Prostatic hyperplasia: signs and treatment of the disease

Prostatic hyperplasia is observed mainly in older men.

According to statistics, in people over 65 years of age, pathology is detected in 85% of cases and is expressed in the formation of a benign tumor, which increases in size over time.

As a result, representatives of the stronger sex have difficulty urinating due to compression of the urethra. In the absence of timely medical care, the disease causes serious complications.

What is this pathology?

Benign prostatic hyperplasia is changes in the tissues and cells of the prostate and further enlargement of this organ. The neoplasm is formed from glandular epithelium, which at the initial stage of development has the appearance of small nodules.

But over time, the nodules increase in size, leading to the growth of a benign tumor. The development of a tumor does not lead to the growth of metastases, but with advanced pathology and lack of timely treatment, prostate hyperplasia can develop into a malignant formation (carcinoma).

In medical terminology, there is another common name for this disease - prostate adenoma or prostatitis.

BPH of the prostate gland - causes

One of the most common factors in the development of adenoma is heredity.

If there are close relatives in the family who suffer from prostatitis, then the likelihood of the disease increases significantly.

This category of men is recommended to undergo an annual examination from the age of thirty for timely detection of pathology. In addition to the genetic factor, sources of risk also include:

• hormonal imbalances (changes in the balance between female and male hormones);
• inflammatory processes of the pelvic organs and urogenital area;
• old age;
• sedentary lifestyle, lack of physical activity;
• frequent hypothermia;
• bad habits (tobacco, alcohol);
• unhealthy diet (predominance of fatty meat foods and lack of plant fiber);
• previous venereal diseases;
• unfavorable environmental conditions and other environmental factors.

Prostatic hyperplasia - diagnosis

Timely diagnosis, especially in the early stages, is very important for quick and successful treatment.

As a rule, it involves a comprehensive examination and includes an examination of the patient, as well as a number of instrumental studies and laboratory tests.

Diagnostic methods are selected individually for each patient, depending on the complaints and the expressed clinical picture:

• examination by palpation;
• urine analysis for red blood cells, white blood cells, protein, glucose;
• blood analysis;
• Ultrasound;
• uroflowmetry (volume and speed of stream during urination);
• contrast urography (X-ray) is prescribed if the presence of stones in the bladder is suspected;
• cystomanometry allows you to determine the pressure on the walls of the bladder;
• Urethrocystoscopy makes it possible to see the structure and condition of the urethra and bladder.

Prostatic hyperplasia - symptoms

The main feature of prostate adenoma is that it is practically asymptomatic for a long time. This is where the danger lies, since the man does not even suspect the presence of a benign formation in the body. Sensations and discomfort become pronounced only when pathological changes in the organ have occurred and the tumor has grown.

The following are the main signs of BPH, which can manifest themselves at any stage of the disease:

• frequent urination, sudden onset of urge;
• emptying in small drops, weak jet pressure;
• the stream during urination is intermittent;
• the pelvic muscles tense when emptying;
• feeling of urine residue in the bladder;
• pain when visiting the toilet;
• involuntary bowel movement;
• chronic urine retention resulting from a narrowing of the canal;
• blood in urine.

If a patient notices at least one symptom, he should take it seriously and immediately consult a doctor. You should not take this lightly and self-medicate.

Stages of development of prostatitis

In the clinical picture of the development of pathology, 3 stages are distinguished.

Prostatic hyperplasia of the 1st degree (compression) is characterized by problems with urination, mainly in the evening and at night. At the same time, the urge to go to the toilet is frequent, and the stream is very sluggish. The duration of the stage can last up to 3 years, while the main symptoms are practically not expressed. At this stage, the tumor responds very well to drug therapy.

The second stage of hyperplasia (subcompensatory) begins with serious disturbances in the functioning of the bladder, when its release poses serious difficulties. The patient feels a constant urge to urinate and spontaneous release of cloudy urine, often mixed with blood. At this stage of the disease, chronic renal failure may develop.

The third stage (decompensation) is the most severe and dangerous, since there is a complete impossibility of emptying the bladder independently. And this is fraught with rupture of its walls.

Urine is characterized by turbidity mixed with blood. During this period, a man feels constant fatigue and loss of strength. He suffers from constipation, his skin becomes pale, and he loses weight.

People suffering from grades 2 and 3 prostatitis have a persistent smell of ammonia from their mouth.

Forms of the disease

Depending on the direction of tumor growth, hyperplasia has several forms:

• subvesical (tumor grows near the rectum). With this form, the patient often experiences discomfort not during urination, but during the act of defecation;
• intravesical (the formation grows in the direction of the bladder). Ingrowth of the prostate into the bottom of the bladder leads to deformation of the neck of the upper urethra;
• prevesical - expansion of the lateral parts of the prostate adjacent to the bladder.

Types of adenoma by growth form

Based on the form of tumor tissue growth, prostate adenoma is classified into 2 types.

Diffuse prostatic hyperplasia is characterized by a uniform increase in the organ during the development of the disease without pronounced foci. Adenomatous prostatic hyperplasia is characterized by the formation of nodules inside the prostate. There can be from one to several depending on the stage and course of the disease.

Prostate hyperplasia - treatment

The treatment regimen is selected by the doctor strictly individually after diagnosis and medical history. Currently, there are 3 methods of treating prostatitis.

1. Drug (conservative) therapy. As a rule, medications are used for mild cases of the disease, as well as for contraindications to surgical interventions.

Specialists have several groups of drugs at their disposal:

• alpha1 - adrenergic blockers help relax smooth muscles and improve the outflow of urine;
• 5-alpha reductase blockers stop the growth of prostate cells, which subsequently leads to normalization of the gland;
• phosphodiesterase blockers - 5 relax the muscles in the urogenital area, which significantly facilitates the outflow of urine;
• herbal preparations contain natural extracts and extracts of medicinal plants (African plum bark, rye, nettle, pumpkin seeds, etc.).

1. Surgical methods of treating prostatitis are indicated in cases where drug therapy does not bring the desired result. The following types of surgical intervention are used:

• Transurethral resection of the prostate is the most commonly used and standard method. A tube with a metal loop and a camera is inserted into the urethra. Under the influence of an electric current, the loop removes the overgrown formation layer by layer;
• Transurethral incision of the prostate is used when the gland is not overgrown. Overgrown tissue is removed between the prostate and the bladder neck;
• Holmium laser enucleation is the most progressive method of treating pathology. A laser is introduced into the urethra, which, under the influence of high power, gradually exfoliates the tissue of a benign tumor;
• open surgery is performed in advanced stages of the disease or in the presence of stones in the bladder. It is carried out through an incision in the bladder and is traumatic, but at the same time guarantees a complete cure.

1. Benign prostatic hyperplasia - treatment with non-operative methods:

• introduction of prostatic stents (coils) into the urethra for long or short periods. Over time, stents must be removed, as untimely removal will worsen symptoms;
• microwave coagulation of the prostate – microwaves heat the prostate tissue to 70 degrees, resulting in its destruction;
• prostate lifting with an implant - this method expands the diameter of the urethra and improves the quality of life for many patients;
• cryodestruction, needle ablation, focused ultrasound, etc. are also performed.

Forecast

If you seek medical help in a timely manner and follow all the recommendations of the attending physician, the prognosis for recovery is very favorable.

Many men put off visiting a doctor for a long time because they are afraid that due to surgical intervention they will have to forget about the pleasures of their sexual life forever.

But this is a common misconception - on average, sexual function is completely restored after a month.

Prevention

In order to stop the disease in the early stages, it is advisable for men to undergo an annual medical examination by a urologist, starting at the age of 40. Since it is impossible to indicate the exact reason why an adenoma develops, all preventive measures are exclusively of a general strengthening nature.

They consist, first of all, of maintaining a proper and balanced diet - less fatty and flour products, and more fiber and protein. It is also necessary to drink a large amount of clean water, and in the evening its intake must be limited.

An active lifestyle and sports help normalize blood circulation in the pelvic organs, which helps prevent stagnation. At the same time, you should be careful about lifting heavy objects and other increased loads.

High-quality regular sex will help ensure good sexual function and prostate health. But excesses in bed and promiscuity can negatively affect a man’s health.

If there are problems with the prostate gland, doctors recommend massaging it. It not only has a beneficial effect on sexual activity and the duration of sexual intercourse, but also removes harmful substances and pathogens.

Source: https://smartprost.ru/giperplaziya-predstatelnoj-zhelezy-prichiny-simptomy-i-lechenie/

Prostatic hyperplasia in men: symptoms and treatment

Other prostate diseases

26.12.2017

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8 min.

Prostatic hyperplasia occurs in men mainly in old age.

This pathology is quite common and is characterized by the formation of a benign tumor, which begins to grow over time. As a result, men experience a lot of problems with urination.

Hyperplasia is fraught with the development of serious complications, including: inflammatory diseases of the genitourinary system and renal failure.

With the right approach, treatment of this pathology is not particularly difficult. Ultrasound examination allows it to be diagnosed at an early stage.

Prostatic hyperplasia is a purely male disease, which is characterized by the formation of a tumor in the prostate. In medicine, there is another name for this pathology - prostate adenoma.

At first, the neoplasms look like nodules, which increase in size as the disease progresses.

This leads to the fact that they put pressure on the urethra, as a result of which the process of urination is disrupted.

BPH

The main cause of diffuse nodular hyperplasia is considered to be dysfunction of the testicles and hormonal changes caused by age-related changes that begin after 45 years. The disease can develop as a result of the negative impact of other factors on the functioning of the organ.

The exact causes of prostate hyperplasia are still the subject of debate among doctors. In most cases, factors can be identified during diagnosis.

The most important factor in the development of hyperplasia is age. According to experts, there are a number of other reasons that can affect both the occurrence of pathology and the course of the disease itself. But the older a person is, the more likely he is to get sick.

Hormonal imbalance is explained by a decrease in the production of male hormones - androgens and an increase in estrogens, which is a prerequisite for the development of prostate hyperplasia. In this case, the violations are internal in nature.

Pathological changes occur at the cellular level directly in the tissues of the prostate gland. This leads to their deformation and growth.

Other factors that can affect the development of BPH include the following:

• alcohol abuse;
• smoking;
• sexual impotence or hyperactivity;
• previously suffered sexually transmitted diseases;
• consumption of low-quality products;
• hereditary predisposition;
• passive lifestyle.

The risk group includes people who have had cases of hyperplasia along the genetic line. For this category of men, starting from the age of 30, an annual examination is recommended. This approach will allow timely detection of the presence of pathology.

The main danger of hyperplasia is its asymptomatic occurrence over a long period of time. Signs become more pronounced when pathological changes have already led to tumor growth. In this case, a moderate load on the walls of the bladder may remain. The main clinical manifestations of the disease are:

• difficulty urinating;
• sluggishness of the jet;
• interruption of urination;
• inability to completely empty the bladder;
• stagnation of urine;
• blood in urine;
• increased urge to urinate, characterized by its sudden onset;
• involuntary urination;
• pain when going to the toilet;
• development of chronic urinary retention, which develops as a result of compression of the urinary canal;
• formation of stones in the bladder.

It is worth noting that the number of manifestations may vary among patients. In this case, everything depends on the size of the tumor and the severity of the disease.

In an advanced form of diffuse hyperplasia, as a result of the development of severe inflammation, the prostate can block the urinary canal, which will lead to the inability to urinate even if the urge occurs. Only urological intervention can save the situation. In this case, urgent insertion of a catheter is necessary.

In urology, there are three degrees of benign hyperplasia.

During the first - compression - stage, problems with urination appear. The occurrence of difficulties is noted mainly at night. Manifestations are accompanied by increased urge and sluggish flow.

At this stage, hyperplasia responds well to drug treatment.

The transition of the disease to the second, subcompensated stage is possible with serious impairment of the functionality of the bladder, when its release is significantly difficult.

Manifestations are accompanied by an increased urge to urinate and involuntary release of cloudy urine. Sometimes you can see blood impurities in it.

Against the background of hyperplasia of this form, chronic renal failure can develop.

The most dangerous is grade 3. It is characterized by the severity of symptoms and is characterized by distension of the bladder and the presence of blood discharge.

In this case, there is a complete impossibility of emptying the bladder, resulting in a risk of rupture of its walls.

In this situation, the patient needs urgent installation of a catheter in order to expand the urinary ducts and relieve spasm.

Prostatic hyperplasia requires high-quality diagnosis, which involves a full examination. The basis for clarifying the diagnosis is the patient’s complaints and the results of instrumental and laboratory tests. In this case, the following are assigned:

• palpation examination, through which it is possible to determine the degree of increase in the size of the prostate gland, the soreness of the organ, the presence or absence of a groove on it;
• general urine analysis;
• biochemical blood test with PSA interpretation;
• echographic examination;
• transrectal ultrasound, which allows you to visualize the prostate gland and determine the exact size of its lobes;
• uroflowmetry - a study through which you can determine the speed and volume of urine during emptying;
• urethrocytoscopy - performed to obtain data on the condition of the bladder and urinary tract;
• CT urography is performed if stones in the bladder are suspected.

Drug therapy for glandular-stromal prostatic hyperplasia shows high effectiveness at an early stage of development . In this case the following applies:

• alpha-blockers, the most popular of which are: Doxazosin and Tamsulosin. Drugs are prescribed to relieve prostate spasm and prevent urinary tract obstruction;
• 5-alpha reductase inhibitors. These drugs interfere with the production of the hormone dihydrotestosterone, as a result of which the size of the prostate decreases and the obstruction is relieved. Medicines of this type include: Dutasteride, Finasteride and Permixon.

While taking the above medications, side effects often develop: deterioration in general health, weakness, low blood pressure, dizziness.

For treatment purposes, minimally invasive methods can be used. One of them is the introduction of a special spiral into the urethra - stents. They are prescribed to patients who have not responded to conservative treatment. In the case of this manipulation, the exclusion of surgical intervention is considered mandatory. The disadvantage of this method is the possibility of spring displacement.

Treatment of prostate hyperplasia

In case of severe glandular hyperplasia, surgical treatment is advisable. Surgery is performed on the walls of the bladder or involves cutting off the affected tissue. Despite the fact that this method is traumatic, it can completely solve the problem.

The surgical technique involves inserting a resesoscope. Removal of part of the affected organ and tumor is carried out using electric discharges. Another invasive treatment option is the use of a green laser.

The advantage of this operation is the complete elimination of the risk of bleeding, since blood vessels are removed.

The use of folk remedies is an alternative way to treat prostate diseases. Herbs and minerals contain a lot of active components.

That is why alternative medicine methods should not be underestimated. But the harmful effects of natural ingredients cannot be ruled out.

That is why it is recommended to consult a specialist before using this or that product.

Several effective recipes:

1. 1. Medicinal decoction for prostatitis and hyperplasia. Prepare like this: 1 tbsp. l. horsetail is poured with cold water in a volume of one liter and put on fire for 10 minutes after boiling. Add 1 tbsp to the decoction. l. buckthorn bark, keep on fire for 5 minutes, then add 1 tbsp. l. medicinal chamomile and St. John's wort and leave for another 5 minutes. Turn off the broth by adding 1 tbsp. l. stinging nettle leaves, plantain fruits, wormwood herb. The product must be left to cool completely, after which it must be strained and put in the refrigerator. Take 2 tbsp. l. three times a day.
2. 2. Tincture for prostate hyperplasia. To prepare, you need to take celandine juice and dilute it with forty proof vodka in a 1:1 ratio. Take in the morning. Drops are added to water: drinking 1/3 glass a day will be enough. Start the first day of treatment with 1 drop of solution, adding 1 more every day, bringing the number of drops to 30. Then count them in the opposite direction. Afterwards, take a two-week break and repeat the course of treatment.
3. 3. Candles. To prepare, take 100 g of goat fat and 25. pre-crushed propolis. The ingredients should be poured into an enamel bowl and kept in a water bath for 3 hours. The fire should be low. Candles can be made from the resulting material. Use every day for a month. Then take a ten-day break and repeat the course.
4. 4. Infusion of onion peels. It is prepared as follows: take a standard glass of washed onion peels and add 500 m of water. Place on low heat, boil for 8 minutes under the lid, leave until completely cool, and strain. You need to add 3 tbsp to it. l. natural bee honey. Drink ½ glass a day for a five-day course.

Prostate hyperplasia is a serious pathology that must be treated without fail.

The active development of prostatic hyperplasia is accompanied by a gradual enlargement of the organ. The tumor can take different forms and form in different areas. For example, subvesical hyperplasia grows towards the rectum. A retrotrigonal neoplasm usually forms under the bladder.

The most common complications are:

• obstruction of the urinary canal;
• genitourinary system infections;
• bladder stones;
• bladder ruptures, diverticula;
• retention of urinary outflow;
• development of renal pathologies.

The earlier prostate hyperplasia is detected, the more the likelihood of complications decreases.

Prevention of prostate hyperplasia is of no small importance. Men are advised to give up bad habits, review their diet and adjust their lifestyle.

For pathological changes in prostate cells caused by prostate adenoma, a special diet is provided. Such patients should avoid eating fatty, fried, spicy and salty foods, smoked meats, chocolate and coffee. The main emphasis in nutrition should be on plant foods, which contain a large amount of fiber.

The ideal option for preventing adenoma would be treatment in a sanatorium. This approach will strengthen the body, eliminating the risk of developing hyperplasia, prostatitis and other diseases of the genitourinary system.

Source: https://zdravman.com/prostate/prostate-diseases/giperplaziya-predstatelnoj-zhelezy.html

Prostatic hyperplasia

Prostatic hyperplasia (prostate adenoma) is a common urological disease in which proliferation of cellular elements of the prostate occurs, which causes compression of the urethra and, as a consequence, urination disorders. The neoplasm develops from the stromal component or from the glandular epithelium.

Source: radikal.ru

Most often, the disease is diagnosed at 40-50 years of age. According to statistics, up to 25% of men over 50 years of age have symptoms of prostatic hyperplasia; at 65 years of age, the disease is found in 50% of males, and at an older age - in approximately 85% of men.

With timely and correctly selected treatment, the prognosis is favorable.

The prostate gland (prostate) is an unpaired androgen-dependent tubular-alveolar gland of external secretion, which is located under the bladder, through which the initial part of the urethra passes - the prostate gland circularly covers the neck of the urethra and its proximal section. The excretory ducts of the gland open into the urethra. The prostate is in contact with the pelvic diaphragm, the ampulla of the rectum.

The functions of the prostate gland are controlled by androgens, estrogens, steroid hormones and pituitary hormones. The secretion produced by the prostate is released during ejaculation, taking part in the liquefaction of sperm.

The prostate gland is formed by the glandular tissue itself, as well as muscle and connective tissue. The process of hyperplasia, i.e.

pathological growth, usually begins in the transition zone of the prostate gland, after which polycentric growth of nodes occurs with a subsequent increase in the volume and weight of the gland.

An increase in tumor size leads to an outward displacement of prostate tissue; growth is possible both in the direction of the rectum and in the direction of the bladder

Normally, the prostate gland does not interfere with the process of urination and the functioning of the urethra as a whole, since, although it is located around the posterior part of the urethra, it does not compress it. With the development of prostatic hyperplasia, the prostatic part of the urethra is compressed, its lumen narrows, complicating the outflow of urine.

Causes and risk factors

One of the main causes of prostatic hyperplasia is hereditary predisposition. The likelihood of the disease increases significantly if you have close relatives suffering from prostate hyperplasia.

In addition, risk factors include:

• changes in hormonal levels (primarily imbalance between androgens and estrogens);
• metabolic disorders;
• infectious and inflammatory processes of the urogenital tract;
• advanced age;
• insufficient physical activity, especially a sedentary lifestyle, which contributes to stagnation in the pelvis;
• hypothermia;
• bad habits;
• poor nutrition (high content of fatty and meat foods in the diet with insufficient amounts of plant fiber);
• exposure to adverse environmental factors.

The main goals of treatment for prostatic hyperplasia are to eliminate urinary disorders and prevent further development of the disease, which causes severe complications in the bladder and kidneys.

Forms of the disease

Depending on the direction of growth, prostatic hyperplasia is divided into:

• subvesical (the neoplasm grows towards the rectum);
• intravesical (tumor grows towards the bladder);
• retrotrigonal (the neoplasm is localized under the triangle of the bladder);
• multifocal.

Based on morphological characteristics, prostatic hyperplasia is classified into glandular, fibrous, myomatous and mixed.

Stages of the disease

In the clinical picture of prostatic hyperplasia, depending on the condition of the organs and structures of the urogenital tract, the following stages are distinguished:

1. Compensation. It is characterized by compensated hypertrophy of the bladder detrusor, which ensures complete evacuation of urine; there are no dysfunctions of the kidneys or urinary tract.
2. Subcompensation. The presence of dystrophic changes in the detrusor, signs of residual urine, dysuric syndrome, decreased renal function.
3. Decompensation. Disorder of the bladder detrusor function, the presence of uremia, worsening renal failure, involuntary loss of urine.

Symptoms of prostatic hyperplasia

The disease develops gradually. The severity of symptoms of prostatic hyperplasia depends on the stage.

The main signs of the early stage of the tumor process are frequent urination and nocturia.

The prostate gland is enlarged, its boundaries are clearly defined, the consistency is densely elastic, the stream of urine during urination is normal or somewhat sluggish.

At the stage of subcompensation, compression of the urethra by the neoplasm is more pronounced, the presence of residual urine, and thickening of the walls of the bladder are characteristic.

Patients complain of a feeling of incomplete emptying of the bladder after urination, and sometimes of the involuntary release of a small amount of urine (leakage). Signs of chronic renal failure may appear.

When urinating, urine is released in small portions, may be cloudy and contain blood. Due to stagnation in the bladder, stones can form.

Against the background of prostatic hyperplasia, serious pathologies of the urinary tract can develop: urolithiasis, pyelonephritis, cystitis, urethritis, chronic and acute renal failure, bladder diverticula.

At the decompensated stage of the disease, the volume of urine excreted is insignificant, urine can be excreted drop by drop, it is cloudy, mixed with blood (rusty color). The bladder is distended with a large amount of residual urine.

Symptoms of prostatic hyperplasia in the later stages include weight loss, a feeling of dry mouth, the smell of ammonia in the exhaled air, decreased appetite, anemia, and constipation.

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Diagnostics

Diagnosis of prostatic hyperplasia is based on the collection of complaints and anamnesis (including family history), examination of the patient, as well as a number of instrumental and laboratory tests.

During a urological examination, the condition of the external genitalia is assessed. Digital examination allows you to determine the condition of the prostate gland: its contour, pain, the presence of a groove between the lobes of the prostate gland (normally present), areas of compaction.

General and biochemical blood tests are prescribed (the content of electrolytes, urea, creatinine is determined), a general urine test (the presence of leukocytes, red blood cells, protein, microorganisms, glucose).

Bacteriological culture of urine may be required to exclude infectious pathology.

The main instrumental methods are:

• transrectal ultrasound examination (determining the size of the prostate gland, bladder, the degree of hydronephrosis if present);
• urofluometry (determination of the volumetric flow rate of urination);
• survey and excretory urography; and etc.

Most often, the disease is diagnosed at 40-50 years of age. According to statistics, up to 25% of men over 50 years old have symptoms of prostate hyperplasia.

If differential diagnosis with bladder cancer or urolithiasis is necessary, cystoscopy is used. This method is also indicated if there is a history of sexually transmitted diseases, prolonged catheterization, or trauma.

Treatment of prostatic hyperplasia

The main goals of treatment for prostatic hyperplasia are to eliminate urinary disorders and prevent further development of the disease, which causes severe complications in the bladder and kidneys.

In some cases, they are limited to dynamic observation of the patient. Dynamic observation involves regular examinations (with an interval of six months to a year) by a doctor without any therapy. Watchful waiting is justified in the absence of pronounced clinical manifestations of the disease and the absence of absolute indications for surgical intervention.

Indications for drug therapy:

• the presence of signs of disease that cause anxiety to the patient and reduce his quality of life;
• the presence of risk factors for progression of the pathological process;
• preparing the patient for surgery (in order to reduce the risk of postoperative complications).

As part of drug therapy for prostatic hyperplasia, the following may be prescribed:

• selective α1-blockers (effective in cases of acute urinary retention, including postoperative origin, in which it is impossible to empty a full bladder for 6–10 hours after surgery; improve cardiac activity with concomitant coronary heart disease);
• 5-alpha reductase inhibitors (reduce the size of the prostate gland, eliminate gross hematuria);
• preparations based on plant extracts (reducing the severity of symptoms).

In case of acute urinary retention, a patient with prostatic hyperplasia is indicated for hospitalization with bladder catheterization.

Androgen replacement therapy is carried out in the presence of laboratory and clinical signs of age-related androgen deficiency.

Suggestions have been made about the possible malignancy of prostatic hyperplasia (i.e., degeneration into cancer), but they have not been proven.

The absolute indications for surgical treatment of prostatic hyperplasia are:

• relapses of acute urinary retention after removal of the catheter;
• lack of positive effect from conservative therapy;
• the formation of a diverticulum or large bladder stones;
• chronic infectious processes of the urogenital tract.

There are two types of surgery for prostatic hyperplasia:

• adenomectomy – excision of hyperplastic tissue;
• prostatectomy – resection of the prostate gland.

The operation can be performed using traditional or minimally invasive methods.

Transvesical adenomectomy with access through the bladder wall is usually used in cases of intratrigonal tumor growth. This method is somewhat traumatic compared to minimally invasive interventions, but is highly likely to provide a complete cure.

Transurethral resection of the prostate gland is characterized by high efficiency and low trauma.

This endoscopic method involves the absence of the need to dissect healthy tissue when approaching the affected area, makes it possible to achieve reliable control of hemostasis, and can also be performed in elderly and senile patients with concomitant pathology.

Transurethral needle ablation of the prostate gland involves the introduction of needle electrodes into the hyperplastic tissue of the prostate gland, followed by the destruction of pathological tissues using radiofrequency exposure.

Transurethral vaporization of the prostate is carried out using a roller electrode (electrovaporization) or a laser (laser vaporization). The method consists of evaporating hyperplastic prostate tissue with its simultaneous drying and coagulation. Also, for the treatment of prostatic hyperplasia, the method of cryodestruction (treatment with liquid nitrogen) can be used.

Embolization of prostate arteries refers to endovascular operations and involves blocking the arteries feeding the prostate gland with medical polymers, which leads to its reduction. The operation is performed under local anesthesia through the femoral artery.

In order to reduce the risk of developing prostatic hyperplasia, timely seeking medical help at the first signs of urinary disorder is recommended, as well as annual preventive examinations by a urologist upon reaching 40 years of age.

Endoscopic holmium laser enucleation of prostatic hyperplasia is performed using a holmium laser with a power of 60–100 W.

The advantages are a lower likelihood of complications compared to other methods and a shorter rehabilitation period.

The patient is recommended to adhere to a diet excluding spicy, hot, fatty foods and alcoholic beverages.

Possible complications and consequences

Against the background of prostatic hyperplasia, serious pathologies of the urinary tract can develop: urolithiasis, pyelonephritis, cystitis, urethritis, chronic and acute renal failure, bladder diverticula.

In addition, advanced hyperplasia can result in orchiepididymitis, prostatitis, bleeding from the prostate gland, and erectile dysfunction. There have been suggestions of possible malignancy (i.e.

degeneration into cancer), but they have not been proven.

Forecast

With timely and correctly selected treatment, the prognosis is favorable.

Prevention

In order to reduce the risk of developing prostatic hyperplasia, the following are recommended:

• upon reaching 40 years of age - annual preventive examinations by a urologist;
• timely seeking medical help at the first signs of urinary disorder;
• rejection of bad habits;
• avoiding hypothermia;
• balanced diet;
• regular sex life with a regular partner;
• sufficient physical activity.

Video from YouTube on the topic of the article:

Source: https://www.neboleem.net/giperplazija-predstatelnoj-zhelezy.php

Prostatic hyperplasia: what is it and how to treat it

After 45 years, a gradual change in hormonal balance begins in the male body.

An age-related decrease in the amount of androgens leads to excessive cell growth in the prostate and a subsequent increase in organ volume.

In this case, the patient is diagnosed with “prostatic hyperplasia” (before the introduction of the International Classification of Diseases, the name “prostate adenoma” was used).

Reasons for the development of the disease

The main factor provoking the appearance of prostate hyperplasia is considered to be age-related metabolic disorders. As a result, prostate cells live longer and divide more times during their life cycle. Thus, there is a gradual proliferation of glandular tissues and an increase in the size of the organ.

According to medical statistics, a benign prostate tumor is diagnosed in almost half of men aged 50-60 years. In older age groups, the risk of detecting the disease increases: by 75-80 years, the probability of detecting pathology is 90%.

Additional causes of hyperplasia: excess weight, lack of physical activity, unbalanced diet, chronic inflammatory processes.

Benign prostatic hyperplasia: main symptoms

The prostate is located under the bladder, with its lobes surrounding the urethra. The initial stage of development of the disease is practically asymptomatic, but with further growth of the organ, additional pressure is created on the neck of the bladder, causing dysuric disorders.

In medical practice, it is customary to divide the signs of BPH into two groups:

• Obstructive symptoms include difficulty urinating, which becomes intermittent and longer. To completely empty the bladder, you have to additionally strain the pelvic muscles, and the urine stream becomes thin and sluggish.
• Irritative symptoms in later stages of BPH are manifested by functional disorders of the neuromuscular apparatus of the bladder. The patient experiences a frequent urge to urinate, regardless of the amount of urine collected, and feels heaviness and pain in the lower abdomen.

Types of BPH

There are two main classifications of prostate hyperplasia: according to the location and composition of the cells that form the tumor. Based on the type of localization, the following types of BPH are distinguished:

Type of hyperplasia	Location
Intravesical	Intravesical growth of a benign prostate tumor occurs upward, towards the bladder neck. Subsequently, prostate tissue may partially penetrate into its cavity, causing serious disturbances in the outflow of urine.
Prevesical	In this case, the tumor forms in front of the bladder. This location of the tumor does not affect the outflow of urine, and therefore the disease is practically asymptomatic.
Subvesical	The lateral lobes of the prostate gland do not change in size, tissue growth occurs towards the rectum. In the later stages of this type of BPH, dysfunction of the upper urinary tract may occur.

Depending on the tissues in which pathological processes occur, the following types of adenoma are distinguished:

• Glandular or nodular prostatic hyperplasia is formed from secretory cells. Initially, single adenomatous nodules appear in the tissues, subsequently their size and number increase.
• Fibrous or glandular-stromal hyperplasia of the prostate gland is formed from cells of glandular and connective tissues. In the absence of timely treatment, cystic cavities may appear in the prostate, which can degenerate into malignant neoplasms.
• Muscular or diffuse prostatic hyperplasia is formed from smooth muscle epithelium.

Stages of prostatic hyperplasia

The development of pathology is conventionally divided into three stages: compensated, subcompensated and decompensated. Determining the stage of the disease is mandatory when making a diagnosis, since the choice of treatment method and the prognosis for the patient depend on this.

First stage of the disease

BPH of the 1st degree lasts from 1 to 5 or more years and is manifested by minor urination problems. The first sign indicating diffuse changes in the prostate is an increase in nighttime urges up to 3-4 times. An increase in the size of the gland leads to a narrowing of the lumen of the urethra; therefore, emptying the bladder may occur with delays and interruptions.

At the first stage, there are no noticeable changes in the structure and functioning of the organs of the urinary system.

Second stage of hyperplasia

The subcompensated stage is characterized by significant disturbances in the urination process. To completely empty, you need to additionally strain the muscles of the pelvic floor and abdomen.

Constant pressure on the walls of the bladder causes stretching and loss of tone of the muscle fibers and the formation of diverticula - bulging and sagging pouches.

Subsequently, urine begins to accumulate in the diverticula, which is not excreted during urination.

Stage 2 prostate hypertrophy provokes kidney dysfunction, which is manifested by thirst and the smell of acetone from the mouth. The course of the disease can occur in waves: alcohol consumption, hypothermia, and stressful situations cause short-term exacerbations with deterioration in well-being.

Third stage of the disease

At the last stage of the disease, the volume of residual urine increases to 1 liter. The smooth muscles of the bladder almost completely lose their ability to contract.

During periods of exacerbation, the patient may develop acute urinary retention. At the same time, ammonia contained in urine inhibits the metabolism of amino acids and negatively affects the functioning of the brain and nervous system.

The absence of urine outflow for a long time leads to general poisoning of the body, followed by death.

Diagnostic methods

When contacting a urologist, the patient is prescribed a comprehensive examination to make an accurate diagnosis, identifying the stage and type of BPH. The list of required studies includes:

• palpation;
• uroflowmetry (measurement of jet pressure);
• Ultrasound (characteristic echo signs of BPH: heterogeneous tissue structure, irregular shape and lack of clear outlines of the organ);
• cystomanometry (measurement of urine pressure).

Patients with a predisposition to cancer require additional differential diagnosis to exclude the presence of cancer.

What is bacterial prostatitis

Prostatic hyperplasia: code according to ICD-10

In the International Classification of Diseases, adenoma is included in the section of diseases of the genitourinary system called BPH (ICD-10 code - No. 40).

The reference book describes in detail the standards for the treatment of BPH, provides clinical recommendations, and lists the groups and names of drugs recommended for use.

Treatment of prostatic hyperplasia

After a man is diagnosed with BPH, the attending physician selects the most appropriate treatment method. In urology, several effective techniques have been developed and successfully used that make it possible to avoid surgical intervention even in the later stages of adenoma.

Patient monitoring

When diagnosing the initial stage of the disease, the patient may be recommended periodic examinations and monitoring of the condition without drug treatment. Correcting your diet and lifestyle, and agreeing with your doctor on the use of medications often leads to reversible processes.

Drug therapy

In cases where prostatic hyperplasia was detected at the first stage, the patient is prescribed drug therapy. The course of treatment includes taking two main groups of drugs:

• Alpha-blockers help eliminate urinary disorders: they reduce the number of urges, increase the lumen of the urethra and ensure complete elimination of fluid. Medicines in this group include Omnic, Adenoprost, Urocard, Artezin.
• The action of 5-alpha reductase inhibitors is aimed at blocking enzymes that promote uncontrolled cell division. Long-term use of drugs helps slow tumor growth, and in some cases, reduce its size. Patients are usually prescribed Finasteride or Dutasteride.

If necessary, in addition to basic medications, antibiotics and herbal medicines are introduced into the course. Folk remedies can be used as maintenance therapy.

TOUR

If, after reviewing the medical history and deciphering the research results, the attending physician determines the second stage of the development of the pathology, the patient may be recommended surgical intervention. Modern medicine offers minimally invasive methods for removing tumors. The most effective is transurethral resection.

The procedure involves inserting a special instrument through the urethra. Using a loop located at the end of the instrument, parts of the adenoma are sequentially cut off until the tumor is completely removed.

TUR of the bladder is contraindicated if there is a risk of hyperplasia degenerating into a malignant tumor.

Open adenomectomy

At the last stage, when treating BPH with other methods is ineffective, adenomectomy is performed. The operation involves opening the abdominal cavity and completely removing the prostate.

Prevention

To preserve men's health, you should give up bad habits, avoid hypothermia, review your diet (if possible, exclude fatty foods, limit the consumption of spices, baked goods, strong tea and coffee). Regular sex life will help normalize the balance of hormones.

After reaching 50-55 years of age, it is recommended to undergo annual examinations with a specialist. After 60 years, you need to visit a urologist twice a year.

Timely detection of prostate hyperplasia will slow down the progression of the disease and improve the quality of life without the use of surgical intervention.

Source: https://men-zdrav.ru/bolezni-prostaty/giperplaziya-predstatelnoj-zhelezy.html