Adenoma of the prostate is a benign tumor that develops from stromal or glandular epithelium of the prostate. The adenoma does not give metastases, however, you can that with the passage of time, to be reborn in adenocarcinoma (prostate cancer).
The 30-40 % of men over the age of 50 years and 75% to 90%, over 65 years of age, changes occur in the form of expansion of glandular tissue in the area of the neck of the bladder.
What is this disease, why it occurs in men after the age of 40, what are the first symptoms that is prescribed as a treatment that you consider the most.
What is the adenoma of the prostate?
The prostatic adenoma is a neoplasm benign paraurethral glands around the urethra. The main symptom of prostatic hypertrophy of the prostate - violation of urination due to the progressive sdavleniya of the urethra one or more of increasing the appearance of nodules.
In the adenoma, there is an increase of authority, which causes the pressure of the bladder and the urethra. This violates the flow of urine and leads to the accumulation of residual urine. Additionally, men may develop an infection of the reproductive tract, urolithiasis and cancer. The increase occurs without pain, which is dangerous for the rapid diagnosis of the disease.
The prostate gland: what is it?
The prostate gland, also known as the prostate is an organ that is located just below the bladder. The main purpose of the prostate – specific elaboration of a secret, that forms part of semen. The secret of the prostate gland, determining the consistency of the ejaculate (in particular, contributing to its aclaracin), contains vitamins, enzymes, immunoglobulin, zinc ions, etc
The main functions of the prostate are:
- the dilution of semen and thanks to this, the spermatozoa acquire active mobility and, in general, are viable;
- the development of secrecy in its composition has enzymes, proteins, fats, hormones, without the gender, the system will not operate normally;
- the release of seed of smooth muscle of the prostate are able to reduce, which allows for the entry of the seed into the urethra, and that way, and produces the ejaculation.
The causes of the
The adenoma of the prostate develops and grows little by little. Although the disease is mainly found among the elderly men, the initial symptoms can be detected already in the 30-40 years. It is interesting that the first, the appearance of nodules of cells of the mass formed, and only after a long period of time, begin to grow in size.
The causes of the development of:
- In the first group are causes arising from the way of life of the person, that increase the likelihood of expansion of the prostate. For example, this may be sedentary work or intellectual assets of the load if not physical. That is why the role of regular physical exercise it is difficult to overestimate.
- The second group includes the objective reasons that do not depend on the way of life of the person. It has been demonstrated that the adenoma of the prostate occurs because of a hormonal change in the background of the men. If we consider that these changes inevitably occur in old age, one can come to the conclusion that only some men have the luck to avoid problems with the prostate gland.
There are a number of factors that can contribute to the development of adenomas. These include:
- Excess weight (accumulation of adipose tissue that are involved in the production of the female hormones);
- A hereditary factor;
- The abuse of tobacco and alcohol;
- The inflammatory processes in the kidneys and the urinary canal;
- The sedentary lifestyle and poor diet;
- The high blood pressure.
Types of benign prostatic hyperplasia
By the structure and the location of the distinguish three types of adenomas:
- The tumor through the urethra penetrates into the interior of the bladder, deforming the internal sphincter and disrupting their function.
- The tumor increases towards the rectum, urination is disturbed slightly, but the loss of the contractile capacity of the prostatic part of the urethra does not allow to fully release the bladder.
- When the uniform compaction of the prostate, under the pressure of adenomas without any increase, are not observed or the delay of urine in the bladder, or of the violation of urination. It is more favorable type of hypertrophy.
The symptoms of prostate hypertrophy in men
There are two groups of symptoms of benign prostatic hyperplasia: irritatio and obstructive.
The first group of symptoms in the prostate hypertrophy refers to:
- increased urination,
- the persistent (mandatory) urgency in urination,
- the incontinence of the urine.
In the group of obstruction of the symptoms characteristic of the adenoma of the prostate include:
- difficulty urinating,
- the start delay and increase in the time of urination,
- feeling of incomplete evacuation,
- urination, slow flashing with a jet.
The first symptoms that you should pay attention:
- The first symptoms of benign prostatic hyperplasia – a slow urine stream, increased urge to urinate, which does not always end with the emptying of the bladder.
- As the tumor acquires serious dimensions, the patient no longer has the desire to find out the causes of hypertrophy of the prostate, as she shakes, the way to get rid of your symptoms. The urination is difficult, it is necessary to endeavor to urinate, connect the abdominal muscles.
With the complication of hypertrophy of the prostate, and its path in the hard stage all the symptoms are going to rise, which would negatively impact the patient's life. In complex cases, can help only the operation, that is why it is so important to pay attention to the symptoms. Even if it was reported 1-2 times, it is necessary to undergo a full examination.
The main changes in the urination this stage:
- more frequent,
- less free,
- not such intensity as before (the stream of urine as you do not have the characteristic appearance of the parabola, and falls almost vertically).
As we continue the growth of the prostate and the strengthening of sdavleniya of the urethra, the following symptoms are present:
- increased urge to urinate during the day,
- the reduction of the emission of the amount of urine,
- intensification constant desire to urinate (so-called imperative of urgency),
- the participation of auxiliary muscles.
Subcompensated – enlargement of the prostate gland has reached levels, when has become very a negative effect on the function of the bladder, show the urine out of your body. Disorders occur:
- the release of the bladder occurs in portions
- the wall of the bubble increase of thickness,
- delay occurs on the part of the urine,
- when filled, the bladder can occur an involuntary loss of urine,
- matthew can be cloudy and contain blood impurities.
3 phase of the adenoma of the prostate - decompensated
There was a fall in the contractile ability of the bladder to the minimum limits, the increase of the residual urine can be in the order of two litres. Also relevant is the drastic cut in the bladder, that its outline into an oval shape or a spherical shape, reaching to the height of the navel, and in some cases rises considerably.
Meanwhile, in the evening, after, and during the day, the urine systematically or consistently stands out, this happens involuntarily, a trickle of full with the bladder.
Accompanying symptoms of adenoma:
- the weakness of the,
- nausea and lack of appetite,
- the thirst and dryness of mouth.
The consequences for the men
Complications of adenoma of the prostate:
- Acute urine retention. The complication appears in 2 or 3 stages of the disease due to the oppression of the urethra exaggerated prostate.
- The inflammation of the urinary tract. Stagnant processes in the bladder lead to the proliferation of bacteria. Promote the development of cystitis, urethritis, pyelonephritis.
- Urolithiasis. The incomplete emptying of the bladder causes in him, microlite, stones, or mineral deposits. They can be the cause of the obstruction of the bladder, the delay of urine.
- Hematuria. The appearance in the urine of erythrocytes, the reason becomes varicose veins of the veins of the neck of the bladder.
It is not an exaggeration if we say that an diagnosis of adenoma of the prostate is directly dependent on the patient's own. In the early stages is the survey can provide the same indicators that the specialist may suspect the presence of the disease.
The diagnosis consists of:
- The doctor will perform a digital study of the prostate.
- To assess the severity of the symptoms of benign prostatic hyperplasia, patient allow to fill in the diary urinary.
- Perform a study of the secretion of the prostate and the strokes of the urethra to the exclusion of infectious complications.
- Performed ultrasound of the prostate, in the moment that define the volume of the prostate, identified the stones and the areas with stagnant phenomena, estimates that the number of residual urine, the kidneys and the urinary tract.
The analysis of PSA in prostate hypertrophy is an important factor in determining the extent of disease and the assignment of the treatment. This study recommended to pass each one of the men over the age of 40 years, every year, since diagnosed with any deviation in the prostate and helps to determine even cancer of the adenoma of the prostate.
Each gram of prostatic hyperplasia of the prostate increases PSA levels of 0.3 ng/l, while each gram of a malignant tumor in 3.5 ng/ml in the adenoma of the prostate, the level of prostate specific antigen almost never rises above 10 ng/ml). If this happens, it causes the suspicion of cancer.
The treatment of benign prostatic hyperplasia
The standard treatment of the adenoma of the prostate in men can be carried out with medicines, rapid and little invasive. The methodology is a surgical operation, which is assigned to all patients with infravesical obstruction.
The treatment of adenoma of the prostate, depending on the stage:
- The first stage can often be done conservative treatment, which, however, does not exclude the manifestations in the acute form, and frequently of delay of the urine, increased frequency of urination (on the order of up to 10 times), the education of bleeding in the stagnation of the veins of the bladder or of the appearance of the larger stones in it. All this, in turn, leads to the forced measure in the form of rapid intervention, even in the absence of residual urine.
- The second phase. The gold standard of the assistance in this stage — the removal of the adenoma with the operation, using a variety of minimally invasive and classical methodology.
- The third phase. Here the main objectives is to ensure a good flow of urine, to remove the intoxication. In this case the use of the percutaneous puncture nephrostomy, cystostomy, etc Following normalized state of the liver, the kidneys, the cardiovascular system, and then decide the question of a possible future, the line of treatment.
Take the medicine for the solution of the symptoms and manifestations of the disease refers to that respects the methods of therapy, which makes it possible to avoid surgical intervention. The effectiveness of the medications depends on the severity of the adenoma.
- The alpha-blockers relax the muscles of the bladder and of the prostate, normalize the process of urination.
- Inhibitors of 5-alpha-reductase are required to reduce the amount of glandular tissue of the tumors of the prostate, control and correct the hormonal state.
- Antibiotics are needed to reduce the activity of pathogenic flora, if the cause of the appearance of adenomas is the infection and its rapid multiplication.
- The anti-inflammatory drugs are needed by man for the quick removal of the inflammation of the prostate, the sharp reduction of pain syndrome in the adenoma of prostate.
- Antispasmodics man are necessary in case of pain syndrome even when the enforcement of a strict diet does not retreat, does not weaken.
Surgical measures are applied to the ineffectiveness of conservative therapy, or when the neglect of the disease. In the adenoma of the prostate, the operation is assigned to the absolute of the evidence:
- The inability to urinate;
- Massive haematuria;
- The stones in the bladder;
- Pathological processes in the prostate;
- The average increase of the proportion of the prostate;
- The kidney failure;
- Large crowds of the residual urine.
Non-scheduled (emergency contraception), the surgery is done during the day, after you set the development of complications, with a strong bleeding, threatened the life of the patient, and in case of delay of urination in a severe manner.
Distinguish the different methods of surgical treatment of benign prostate hyperplasia:
- Transurethral resection of the TOUR – the most widely used method, since this operation is done through the urethra without cuts. However, it can be applied only when the mass of the adenoma up to 60 g and 150 mg of the residual urine in the bladder. In addition, this method cannot be used in the renal failure patient.
- Adenomectomy (open prostatectomy) is a method of surgical treatment of the benign prostatic hyperplasia due to the lower amount of contraindications. Its important to use when the mass of the prostate is over 40 g and the amount of the residual urine 150 ml does Not prevent the accomplishment of the surgery and several of the complications of the pathology.
The diet of hypertrophy
The power mode is adjusted to each patient individually, taking into account the degree of negligence of the pathology, the patient's general condition and medical history, as well as the flavor of the affiliation of the patient. But, as practice shows, without changing the mode, and the balance of power does not happen.
Special attention to play products rich in selenium (Se) and zinc (Zn), which is favorable to the tumor, reducing its size. During the disease, the man must receive throughout the day to 25 mg of zinc, and not less than 5 micrograms of selenium.
The adenoma of prostate is a serious disease that requires timely treatment, but only under the supervision of a specialist. No self-medication here is not allowed. Everything good and take care of your health!