The most common urological pathology, which a urologist is referred to by men older than 45 years, is prostate adenoma.The existence of this pathology significantly worsens the quality of life of men.One of the most powerful consequences of the abnormal process is the degeneration of malignant tumors of benign prostate hyperplasia.
Surgical and drug methods of treatment are used to combat prostate adenoma.Hospital specialists choose the most effective drugs or methods of surgical intervention, taking into account the disease, general condition and age, as well as the presence of related pathologies.Comfortable conditions for the treatment of patients were created at the Surgery Clinic.
Causes of the Disease of Disease
Adenoma is most commonly associated with age -related prostate -related changes, in particular the change in its structure and the increase in measures.As a result of such changes, the urethra is gradually compressed, located in the thickness of the prostate gland and causes the urinary tract.
In men, prostate adenoma develops due to hormonal restructuring in the body associated with age -related changes.Testosterone (male hormone) levels gradually decrease with age, and the female sex hormone concentration (estrogen), on the contrary, increases.This phenomenon is called male menopause.
The development of prostate adenoma may be caused by the following risk factors:
- Patient Age - Prostate iron increases is very rare in men under the age of forty, and sixty years later diagnosed almost every second;
- Hereditary predisposition - If prostate adenoma is diagnosed in human close blood relatives, it has a high risk of inheritance of the disease;
- Diabetes mellitus, cardiovascular diseases-a benign tumor (adenoma) can occur not only as a result of these diseases, but also for the harmful effects of drugs for their treatment (eg, beta-blockers);
- In the wrong way of living - the risk of developing prostate adenoma increases with obesity, with insufficient physical activity.
Symptoms
Prostate adenoma may be suspected when a person appears in the following symptoms that are most typical of this disease:
- Urinary duties;
- Due to the need for abdominal muscle tension for urination;
- Pain, burning, urinary sluggish flow;
- Bladder discomfort and insufficient emptying;
- Increase the duration of the urine process.
Prostate adenoma causes not only a decrease in human quality of life, but also a severe delay in urination, which requires the use of surgical treatment methods.To prevent surgical intervention, many patients use special drugs to treat prostate adenoma, to eliminate symptoms, and to restore normal prostate action.However, only a qualified specialist can indicate the best remedy for prostatitis and prostate adenoma.It is necessary to contact it when the first symptoms of the disease appear.
Treatment of prostate adenoma individually for each patient.Preparations for the treatment of prostate adenoma, their dose and duration of use are prescribed by the attending physician.Products obtained from prostatitis and prostate adenoma can be not only ineffective but also dangerous.Due to the presence of some "personal" chronic diseases in men, drugs should be chosen to treat prostate adenoma with concomitant pathologies.
Stages of development of the disease
Prostate adenoma is characterized by a gradual development that can be divided into three stages.
- The first stage of the disease continues with minimal disorders of the urine.Its slight growth, especially at night, and the sluggish flow of urine can be observed.The first stage may last from one year to 12 years or more.
- The second stage of prostate adenoma is characterized by more pronounced urine disorders: the flow of urine flow, the need to strain in the urine, and the feeling of incomplete emptying of the bladder.The residual urine, which acquires the bladder and urinary tract, causes an inflammatory process accompanied by pain, burning sensation during urination, pain in the lower back and above the pub.
- The third stage is characterized by periodic or permanent discharge of urine, forcing the patient to use urine.
Complications
In some men of prostate adenoma, the quality of life will not deteriorate and occur without the development of complications.However, in some cases, the disease can lead to the following negative consequences:
- Severe urinary delay - It is characterized by the sudden impossibility of emptying the bladder and pain in the right side region.In a similar condition, the patient needs urgent medical care with catheterization or minor surgery;
- The case of urinary tract infections is stagnation of urine, which creates favorable conditions for the reproduction of pathogens, causing cystitis and pyelonephritis;
- The formation of stones in the bladder - is also the result of stagnation of urine;
- Urinary bladder damage - with irregular bladder protection, it stretches, the formation of protrusions (pockets) in the walls of the body in which the urine stagnates;
- Kidney Damage - Increased pressure in the urethra and bladder has a direct harmful effect on the kidneys, resulting in renal failure.
Prostate adenoma and potential
Prostate adenoma and potential are closely linked.Adenoma disrupts the structure of the gland tissue, which in turn causes the defeat of others, no less important organ - the tests responsible for androgen products.Thus, prostate adenoma can lead to impotence that requires prolonged and difficult therapy.
Diagnostics
A simple and effective way to make a preliminary diagnosis is to maintain a urinary diary by maintaining quantitative and qualitative parameters: allocated urine volume, consumed fluid characteristics, imperative calls, night demand.The main physical method of examination is if prostate adenoma suspected is a rectal examination of the prostate finger to identify its growth and exclude other pathologies.
The diagnosis of prostate adenoma in the hospital is made using the following laboratory and instrumental methods:
- General blood and urine tests;
- Biochemical blood test for kidney, urea and creatinine levels;
- Analysis for dog level (to exclude prostate cancer);
- Transrectal ultrasound examination (ultrasound);
- Urophlometry (to determine urine power);
- Determination of residual urine volume (using ultrasound);
- Pelvic lower electromyography;
- Urethocystoscopy;
- Excretion urography.
Treat
The treatment of prostate adenoma is aimed at facilitating the symptoms of the urinary tract, improving the patient's quality and developing disease complications.Patients with poorly pronounced symptoms that do not worsen the quality of life often prescribe a regular examination of a dynamic observation with a urologist that controls the course of the disease and recommends how to stop the growth of prostate adenoma.During this period, the focus is on non -drug therapy.Theert methods may be the addition of conservative treatment, which is the following medications:
- Alpha blockers (tamsulosine, alphusosine);
- 5-Alfa Reductase Inhibitors (Finsteride);
- Type 5 phosphodesterase inhibitors (Sildenafil);
- 5-alpha reductase inhibitors and alpha blockers;
- Muscarin receptor blockers or M-cholinolysis.
Patients with prostate adenoma at the advanced stage are recommended for surgical treatment, which can be performed in several ways: transurethral excretion, transurethral resection and prostate removal.
There are some instructions on the use of surgical treatment:
- Repeated delay in urine;
- Renal failure is provoked by prostate adenoma;
- Bladder stones;
- Repeated infections of the urinary tract;
- Repeats hematuria.
In addition, surgery is necessary for patients, in the absence of efficacy from the treatment of drugs.
During conservative therapy or postoperative period, patients need constant medical control with standard studies (determination of urine power speeds, ultrasound, PSA level analysis).
Medicines
There is a certain scheme that specific medications are prescribed for the treatment of prostatitis and prostate adenoma.High efficacy of treatment is achieved thanks to the use of alpha reductase inhibitors and alpha-blockers.For the treatment of prostate adenoma in men, these medications help to eliminate the underlying symptoms of the disease as well as restore sufficient urination.
Which is the most effective and widely used tablets from prostate adenoma?The list is led by Alpha1-Adrenergic receptor blockers.In addition, this list includes 5-alfa reductase, vitamins and minerals inhibitors.
Drug therapy complex includes not only drugs.With prostate adenoma, conservative treatment can be added to biologically active additives - dietary supplements that enhance the therapeutic effect of drugs and provide early recovery.Some of them include zinc.This macro element is directly involved in the synthesis of spermatogenesis and testosterone.Plant phytosterols normalize urination.
Treatment of antagonists drugs with a group of alpha 1-adreno core
These drugs for the treatment of prostatitis and prostate adenoma ensure smooth muscle relaxation of the urinary system and improve the urinary process.Tamulosine is a part of the same name of the active ingredient (alphusosine, silod, etc.), a highly consistent drug that has a selective effect on prostate muscle alpha 1-adrenergic receptors, urethra and bladder prostate.Thanks to the decrease in muscle tone, drainage and urinary release contribute.Tamsulosine, like all selective drugs, has a minimal amount of side effects, does not affect the tone of blood vessels and may be prescribed for patients with chronic hypertension.
Alpha-adrenergic receptor antagonists should be used constantly, so you can achieve a gradual reduction in irritation and delay with prostate adenoma.The drug tamulosine is a well -deserved priority for the treatment of prostate adenoma.
The form of the drug tablet is considered more progressive because of the controlled release of tamsulosin, the active ingredient in the body is in constant concentration.Medicine is evenly entered into the bloodstream, thereby reducing the likelihood of developing the main side effects of the adrenhobococcus groups - a sharp decrease in blood pressure.
An equally effective drug is a lesson with the active substance tamulosine.This drug is accompanied by the following adverse effects: orthostatic hypotension, tachycardia, an increase in angina attacks in patients who have a coronary heart disease, so it can be identified for men with cardiac pathologies.Properly selected dose and all rules on the use of alpha-blocker group drugs allow you to achieve a good therapeutic effect in the almost complete absence of side effects.
Reductase medications of the inhibitors group (blockers)
Drugs of this pharmacological group (Finsteride, Dutasteride) help to alleviate the drainage of urine and, consequently, eliminate the main symptoms of the disease.A stable therapeutic effect occurs two to three weeks after the course.All symptoms are completely suspended after three months.According to clinical trials, maximum efficiency is achieved with these drugs after six months of therapy.
Finasteride and dutasteride are specific 5 -alfa reductase -specific inhibitors (cell enzyme responsible for transforming testosterone dihydrotestosterone).The growth of prostate adenoma is directly related to a similar transformation of testosterone.Thanks to 5-alfa reductase inhibitors, intra-industrial dihydrotestosterone products are blocked and its concentration in the blood is significantly reduced.
Finsteride and dutasteride are used for the following purposes:
- Treatment and control of prostate hyperplasia;
- Improvement of urine drainage and elimination of symptoms of prostate adenoma;
- Reduce the risk of developing acute urinary retention and the need for surgical intervention.
Finasteride and dutasteride have a pronounced anti -i -dyrogenic effect, that is, it helps to reduce the levels of male hormones in the blood.In addition, these drugs have a teratogenic effect, so their caution should be taken.With the help of modern drugs, you can stop the growth of prostate and avoid the need for surgical treatment.
Antispasmodics and analgesic tablets with exacerbation of disease
The main recipe for antispasmodic and analgesic effects with exacerbation of prostate adenoma is the release of the patient's general condition and the elimination of pain syndrome.Anti -and analgesic and analgesic effects are carried out by non -agricultural anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -legal antiThey promote not only the struggle with painful sensations that occur during the urination, but also with constant pain in the gum and perinum.Due to the effects of non -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -anti -aging agents, swelling of the prostate gland decreases, body temperature is normalized, and unpleasant symptoms are eliminated.
Neopoid analgesics produced in tablets or candles help to stop pain syndrome by exacerbating prostate adenoma.The most affordable of these is sodium metamizole.However, this drug is more intended for single use, as it can only affect weak pain syndrome.In addition, analgesics are effective with lidocaine, benzocaine, anesthesine and novocaine (Ikhamol, benzocaine, tribenoside + lidocaine).
Vitamin E 400
Tocopherol acetate or vitamin E is often part of prostate adenoma as an antioxidant, radio -producer agent and a complex treatment of an indispensable connection in reproductive processes.Vitamin E 400 mg of urologist is prescribed in patients with erectile dysfunction and spermatogenesis associated with the adenoma of the prostate gland.
Treatment of such a serious chronic disease as prostate adenoma should be prescribed and controlled by a urologist.It is strictly forbidden to take certain medications independently without prior consultation with the attending physician, as in this case self -government can be not only ineffective but also dangerous to the health of men.Only a qualified specialist can indicate which tablets from prostate adenoma are most effective in each case, and which can lead to negative consequences.
Actions
Hospital urologists skillfully perform classical and minimal invasive surgical interventions, use innovative methods of surgical treatment of prostate adenoma.Each patient has chosen the surgery that is more suitable for it.
The generally recognized standard in the surgical treatment of prostate adenoma is the transurethal resection of prostate.The operation is very effective.After the intervention, patients avoid infrasive obstruction (narrowing of the urethra) and the symptoms associated with them.The rehabilitation period is short.During or after surgery, bleeding, "water intoxication" syndrome may develop.
Alternative methods of treatment for prostate adenoma include the following surgical interventions:
- Stenting;
- Bladder dilatation;
- Hyperthermia;
- Thermotherapy;
- Ultrasound, laser and needle ablation;
- Interstitial coagulation.
After them, complications arise more often, but these methods are subordinate to transurethral resection in terms of efficacy, both clinical and economically.
Laparoscopic removal of prostate adenoma is used when the tumor is significantly increased and its removal is problematic using transurethral resection.This operation is more difficult to perform under anesthesia.With small wounds, the surgeon introduces special instruments in the body cavity, which performs the removal of prostate adenoma.Operation is carried out from the video cameras as shown on the screen.The main advantages of the intervention are the minimum volume of blood loss, with a slight likelihood of complications.After surgery, the patient does not need long rehabilitation.
When there are signs of prostate adenoma in men, doctors use a high -tech method to treat adenoma - laser enuclear.Intervention is performed in large dimensions of neoplasm.Excess fabrics are removed using a laser.The operation is performed through the urethra.The tumor is separated, divided into small pieces and then shown.The method is considered minimal invasive.It has many important advantages: it does not disturb the integrity of the cavity, does not cause excessive damage.
Laser evaporation involves the destruction of adenoma through laser evaporation.Through the urethra, the urologist presents a special device, imported into a neoplasm and is influenced by a strong green laser.The depth of laser penetration and the accuracy of its hit can prevent damage to neighboring areas.The method is minimal, bloodless, fast and effective.Its only disadvantage is the inability to obtain tumor tissue for histological examination.
In some situations, abdominal surgery - adenomectomy - is an inevitable method of treatment for prostate adenoma.It is performed when other methods cannot help the patient.During surgery, a surgeon with a scalpel performs the prostate gland and manually, using surgical instruments, removes adenoma.As a result of surgery, significant blood loss can occur, complications develop.After surgery, the patient needs prolonged rehabilitation.
Removal of prostate adenoma by guardianship (transorial) adenomectomy consists of a radical excretion of prostate hyperplasia tissue through the longitudinal wound of the abdominal wall and bladder.Surgery is performed at an advanced stage of the disease, when the tumor reaches large measures, the bladder is unresolved due to the accumulated urine drain, and renal failure develops.
The bubble is pre -offended and filled with sterile solution of furacillin or other substance.Then it is excreted and taken in two places in a special holding, for which they prepare the body wall.The surgeon distinguishes the formed fold and performs the bladder opening.
At the inner end of the urine catheter, it defines the area of the bladder neck and around the urethra holes that appeared in the field of vision, retreating 0.5-1 cm from it, forming the mucous membrane of the mucous membrane.Thereafter, the operating urologist penetrates the finger into the thickness of the prostate, enters it between the tumor capsule and the adenomatous nodes, and puts it on the latter.At the same time, the doctor gives the gland to the front of the patient in the rectum of the patient, in the rectum in the anterior abdominal wall.This is more accessible for manipulation.Thanks to this technique, the time of operation is reduced and blood loss decreases.
The surgeon then performs a remote adenoma bed with hemostasis (stopped bleeding) and bladder, leaving thin drainage in the wound.It is designed to wash the resulting blood clotting from its cavity.The urine catheter, which is introduced before surgery, is not removed for 7-10 days.Around it, a new section of the urethra is created during the prostatic part of the urethra.
Cuspular adenomectomy refers to all the methods used for the adenoma of the prostate gland.It is accompanied by the risk of developing the following complications:
- Bleeding from neoplasm housing;
- Stagnant pneumonia;
- The function of a decreased intestinal motor evacuation, which is manifested by constipation.
To prevent complications, after surgery in the hospital, the patient is performed early activation.The following adverse effects of operations can be taken to remove prostate adenoma:
- Inadequate bladder drainage;
- Narrowing his neck;
- Urinary infiltration of near -pus tissue;
- Formation of "prenatal" (residual cavity where prostate adenoma was removed);
- Formation of narrowing of the urethra lumen;
- Urinary incontinence.
This has a negative effect on the quality of life of patients and continues to restore adequate urination.
The results of the operation are less pronounced when the intervention is performed using a laparoscope.Laparoscopic surgery to get rid of prostate adenoma is one of the less invasive options for surgical intervention on the prostate gland.Hospital urologists use this technique if the patient has a sufficiently large adenoma of the prostate.
If the prostate gland with adenoma does not exceed 120 cm3, it is recommended for the transurethral resection of prostate adenoma.But 10% of patients who need surgery are not suitable because iron reaches more than 120 cm3.Laparoscopic surgery is not performed during the relief of prostate adenoma, the angina hernia, the bladder diverticulum and the lower extremities of the lower extremities.In this case, the decision on the possibility of surgery is made by a college, an andrologist, abdominal surgeon and other hospital specialists.