The causes, symptoms and treatment of prostate adenoma

Benign prostatic hyperplasia( BPH), more commonly known as prostate adenoma or prostate adenoma, is one of the most common genitourinary diseases in men over 50 years of age. In the tissues of the prostate develops one or more nodules, which, gradually increasing in size, press on the urethra( urethra) and lead to a violation of urination. Neoplasms do not belong to malignant tumors, but the unpleasant sensations caused by their growth force men to consult a doctor.

• reasons
• Symptoms
• Irritative( filling symptoms)
• obstructive( voiding symptoms)
• Other
• Forms
• Stage
• Consequences
• Diagnostics
• Treatment
• Preparations
• Operation
• Other minimally invasive techniques
• Homeopathy
• Massage
• Washer
• Exercise
• Folkfunds
• Bee products
• Herbs
• Diet
• Prevention

It is necessary to distinguish between prostatic adenoma and often( in 80% of cases)Prostatitis is inflammation of the prostate gland. Symptoms of these diseases are similar in many respects, however the reasons for their occurrence and treatment differ.

Reasons for

To date, there is no reliable data on the causes of the disease. Adenoma of the prostate is considered a manifestation of menopause in men.

Risk factors are:

• Genetic predisposition of .In some cases, adenoma is diagnosed at 35 years, and some men may not develop.
• Age of the .According to statistics, about 50% of men aged 40-50 years suffer from BPH.In the elderly and elderly, the disease develops in 80-85% of men, and at a younger age, the incidence of the disease is very small.
• The level of hormones .The balance of androgens and estrogens( male and female sex hormones) in the body of a man with age is disrupted, less testosterone is produced, which is why the control of growth and functioning of the cells of the prostate gland is weakened.

There are also factors that can indirectly affect the onset of prostate adenoma, but their association with the disease is not well established:

• inflammation in the kidney or urethra;
• transferred venereal and other infectious diseases of the genitourinary system;
• is overweight;
• incorrect lifestyle( unhealthy diet, excessive use of alcohol and tobacco products, insufficient physical activity);
• atherosclerosis of vessels;
• irregular sexual activity, prolonged periods of abstinence;
• excessive emotional and mental stress, stress.

Men with removed sex glands are not prone to disease.

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Symptoms of

The manifestations of prostatic adenoma can be divided into 2 groups:

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Irritative( filling symptoms)

Associated with impaired detrusor function - the muscular membrane of the urinary bladder that expels urine. With age, men develop hypoxia( lack of oxygen) of the smooth muscles of the bladder, leading to its instability:

• Rapid urination, nocturia( nighttime urination).
• Appearance of imperative urges( empty, not ending with urination), including at night.
• Inability to retain urine during urge, the appearance of uncontrolled expiration through the urethra.

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Obturation( symptoms of emptying)

Caused by pressure of the enlarged prostate gland on the neck of the bladder and urethra, which causes the inability to empty and accumulate residual urine:

• Difficult, delayed onset of urination.
• A thin, flaccid, intermittent stream of urine, sometimes its allocation occurs drop by drop. For better emptying a person has to strain and connect the muscles of the press.
• Reduction in the volume of urine output, sensation of incomplete emptying of the bladder. The amount of urine decreases from the prescribed 200-250 milliliters to 30-50, gradually the level of the liquid remaining in the urea reaches 1 liter.

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Other

Other manifestations of adenoma are also possible:

• unpleasant odor from the body, from the mouth;
• color change, blurred urine;
• pain in the lumbar or suprapubic region, abdomen;
• decreased potency;
• painful ejaculation( ejaculation);
• constipation;
• appetite impairment;
• appearance of a feeling of dryness in the mouth;
• anemia;
• general weakness, excessive irritability.
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Forms of

Usually a nodule forms in the middle of the prostate, capturing both lateral lobes, and then grows towards the bladder or intestine. Depending on the location of the adenoma, the following forms are distinguished:

• Intravesical - grows towards the bladder.
• Dosage - develops in the direction of the rectum.
• Retrotrigonal - located under the triangle of the ureter, formed by the ureteral ureters and the internal hole of the urethra. In this case, the tumor complicates the outflow of urine from the bladder and its passage through the ureteral orifices.
• Multifocal - fabrics grow in several directions.

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Stages of

The development of the disease depends on the location, size and growth rate of the neoplasm, the degree of impairment of the bladder.

The following stages of the disease are distinguished:

• The first( compensated) .It lasts 1-3 years and is manifested by a delay in urination, lethargy, rapid urges. Emptying the bladder is complete, with no residual urine.
• The second( subcompensated) .Due to the growing pressure on the urethra, the ability of the bladder to function normally and to expel the urine is lost. There is a feeling of incomplete emptying, the level of secreted fluid decreases, overflow of the bladder leads to involuntary discharge of urine, possibly its turbidity. Symptoms of renal dysfunction are attached.
• The third( decompensated) .The bladder will overgrow due to the large amount of residual urine that is excreted by drop. The color of the liquid is cloudy, impurities of blood or pus are possible. Renal failure develops, the man has weakness, slimming, a smell of urine with exhalation, vomiting, convulsions.
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Consequences of

Absence of treatment for prostate adenoma can lead to serious complications of the disease:

• acute urinary retention - causes the need for immediate catheterization of the bladder;
• inflammatory processes of the urogenital system - urethritis, cystitis, prostatitis, pyelonephritis;
• hematuria( blood in the urine);
• urolithiasis( the appearance of stones in the bladder);
• vesicoureteral reflux( urine discharge from the bladder up the ureter);
• diverticula of the bladder( saccular protrusion of its wall);
• hydronephrosis( dilated capillary system of the kidneys);
• chronic renal failure;
• uremia - autointoxication, which occurs against the background of renal failure and leads, among other things, to brain damage and strange behavior;
• in some cases, prostate adenoma can degenerate into a malignant tumor.

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Diagnostics

The following survey methods can be used for diagnosis:

• Questioning. Allows you to assess the severity of the symptoms of the disease. Men are invited to answer 7 questions, choosing options from 0 to 5 points. Due to this scale, patients are divided into 3 groups: from mild( 0-7 points), moderate( 8-19) or severe( 20-35) symptoms. Finger rectal examination. It is used to determine the size of the prostate gland, the smoothness of its surface, the symmetry of the lobes, the presence or absence of seals. Normally, the prostate has a length of 25-45 millimeters, the same width, a volume of up to 30 cubic centimeters, and is easily traced by a finger. The study is practically painless and allows to exclude prostate cancer.
• Exterior examination and palpation of the abdomen - is performed in the supine position. A healthy empty bladder is not palpable. If it is full, then it is slightly protruding and feels at the touch.
• Transrectal ultrasound( TRUS) - ultrasound examination of the prostate by a rectal sensor.
• Uroflowmetry - measurement of the rate of urination with the help of a special apparatus( uroflowmetry) or measuring dishes and a stopwatch.
• Cystography - X-ray examination of the bladder when it is filled with contrast medium.
• Cystoscopy - examination of the inner surface of the bladder using an endoscope( catheter with an optical system), which is injected through the urethra. It is carried out according to the indications.
• Assay for detecting the level of prostate-specific antigen ( PSA) in serum - with adenoma or prostate cancer it significantly increases.
• Evaluation of kidney function. Includes a general urine test, a blood test for urea and creatinine, ultrasound.
• Prostate adenoma biopsy - taking prostate tissue for examination under a microscope, is performed with a suspicion of cancer.

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Treatment of

Depending on the stage of the disease, the therapy can be carried out by several methods:

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Drugs

Drugs can be represented by various forms of release - capsules, tablets, rectal supplements, microclysters, solutions for injection:

• Alpha-1-adrenoblockers ( Alfuzosin, Vezomni, Doxazosin, Cardura, Omnik, Tamsulosin, Terazozin, Urerek).Eliminate the spasm of the smooth muscles of the urogenital system, facilitating the passage of urine and preventing obstruction( obstruction) of the urethra.
• Blockers( inhibitors) of 5-alpha-reductase ( Dutasteride, Indigal, Proscar, Finasteride).Prevent the formation of dihydrotestosterone, help reduce the size of prostate adenoma and counter obstruction of the urethra.
• Plant extracts of ( Prostamol Uno) - regulate the peristalsis of the urinary tract.
• Antibacterial drugs ( Azithromycin, Amoxiclav, Gentamicin, Nolycin, Tetracycline) - are effective with concomitant inflammatory lesions caused by a bacterial or fungal pathogen( prostatitis, urethritis).
• Probiotics ( Bifidumbacterin, Lineks) - used to restore intestinal flora after taking antibiotics.
• Anti-inflammatory drugs ( Diklovit, Diclofenac, Prostatilen, Prostopinum, Tykveol) - relieve inflammation of the prostate and nearby organs.
• Analgesics ( Anestezol, Indomethacin, Nimesil, No-shpa) - are used in severe pain syndrome.
• Immunostimulants ( Derinat, Interferon, Pyrogenal) - serve to stimulate immunity for infectious lesions.
• Drugs that improve blood circulation in the prostate ( Trental) - provide blood flow to create the necessary concentration of drugs in the prostate gland.
• Preparations of animal origin ( Vitaprost, Uroprost) - an extract of a prostate of large horned livestock.

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Operation

The following methods are used:

• Cystostomy .It is a cut( or puncture) in the abdominal wall, through which a hollow tube( catheter) is inserted into the body of the bladder for the outflow of urine. It is a preparatory manipulation before the operation, it is carried out in conjunction with anti-inflammatory therapy and allows to reduce intoxication, improve the patient's condition, normalize the kidney function, and reduce the number of complications after surgical intervention.
• Open( cavitary) operation( transvesical adenomectomy) .It is carried out with the started form( large size) of the prostate adenoma or the impossibility of removing it by another route. It is carried out under general anesthesia through a cut of the abdominal cavity between the navel and the pubis. It is characterized by great trauma and a significant number of complications.
• Laparoscopy .Used for large prostate sizes and the presence of concomitant diseases( urolithiasis, diverticula, inguinal hernia).It is carried out using 3-5 trocars - hollow tubes, which are inserted into the cavity of the damaged organ through small incisions. In the gaps of trocars are introduced tools, including a video camera. Compared with open surgery, laparoscopic removal is characterized by a lower incidence of complications, minor pain syndrome, rapid healing of tissues, good cosmetic effect. Transurethral resection of the prostate( ).It is the "gold standard" of urological surgery, a low-traumatic surgery that allows to save the sphincter of the urethra and the nervous bundle necessary for the sexual function of the patient. During epidural anesthesia, a fiber-optic resectoscope( a long tube with a diameter of 1 centimeter) is inserted into the urethra, with the help of the electrical loop of which a layered removal of the expanded tissue takes place. The method is effective for mild and moderate severity of the disease. Transurethral holmium laser enucleation of the prostate( HOLEP) .Progressive method of endoscopic( without incisions, through the urethra) of the extraction of hyperplastic prostate lobes into the bladder cavity, their subsequent grinding and washing through the urethra. The extracted cells undergo a check for malignancy. The procedure is carried out using a high-power holmium laser and is suitable for the removal of BPH of any size. It is characterized by high efficiency, a small number of complications, a short postoperative catheterization period of the bladder( 1 day).
• Laser ablation or photosensitive laser vaporization .Removal of the tumor by burning it( evaporation) with high temperatures. Often carried out using the device "Green Laser"( Green Light Laserscope).No less effective than the previous method, and does not require the use of solutions for washing the bladder.
• Interstitial laser coagulation .With this method, the doctor produces several punctures in the mucosa of the urea or overgrown tissues, through which a laser is injected. Under the influence of the apparatus, tissues are atrophied and pressure on the urethra is reduced. The disadvantages of the procedure are a long recovery period and low efficiency, sometimes requiring a second operation.
• Embolization of the arteries of the prostate( EAP) .Refers to endovascular surgery and is a blockage of blood vessels carrying blood to the adenoma of the prostate gland, a special polymer. As a result, tissues are not fed and diminished in size. It is performed under local anesthesia at the puncture site of the femoral artery.

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Other minimally invasive methods of

Among the less popular methods that can be used to treat adenoma are the following:

• Balloon dilatation is an introduction to the urethra of a catheter with an inflated balloon. When leading to the narrowed section of the prostate balloon inflated, increasing the lumen of the urethra.
• Stenting - installation of urethral stents( cylindrical scaffolds) to maintain the width of the urethral lumen.
• Focused ultrasound of high intensity ( FUVI) - the effect on the prostate by ultrasound, under the influence of which the tissues are heated and destroyed. The procedure is performed using endoscopic technique.
• Thermotherapy or transrectal microwave therapy .The method consists in the action of high-frequency microwaves on the prostate through the rectum with the aid of a retro-scope.
• Transurethral needle ablation or Radiofrequency therapy is the heating and destruction of hyperplasic tissues by means of radio waves that are fed through special needles placed in the prostate with a cystoscope.
• Cryotherapy - exposure to prostate tissue with liquid nitrogen. It is carried out with the help of an endoscope, at the end of which a freezing head is attached.

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Homeopathy

If you agree with a doctor, the use of homeopathic remedies is acceptable - some of them have diuretic properties, they can relieve pain and inflammation in the prostate.

Among the most popular agents are: Acidum nitricum, Aurum muriaticum, Clematis, Digitalis, Ferrum picrinicum, Pareira brava, Populus tremuloides, Populus tremuloides( Populus tremuloides)), Sabal serulata( Sabal serulata).

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Massage

Auxiliary therapy for BPH is a prostate massage. It improves the blood supply to the body, relieves puffiness, improves trophism and the effect of medications, reduces pain.

Procedure is performed through the rectum with a finger in a sterile glove for no longer than 3 minutes. The patient is in a position on all fours or lying on his side.

Massage is performed by experienced specialists in the clinic. When performing the procedure at home, the patient or his relatives should undergo a course of study so as not to cause harm to the patient by negligence.

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Apparatus

Physiotherapy is also used to treat prostatic adenoma.

The main instruments are:

• Acoustics. Develops low-energy bioresonance waves and effectively eliminates pain syndrome, swelling and inflammation of the prostate, has an antiparasitic effect.
• Almag 01. Affects organs due to magnetic impulses. Has analgesic, relaxing, anti-edematous, anti-inflammatory effect, normalizes blood flow. Can be used in hospitals and at home.
• Vitafon. Affects organs with acoustic ultrasound. Improves blood circulation, relieves spasms of smooth muscles.
• Mavit ULP-01. Affects the prostate with pulsed magnetic flux, heat and vibrating massage. It is an alternative to finger massage, especially for psychologically sensitive patients.
• Ranet of the DMV 20-1. Affects tissues with a high-frequency electromagnetic field, which increases the temperature of blood, lymph and muscle tissue, normalizes blood circulation, reduces stagnant processes, improves prostate function. Requires medical supervision.
• Termex 2. It is used for local destruction of hyperplastic gland tissues and release of the urethra. Used under medical supervision.
• Ereton. Urological apparatus, can be used for self-massage. Affects the prostate gland with low-frequency microvibration, a constant magnetic field and a pulsed electric current.

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Physical Exercises

To select the set of exercises you need with a doctor, the most effective are:

• Technique for relaxing the muscles of the buttocks and perineum - tension and relaxation of them, pulling the rectum inward.
• Walking on steps with passes - stepping over first through one, then through two and if possible through three steps.
• Stretching - you need to sit for a few minutes in the lotus position, try to make a "twine", touch the toes with your hands, without bending your knees.
• Exercise for the press - push-ups( at first it is possible on all fours), lifting up the trunk or legs in the prone position, the exercise "scissors" and "bicycle".

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Folk remedies

To remove unpleasant symptoms and improve the quality of life, folk medicine methods also help:

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Beekeeping products

• Beef podmore. 2 tablespoons dried and crushed raw materials put in a glass jar, pour 0.5 liters of vodka, cover and put on a water bath for 25-30 minutes, periodically shaking. Then leave the container for 2 weeks in a dark dry place, shaking daily.1 teaspoon of the extract obtained is mixed with 1 tablespoon of honey and eaten for a day, divided into 3 doses.
• Propolis - used for the preparation of rectal suppositories.50 grams of the substance is displaced with the same amount of pumpkin oil, add 100 milliliters of alcohol and heated in a water bath for about 30 minutes. Means to cool and form candles. Enter into the rectum before bedtime. It is desirable to simultaneously take inside 10% tincture of propolis.
• Perga. It is necessary to eat 1 teaspoon of the product 3 times a day for 1 hour before meals.

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Grasses

• Red root ( root of the penny-tree).The infusion of the plant is a diuretic and an immunostimulating agent. To eat inside 25 grams of dry raw materials put in a thermos, pour 2 cups of boiling water and leave for 3-5 hours. For a cleansing enema 1 teaspoon of root is poured with 1 liter of boiling water.
• Onion husks. Clear 2 bulbs, pour 0.5 liters of water and boil in a water bath for 5-7 minutes. Broth strain and take 0.5 cup 3-4 times a day with the addition of honey.
• Ivan the Tea. Infusion of the plant has an anti-inflammatory effect, prevents the proliferation of the prostate and the malignant degeneration of its cells.2 tablespoons of willow-tea pour 0.5 liters of boiling water, allow to cool and drink 0.5 glasses 3-4 times a day. In the tea, you can add a root of burdock or nettle, birch buds.

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Diet

The following foods should be included in the diet:

• liver( cod, beef);
• seafood;
• cereals( buckwheat, barley, oatmeal, pearl barley);
• wheat sprouts, beans;
• nuts, dried pumpkin seeds, sesame seeds;
• vegetable oils - olive, pumpkin, linseed;
• vegetables, fruits, berries - tomatoes, carrots, parsley, celery, garlic, onion, dog-rose, sea-buckthorn;
• sour-milk products( cottage cheese, kefir, fermented baked milk);
• compotes, kissels, green or herbal teas.

Foods that are not recommended for use:

• coffee, strong tea, carbonated drinks alcohol;
• fatty, spicy and salty dishes, canned food, spices;
• sugar, baking.

If the amount of nutrients obtained with food is not enough, it is recommended to take vitamin-mineral complexes with zinc and selenium.

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Prevention of

However, delaying its appearance will help a healthy lifestyle:

• regular sexual life - ejaculation is a kind of massage of the prostate and prevents stagnant processes in the organ;
• physical exercises, water procedures, massage - also improve blood circulation;
• proper nutrition, body mass correction;
• rejection of bad habits;
• good state of health - hypothermia, constipation, urinary retention, infectious diseases are reflected in the condition of the genital organs;
• annual preventive examination by a specialist.