The most common urological pathology, addressed to the urologist, men over 45 years old, is prostate adenoma.The presence of this pathology significantly exacerbates the quality of life of men.One of the most terrible possible consequences of the pathological process is the degeneration of benign prostate hyperplasia in malignant tumor.
To combat prostate adenoma, surgical and pharmaceutical methods of treatment are used.Hospital experts choose the most effective drugs or methods of surgery taking into account the stage of the patient's disease, general condition and age, as well as the presence of related pathologies.Comfortable conditions for the treatment of patients have been created in the surgery clinic.
The causes of the development of the disease
The appearance of adenoma is more commonly linked to the age -related changes in the prostate, that is, a change in its structure and increased size.As a result of such changes, the urethra is gradually compressed, which is at the thickness of the prostate gland and there are violations of the urination process.
Prostate adenoma in men develops due to hormonal restructuring of the body associated with age -related changes.The level of testosterone (male hormone) gradually decreases with age, while the concentration of female hormone (estrogen), on the contrary, increases.This phenomenon is called male menopause.
The development of prostate adenoma may be due to the following risk factors:
- The age of the patient - the increased iron iron is extremely rare in men under forty years, and after sixty years is diagnosed almost every second.
- Hereditary predisposition - If the prostate adenoma was diagnosed with close blood relatives, it has a huge risk of inheriting this disease during adulthood.
- Diabetes mellitus, cardiovascular disease-a benign tumor (adenoma) of the prostate can occur as a result of not only these diseases themselves but also the harmful effects of drugs to treat them (for example, beta-blockers).
- The wrong lifestyle - the risk of developing prostate adenoma increases in men with obesity, inadequate physical activity.
Symptoms
Prostate adenoma may suspect when a person appears in the following symptoms that are most characteristic of this disease:
- duties of urination;
- the appearance of the need for abdominal muscles for urination.
- the presence of pain, combustion, hypotonic urine current.
- Discomfort and inadequate bladder evacuation.
- Increasing the duration of the urination process.
Prostate adenoma leads not only to a reduction in a person's quality of life, but also to acute delay in urination, which requires the use of surgical treatment methods.In order to avoid surgery, many patients use special medicines to treat prostate adenoma, eliminating symptoms and restoring the normal activity of the prostate.However, only one expert can suggest the best treatment for prostatitis and prostate adenoma.It is necessary to contact this when the first symptoms of the disease occur.
Treatment of prostate adenoma individually for each patient.Preparations for the treatment of prostate adenoma, their dosage and duration of use are determined by the treating physician.Downloading products from prostatitis and prostate adenoma independently can not only be an ineffective but also a dangerous measure.Due to the presence of men in the older generation of certain "personal" chronic diseases, medicines for the treatment of prostate adenoma should be selected by taking into account accompanying pathologies.
Stages of disease growth
Prostate adenoma is characterized by gradual growth, which can be divided into three stages.
- The first stage of the disease progresses with minimal urination disorders.Its insignificant increase, especially at night, and a hypotonic urine stream can be observed.The first stage can last from one year to 12 years or more.
- The second stage of prostate adenoma is characterized by more intense urinary disorders: urine stream breaks, the emergence of the need for erection during urination and insanity of the bladder evacuation.The residual urine, which remain in the bladder and urinary tract, cause an inflammatory process accompanied by pain, burning sensation during urination, lower back pain and above the pubis.
- The third stage is characterized by periodic or constant unintentional urine release, which forces the patient to use the ureter.
Complications
In some men in prostate adenoma, the quality of life does not worsen and progresses without the development of complications.However, in some cases, the disease can cause the following negative consequences:
- The acute delay in urine - is characterized by a sudden inability to evacuate the bladder and pain in the area to the right.With a similar condition, the patient needs medical emergency care with catheterization or small business.
- The occurrence of urinary tract infections is urine stagnation, which creates favorable conditions for the reproduction of pathogens, leads to the development of cystitis and pyelonephritis.
- The formation of stones in the bladder - is also a consequence of urine stagnation.
- Damage to the bladder - with irregular bladder evacuation, is stretched, the formation of protrusions (pockets) on the walls of the instrument, in which the urine stagnates.
- Kidney damage - increased pressure on ureters and bladder has immediate damage to the kidneys, as a result of which renal failure is developed.
Prostate Prostate and Power
The adenoma and prostate power are closely interconnected.The adenoma disrupts the structure of the tissue of the glands, which, in turn, leads to the defeat of another, no less important instrument - the testicles responsible for androgen products.Thus, prostate adenoma can cause impotence that requires prolonged and complex treatment.
Diagnosis
A simple and effective way to determine a preliminary diagnosis is the patient while maintaining a urinary diary with quantitative and qualitative parameters stabilizing: special urine volumes, fluid characteristics, urgent calls, night push.The main natural examination method in the event of suspicion of prostate adenoma is an examination of the prostate finger rectal to determine its increase and exclude some other pathologies.
The prostate adenoma is diagnosed in the hospital using the following laboratory and organic methods:
- General blood and urine tests.
- Biochemical blood test for indicators of kidney, urea and creatinine condition.
- Analysis for the dog level (in order to exclude prostate cancer).
- International Ultrasound Examination (Ultrasound);
- Urophistal (to determine the speed of urine current).
- Determination of residual urine volume (using ultrasound).
- Pelvic electromyography.
- Uretholization.
- Abrupt urography.
Treatment
The treatment of prostate adenoma aims to facilitate the symptoms of the lower urinary tract, improve the quality of the patient and prevent the development of complications of the disease.Patients with insufficiently exposed symptoms that do not exacerbate quality of life often prescribe the tactic of dynamic observation with regular urologist tests, which controls the course of the disease and gives recommendations on how to stop the development of prostate adenoma.During this time, the attention is focused on the treatment of non -drug.Methods that can be an addition to conservative treatment, which is the intake of the following drugs:
- Alpha Blockers (Tamsulosin, Alfuzosin);
- 5-alfa reduction inhibitors (Finstry).
- Phosphodesterose inhibitors type 5 (sildenafil).
- Combinations of 5-alpha reduction inhibitors and alpha inhibitors.
- Muscarine receptors or M-cholinolytics.
Patients with prostate adenoma at an advanced stage are recommended for surgical treatment, which can be performed by various methods: metaphysical resection, piercing resection and removal of the prostate.
There are some indications for the use of surgical treatment:
- Repeated urine delay.
- Kidney failure caused by prostate adenoma.
- Stones in the bladder.
- Repeated urinary tract infections.
- Repeated hematuria.
In addition, surgery is essential for patients, in the absence of efficacy from medication treatment.
During conservative treatment or in the postoperative period, patients need stable medical examination with standard studies (defining the rate of urine current, ultrasound, PSA level analysis).
Drugs
There is a certain shape according to which specific drugs are prescribed for the treatment of prostate and prostate adenoma.The high efficacy of treatment is achieved thanks to the use of drugs in alpha reductional inhibitors and alpha-blockers.These medicines for the treatment of prostate adenoma in men help eliminate the main symptoms of the disease, as well as to remedy adequate urination.
What are the most effective and widely used tablets from prostate adenoma?The list is directed by Alpha1-adrenergic receptors inhibitors.In addition, this list includes inhibitors of 5-alpha reductase, vitamins and minerals.
The complex of pharmaceutical therapy includes not only medication.With prostate adenoma, conservative treatment can be complemented by biologically active additives - dietary supplements that enhance the therapeutic effect of drugs and provide early recovery.Some of them include zinc.This macroeconomic element is directly involved in spermatogenesis and testosterone synthesis.Herbal phytosterols normalize urination.
Treatment with drugs by Alpha1-Adrenoceptors Competitors Group
These medicines for the treatment of prostate prostatitis and prostate adenoma provide relaxation of the smooth muscles of the urinary tract and improve the urine process.Tamsulosine, with the same name of the active substance, which is part of other drugs (Alfuzosin, Silodicus, etc.), is an extremely successive drug that has a selective effect on alpha1-adrenergic receptors of the prostate muscles, urethral prostate and bladder.Thanks to the decrease in muscle tone, the outflow and urine release facilitate.Tamsulosine, like all selective drugs, has a minimum number of side effects, does not affect the tone of blood vessels and can be prescribed in patients with chronic hypertension.
Alpha-adrenergic receptor competitors must be used constantly, so that you can achieve a gradual reduction of irritation and obstruction with prostate adenoma.Tamsulosin in the treatment of prostate adenoma occupy a well -preserved priority in the purpose of urologists.
The form of tablet of the drug is considered more progressive, since due to the controlled release of tamsulosine, the active substance is in the body at a constant concentration.The drug enters the bloodstream evenly, thereby ensuring the risk of developing the main side effects of Adrenaehobocators group - a sharp decrease in blood pressure.
An equally effective drug as active substance tamsulosin is a lesson.Taking this drug is not accompanied by the following unwanted results: orthostatic hypotension, tachycardia, increased angina attacks on coronary heart disease so that it can be prescribed for men with heart pathologies.Properly selected dosage and compliance with all the rules on the use of alpha-blockers group drugs allow you to achieve a good therapeutic effect in the almost complete absence of side effects.
Group drugs (inhibitors) reductase
The medicines of this pharmacological group (finterene, dutasteride) contribute to the relief of urine outflow and, therefore, the elimination of the main symptoms of the disease.A stable therapeutic effect already appears two to three weeks after the start of the course.All symptoms stop completely after three months.According to the results of clinical trials, maximum performance is achieved after six months of treatment with these medicines.
Finasteride and Dutasteride are specific 5-alpha reductional inhibitors of the 2nd type (cellular enzyme responsible for converting testosterone into dihydrotestosterone).The development of the prostate with prostate adenoma is directly related to a similar testosterone transformation.Thanks to 5-alpha inhibitors, the products of intracellular dihydrotestosterone are prevented and its blood concentration decreases significantly.
Finsteride and Dutasteride are used for the following purposes:
- Treatment and control of prostate hyperplasia.
- Improving urine outflow and eliminate the symptoms of prostate adenoma.
- By reducing the risk of developing acute urine maintenance and the need for surgery.
Finasteride and Dutasteride have a strong anti -anti -anti -anti -anti -anti -anti -level effect, that is, they help reduce the level of male hormones in the blood.In addition, these drugs have a teratogenic effect, so they should be taken carefully.With the help of modern drugs, you can stop the development of the prostate and prevent the need for surgical treatment.
Antigenic and analgesic tablets with worsening of the disease
The main recipe for anticonvulsant and analgesic effects with the deterioration of prostate adenoma is to relieve the general condition of the patient and the elimination of pain syndrome.The anti -inflammatory and analgesic effect is exerted by non -serpeal anti -inflammatory drugs (Diclofenac, ibuprofen).They help fight not only with painful sensations that occur in the urination process, but also with constant pain in the groin and perineum.Due to the action of non -seroidal anti -inflammatory drugs, the inflammatory process is reduced, the prostate gland is reduced, the body temperature is normalized and unpleasant symptoms are eliminated.
The neoppy analgesics produced in the form of tablets or candles help to discontinue the pain syndrome by deteriorating prostate adenoma.The most affordable of these is sodium metamizology.However, this medicine is intended more for a use of time, as it can only affect a weak pain syndrome.In addition, analgesics with lidocaine, venosocin, anesthesia and novocaine (Ichtammol, venosocin, tribenoside + lidocaine) are effective.
Vitamin E 400
Acid tocopherol or vitamin E is often part of the complex treatment of prostate adenoma as an antioxidant, radiation protective agent and a necessary bond in reproductive processes.Vitamin E at a dosage of 400 mg of urologists are prescribed in patients with erectile function and spermatogenesis disorders associated with prostate adenoma.
The 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 medicines independently, without a preliminary consultation with the treating physician, as self -interference in this case can be not only ineffective but also dangerous to men's health.Only a specialized expert can indicate which tablets of prostate adenoma are the most effective in any case and which can have negative consequences.
Acts
Hospital urologists literally perform classic and minimally invasive surgeries, use innovative methods of prostate adenoma surgery.Each patient is chosen this function that suits him best.
The generally recognized standard in surgical treatment of prostate adenoma is post -prostate -prostate resection.The operation is extremely effective.After intervention, patients get rid of subdivision of subdivision (urethral stenosis) and related symptoms.The recovery period is short.During or after surgery, bleeding, "water poisoning" syndrome may develop.
Alternative methods of prostate adenoma treatment include the following surgeries:
- Stenting?
- Balloon expansion.
- Hyperthermia?
- Thermotherapy?
- Ultrasonic, laser removal and needles.
- Interstitial coagulation.
After that, the complications occur less often, but these methods are lower than permeable resection on efficacy, both in the clinic and the economy.
Laparoscopic removal of prostate adenoma is used when the tumor has increased significantly and is problematic to remove it using perpetual resection.This function is more complicated, performed under anesthesia.Through small incisions, the surgeon introduces special tools into the body cavity, which performs the removal of prostate adenoma.The operation is performed according to the image by camcorders, which appears on the screen.The main advantages of intervention are the minimum volume of blood loss, a small chance of complications.After surgery, the patient does not need long -term rehabilitation.
When there are signs of prostate adenoma in men, doctors use a high -tech method to treat laser adenoma - content.The intervention is carried out with large sizes of tumor.Excessive fabrics are removed using a laser.The operation is performed through the urethra.The tumor is separated, divided into small parts and then occurs.The method is considered minimally invasive.It has many significant advantages: it does not violate the integrity of the cavities, it does not cause unnecessary damage.
Laser exhaust consists of destroying the adenoma with laser evaporation.Through the urethra, the urologist introduces a special device, is transferred to the neoplastic and affects it with a bright green laser.The depth of laser penetration and the accuracy of its blow can avoid damage to neighboring areas.The method is minimal, without blood, fast and effective.Its only disadvantage is the inability to obtain a tumor tissue for histological examination.
In some cases, the inevitable method of treating prostate adenoma is abdominal surgery - adenomectomy.It is performed if other methods cannot help the patient.During surgery, the surgeon with a scalpel has access to the prostate gland and by hand, using surgical organs, removes the adenoma.As a result of function, significant blood loss may occur, complications develop.After surgery, the patient needs prolonged rehabilitation.
The removal of prostate adenoma by the method of custody (translucent) adenomectomy consists of a radical resection of the prostate tissues through the longitudinal incision of the anterior abdominal wall and bladder.The function is performed in the advanced stages of the disease, when the tumor reaches large sizes, the bladder is overturned due to the overflow of accumulated urine and the renal failure develops.
The bladder is predetermined and filled with a sterile solution of fuchillin or other substance.It is then available and taken in two positions in special farms, for which they increase the wall of the instrument.The surgeon analyzes the formed fold and performs the opening of the bladder.
Up to the inner end of the established urinary tract catheter, it determines the area of the bladder neck and around the urethra holes that appeared in the field of vision, falling 0.5-1 cm from it, makes the mucous membrane of the mucosa.After that, the functional urologist penetrates a finger on the thickness of the prostate, entering the volume capsule and the adenomatous nodes and the latter.At the same time, the doctor gives the gland on the front of the patient in the patient's rectum on the right abdominal wall.Becomes more accessible for manipulation.Thanks to this technique, operating time decreases and blood loss decreases.
The surgeon then performs hemostasis (stopping bleeding) of the remote adenoma bed and bladder stitches, leaving a thin drain on the wound.It is designed to wash its cavity from the resulting blood clots.The urine catheter, introduced before the business starts, has not been removed for 7-10 days.Around this, a new part of the urethra is formed instead of being overlooked during the protector of the urethra.
Co -productive adenomotomy refers to the most traumatic of all the methods used for the prostate gland.Accompanied by the risk of developing the following complications:
- Bleeding from the neoplasm shelter.
- Stagnant pneumonia.
- Reduced kinetic -gut function, manifested by constipation.
In order to avoid complications, after hospital surgery, the patient takes early activation.The following undesirable consequences of the tasks may occur to remove prostate adenoma:
- Insufficient bladder drainage.
- Narrowing his throat.
- The infiltration of the urinary tissue near the tissue.
- The formation of the "prenatal" (the residual cavity in the place where the prostate adenoma was removed).
- The formation of the stenosis of the urethra lumen.
- Urine incontinence.
This negatively affects the quality of life of patients and prolongs the restoration of adequate urination.
The effects of operation are less severe when intervention is performed using a laparoscope.Laparoscopic function to remove prostate adenoma is one of the least invasive options for surgery in the prostate gland.Hospital urologists use this technique if the patient has sufficiently large prostate adenoma.
If the patron of the patient with adenoma is not exceeding 120 cm3, it is recommended for diuretic resection of prostate adenoma.But 10% in patients who need surgery, this option is not appropriate, as iron reaches more than 120 cm3.The laparoscopic function for removing prostate adenoma during Uarolitis, groin hernia, bladder diverticulum, and the joints of the lower extremity of the lower extremities is not performed.In this case, the decision to carry out a business is collected by a urologist, Androtoko, abdominal surgeon and other hospital experts.