life, watchful waiting, also called active waiting, is used. It consists of regular monitoring of the condition without the use of drugs. Additionally, behavioral therapy is performed, including:

  • refusal to take anticholinesterase drugs and diuretics without further instructions from the attending physician;
  • mandatory complete emptying of the bladder before bedtime;
  • physiotherapy exercises, Kegel exercises and other actions aimed at training the pelvic muscles;
  • reducing the use of diuretic products and liquids, in particular - three hours before going to bed.

The technique is used both independently and in addition to drug therapy.

Pharmacological treatment

A number of medications can be prescribed for severe to moderate symptoms, including:

  • alfuzosin, tamsulosin and other alpha blockers;
  • solifenacin, M anticholinergics, muscarinic receptor blockers - with a clear predominance of symptoms caused by congestion;
  • type V phosphodiesterase inhibitors - commonly used in the treatment of impotence and its causes, but have been shown to be effective in the treatment of hyperplasia;
  • finasteride and other 5-alpha-reductase inhibitors: reduce the proliferation rate of prostate tissues, reduce its size.

These and other drugs are usually used before surgery or in cases where it is contraindicated for some reason.

Surgery

Surgery is now considered the "gold standard" and the most effective treatment for prostate adenoma. With their help, you can achieve complete removal of prostate adenoma with minimal consequences for the body, while maintaining normal urination and erection. Their main advantage is the ability to apply at any stage of the disease. In our clinic, several main types of surgery are performed. The decision on how to treat prostate adenoma is made by the attending physician together with the patient after a thorough examination and examination.

Open adenomectomy

Open adenomectomy is a classic surgery that involves an incision in the perineum or lower abdomen and the removal of inflamed glandular tissue using various tools. The main advantage of the method is its good knowledge and the absence of the need for special equipment, so it can be used in almost any clinic. However, due to the opening, the operation is often accompanied by extensive bleeding. In addition, due to the proximity of the prostate to the nerve nodes, there is always the risk of damage leading to impaired sexual and urinary functions.

Transurethral resection

TURP of prostate adenoma is a procedure to remove part of the prostate gland using an electroresection loop. Today it is one of the most preferred and frequently performed operations due to its low invasiveness. All tools are brought to the formation through the urethral canal without incisions, as a result of which there is no blood loss, there are no scars on the skin, and the recovery period is a few days. Also, during the procedure, complete information about the state of the urinary system is collected and any abnormalities found are eliminated.

News in the treatment of prostate adenoma

The most promising are minimally invasive methods using advanced technologies and equipment. These include:

  • Holmium laser enucleation of prostatic hyperplasia (HoLEP) - the operation is performed through small incisions (up to 2 cm). With the help of a laparoscope, a laser fiber is introduced into the bladder and through its neck to the gland. The adenomatous tissue is removed by light incisions made with an ultra-precise and safe holmium crystal laser, after which it is morcellated. This approach guarantees almost complete absence of damage to healthy tissues and minimal blood loss;
  • transurethral photoselective vaporization - the method consists in the complete combustion of damaged tissues using focused laser radiation without damaging healthy cells. The operation is performed through the urethral canal, which excludes any incisions and scars, allows to obtain a minimum number of relapses, reduces recovery times to several days;
  • robot-assisted laparoscopy - performed using the "Da Vinci" advanced robotic complex, equipped with the tools and equipment necessary for video shooting. The check is performed by an experienced surgeon on a special terminal and the camera image is displayed on a large, high-resolution monitor, which greatly expands the operating field. Special algorithms of the robot smooth out all sudden and random movements of the operator, completely eliminating a human factor such as tremors. The use of the complex allows you to perform the operation as accurately and accurately as possible, through small incisions of several millimeters.

All these methods have a significant drawback - expensive equipment and the need for experienced skilled personnel to work with them. Therefore, these techniques may not be used in all hospitals.