To date, the only method of treatment that is guaranteed to relieve a man of a benign neoplasm of the prostate gland, which is an adenoma, is an operation. But at the initial stage of the disease and in the presence of contraindications to surgical intervention, medicamentous treatment of adenoma of the prostate gland, or prostate, whose purpose is to reduce the severity of constantly progressing symptoms of the disease, is used.
Table of contents:
- Symptoms of prostate adenoma
- Causes of
- Diagnosis of
- Treatment of prostatic adenoma
Various methods of physiotherapeutic treatment of wide distribution due to low efficiency have not been received. However, studies to develop new non-surgical methods of treatment are continuing. In many ways, their relevance is associated with the age category of patients with adenoma, and it affects mainly elderly people.
Symptoms of prostatic adenoma
Prostate adenoma manifests itself primarily as a rapid urge to urinate, often at night, with a delayed onset of urination and a weak stream of urine. Gradually, the difficulty of emptying the bladder increases, as a result, its muscular wall thickens, which is accompanied by incomplete emptying after urination, the volume of residual urine can be 100 ml or more.
In this stage, the patient has a feeling of incomplete emptying, urinating with a thin stream is possible only in several stages. There is also an acute retention of urine, the cases of which are provoked, as a rule, by the use of alcohol or hypothermia.
With further progression, the loss of tonus of the smooth muscles of the bladder, which manifests itself in the form of acute urine retention, and incontinence in the form of involuntary discharge by drop in case of bladder overflow, is characteristic. This phenomenon is called "paradoxical urination".
An important factor in the development of this pathology belongs to the age factor. With age in the male body, a number of changes occur, manifested hormonal disorders and obesity, atherosclerosis and circulatory disorders. These factors contribute to the appearance of prostatic hyperplasia. Nevertheless, there is no unified theory of the occurrence of adenoma at the present time. One can not ignore the influence of environmental factors, stress, lifestyle, alcohol abuse and smoking. Some scientists have a role in the possible emergence and development of prostate adenoma given to the deficiency of the microelement of zinc, involved in the regulation of testosterone metabolism.
Patient's typical complaints usually allow you to immediately suspect that he has an adenoma. However, differential diagnosis is necessary, with the aim of eliminating another pathology that causes a micturition disorder. To confirm the diagnosis, rectal finger examination is used, which allows to determine the increase in size and change in the shape of the prostate, evaluate its consistency and the degree of pain. Also carried out ultrasound, transbranch or transrectal, allowing you to specify the size of each share of this organ.
To study the rate of urination, uroflowmetry is used. To exclude any pathology of the bladder and urethra - cystoscopy, which allows to assess the condition of their internal walls visually. The most important point in diagnosing adenoma is differentiation from a cancerous tumor, for this use the method of pneumocystography and the determination of oncomarkers. In addition, additional information about the pathological process can be obtained by laboratory tests of blood and urine: general tests, biochemical blood tests.
Treatment of prostate adenoma
According to the symptom scale, which in 1993 proposed an international committee for the treatment of adenoma based on an assessment of severity in points of urinary disorders, for an amount up to 8 points of active treatment is not required, for an amount up to 18 points conservative therapy is necessary, andif the score is 18 or more, surgical treatment is indicated, unless there are contraindications to it.
The operation method is chosen depending on the general condition, the severity of the symptoms, the size of the adenoma, the volume of residual urine. To date, preference is increasingly being given to minimally invasive methods, the loss of blood at which is minimized, performed, as a rule, under spinal anesthesia.
There are following methods of surgical treatment of this pathology:
- open adenomectomy( prostatectomy);
- transurethral resection;
- transurethral vaporization;
- radiation destruction;
- laser ablation.
Open adenomectomy remains the most common type of surgical treatment. Indications for this operation are the mass of adenoma 40 g and more, the volume of residual urine from 150 ml, as well as various complications of adenoma or suspicion of its malignancy.
Transurethral resection through the urethra without incisions. But for its implementation there are restrictions: the mass of the adenoma should not be more than 60 g, and the volume of residual urine should not be more than 150 ml.
Transurethral vaporization, laser destruction and ablation of the prostate gland are more gentle methods, which are possible with an adenoma mass exceeding 60 g. These methods are preferred if necessary to preserve genital function.
The operation allows to completely rid the urinary tract from compression. But even the most simple operation has some contraindications and can be accompanied by complications. In a number of cases, operations end in a lethal outcome. Therefore among surgeons there is an opinion, that the best operation is that which it was possible to not do.
The effectiveness of physiotherapy for this disease is extremely low, and medical therapy at the initial stage consists in the use of the following two groups:
- relaxing smooth muscle medicines that facilitate the process of urination;
- preparations blocking the transition of testosterone into its active form, which allows to reduce the volume of the prostate gland and, as a result, the pressure on the urethra.
The side effect of the drugs of the first group is the possibility of retrograde ejaculation( pelting the sperm through the urethra into the bladder).Side effects of the drugs of the second group - a decrease in sexual desire, including impotence, and the same retrograde ejaculation.
In addition to these two methods, there is a popular method for physiotherapy of prostate adenoma - radiofrequency thermotherapy. This method is based on the use of microwaves that block cell systems that affect the development of adenoma.
Folk treatment of
Folk methods of treatment of adenomas are based on the use of various medicinal plants. The most widely used pumpkin. There is also a tablet form - a pumpkin, but such treatment, which slows down the development of adenoma, can be used independently. Use both pumpkin juice and pumpkin seeds.
Various herbs are also used to treat adenoma. Treatment with folk methods can be combined with medication.
- Cystoscopy of the bladder
- Adenocarcinoma of the prostate in the elderly