BPH - what is it? Symptoms, treatment of benign prostatic hyperplasia

In modern medicine, often used abbreviations, not quite understandable to a normal person without honey. Education. One of these incomprehensible abbreviations is BPH. What it is? Speaking in the language of doctors, this is benign prostatic hyperplasia. But in the people it is called simpler - adenoma of the prostate (possible option "adenoma of the prostate gland"). Often adenoma of the prostate is confused with a disease like prostatitis. BPH is a benign formation, and it grows not without the participation of the stromal component of the prostate (in other words - the glandular epithelium), and prostatitis is nothing more than inflammation of the prostate gland. Do not confuse them.

BPH. What it is? Statistics

As mentioned above, BPH is a benign neoplasm. With him in the prostate (the abbreviated name of that very prostate gland) small nodules are formed, which as you grow more and more squeeze the urethra.

Because of this, a man has urinary disorders. This disease has benign growth, and this is what distinguishes BPH from cancer.

BPH is one of the most common diseases in urology today. According to statistics, it appears in almost 80 percent of men in senile age. In 20 percent of cases, atrophy of the gland or its increase is observed instead of BPH.

Disease BPH occurs most often in men over 45 years of age.

More than half of men from 40 to 50 years old turn to a specialist with this ailment, and only in rare cases the disease can overtake the young.

The causes of BPH

To date, it is impossible to indicate the exact reasons for the development of BPH of the prostate gland, since they are simply not clear up to the end. It is believed that the disease is one of the signs of menopause in men.

The only risk factors are the level of androgens in the blood and the age of the person.

Usually, with age, the man gradually breaks the balance between estrogens and androgens, which causes a violation of control over the growth and function of the gland cells.

It is known that there is no connection between BPH of prostate and sexual activity of a person, orientation, harmful habits, transferred venereal and inflammatory ZAP, and none of the above does not affect the appearance of the disease.

Pathogenesis

BPH prostate gland most often appears in its central part, but sometimes it can also capture lateral lobes. The growth of benign hyperplasia depends on the adenomatous proliferation (tumor) of the paraurethral glands. As a consequence, the gland's own tissue is shifted to the outside, and around it, a capsule is formed around the growing adenoma.

Hyperplated cells of the prostate gland tissue also have the property of growing both in the direction of the rectum and the bladder, and this is the cause of an upward displacement of the inner opening of the bladder and an extension of the posterior part of the urethra.

There are several forms of hyperplasia according to the type of its growth:

• Subcubic form of BPH. What it is? With this disease, the tumor grows in the direction of the rectum.
• Intravesical form of BPH. The history of the disease is characterized by the growth of the tumor to the bladder.
• Retrotrigonal form of BPH. The tumor in this case is located directly under the triangle of the human bladder.

Quite often several forms of BPH can be seen in one person at a time. This happens when the tumor grows into several sides at once.

BPH: symptoms

The signs of this disease directly depend on the location of the tumor, its growth rate and size, as well as the degree of impairment of the bladder.

BPH of the prostate can be divided into three stages:

• Compensated, or the first stage. This form of the disease is manifested by delays in the beginning of urination (frequent desires for emptying, especially at night - a concomitant symptom). In BPH 1 degree prostate gland increases in size, has a densely elastic consistency. Its borders are clearly outlined, and in general the palpation of the gland (and its median furrow) is painless. At this stage of the disease, the bladder is completely emptied, and there is absolutely no residual urine. BPH 1 degree can last from one year to three.
• Subcompensated, or the second stage. As the tumor develops, it compresses the urethra more and more, and the bladder is no longer able to function normally and is fully emptied (its walls thicken at the same time). As a result, with residual BPH of grade 2, residual urine appears, due to which the patient feels incomplete emptying of the bladder. Because of the compression of the urethra, patients urinate in small portions, and after a while urine and does begin to stand out spontaneously (the reason for this is the overflowing bladder). BPH of the 2nd degree is sometimes accompanied by symptoms of chronic renal failure (developing on its background).
• Decompensated, or the third stage. The urinary bladder is strongly stretched due to residual urine, the urethra is still compressed, and urine is literally dropped, sometimes even with a trace of blood. At this stage, BPH causes renal impairment (renal failure). There is also weakness, severe weight loss, poor appetite, constipation, anemia, dry mouth.

Diagnosis of the disease

The basis for the diagnosis is the characteristic complaints of men for whom a special scale of assessment of symptoms of prostate adenoma (in English I-PSS) was created. Basically, the diagnosis of BPH is made after a clinical examination of the patient, as well as such research methods:

1. Palpator (finger) rectal method of examination of the prostate gland. Thanks to him, doctors have an idea of the consistency and size of the gland, the presence of a beard between its lobes, as well as the degree of soreness of the palpation.
2. Laboratory studies of BPH. What it is? First of all, it is a familiar general analysis of urine. Also, a biochemical blood test is performed to determine the level of PSA (deciphered as a prostate specific antigen).
3. Instrumental methods. Most often this is cystoscopy and urethroscopy. With their help you can check the patency of the urethra, the state of the lobes of the gland and the neck of the bladder. With these procedures, you can determine the amount of residual urine.
4. Ultrasonography. This is also one of the types of instrumental methods, allowing to see the dimensions of each lobe of the gland, its condition (the presence of stones, nodal formations). In addition to conventional ultrasound, Truzui (transrectal) is also used.
5. X-ray methods of research. Excretory urography (with contrast) and review radiography (without contrast) can help determine the presence of complications of BPH, the treatment of which was started. Using X-rays, stones are found in the bladder and kidneys.

Treatment of BPH

At the moment there are many ways to treat the disease, each of which is highly effective at different stages of BPH. The treatment of this ailment can be divided into three parts:

• Drug treatment
• Operative method of treatment
• Other non-surgical methods of treatment

Medication is usually used at the first sign of BPH.

At the first stages of BPH prostate cancer treatment is aimed at reducing the growth rate of hyperplastic prostate tissue, improving blood circulation in a number of located organs, reducing inflammation of the prostate and bladder, eliminating stagnation of urine, eliminating constipation, relieving urination.

In addition to the use of medicines, the patient is recommended to observe a mobile lifestyle, to give up alcohol and harmful (too fat, spicy, spicy) food, smoking.

It is also necessary to reduce fluid intake in the afternoon, especially before bedtime.

In the presence of clinical and laboratory signs of androgen deficiency, androgen-replacement therapy is also prescribed.

Often, in parallel with the treatment of hyperplasia, treatment of its complications is carried out - cystitis, prostatitis or pyelonephritis.

Sometimes (against a background of hypothermia or drinking alcohol), the patient may develop an acute retention of urine. In this case, the patient should be urgently hospitalized and a catheterization of the bladder.

Let's take a closer look at each type of treatment.

Medication

Most often, two types of medications are used to treat BPH:

• Alpha-1-adrenoblockers (eg, tamsulosin, doxazosin, or terazosin). Their action is aimed at relaxing the smooth musculature of the prostate and the neck of the bladder, which leads to easier passage of urine. The effect of these drugs can be prolonged or short.
• Inhibitors (blockers) of 5-alpha-reductase (permixone, dutasteride or finasteride). These drugs do not allow dihydrotestosterone (a biologically active form of testosterone) to form in the body of a sick person, so that the prostate gland decreases.

Operative method of treatment

In particularly severe cases, one drug treatment can not be avoided, and, as a rule, one has to resort to surgical intervention. This may be excision of hyperplastic tissue (adenomectomy) or total resection of the prostate (prostatectomy).

There are two types of surgical intervention:

• Open surgery (transvesical adenomectomy) . With such an intervention, access to the gland tissue is obtained through the wall of the bladder. This species is the most traumatic, and is used only in neglected cases. Open surgery provides a complete cure for BPH.
• Minimally invasive operations (in which there is practically no surgical intervention). Are carried out with the help of modern video endoscopic technique, without a cut. Access to the prostate through the urethra.

There is another type of surgical intervention, which can not be compared with the above. Embolization of the arteries of the prostate is an operation that is performed by endovascular surgeons (described above by urologists) and consists in occluding the arteries of the prostate with small particles of a special medical polymer (through the femoral artery). Hospitalization is not required, the operation is performed under local anesthesia and is not traumatic.

After any kind of surgery, there is little risk of complications, such as incontinence, impotence or stricture of the urethra.

Non-operative methods of treatment

Non-operative methods of treatment include the following:

- cryodestruction;

- Transurethral needle ablation;

- treatment with focused high intensity ultrasound;

- method of microwave coagulation of the prostate or thermotherapy;

- introduction of prostatic stents into the narrowing;

- balloon dilatation of the prostate.

Postoperative period

Alas, at some stages of the disease, surgery is simply necessary. BPH is a serious illness, and even after surgery you need to follow certain rules to finally get rid of the disease and not to provoke a re-appearance. The three main points that you must follow after surgery are the correct diet, a healthy lifestyle and regular visits to the doctor.

The diet in the post-operative period is extremely important for the patient, as it can significantly contribute to a faster recovery. Diet after surgery completely eliminates fatty foods, spices, salty and spicy dishes and, of course, alcohol. It is recommended to eat low-fat, fiber-rich foods.

As for work, if your profession does not involve frequent physical loads, then you can return to the workplace after a couple of weeks after the operation. When sedentary work every half hour is recommended to do a warm-up. A sedentary lifestyle can contribute to the stagnation of blood in the organs, from which the disease only exacerbates. The first few days after surgery, do not even think about lifting weights!

Give up smoking at least in the postoperative period (two weeks after surgery), if you can not give up the addiction at all. Nicotine damages the walls of blood vessels, and this affects the blood circulation of the prostate, resulting in an inflammatory process.

Many people think that after the removal of BPH it is necessary to forget about sexuality forever. This opinion is erroneous, and the sexual function of a man is completely restored after a while. However, to resume sexual relations is not earlier than 4 weeks after the operation.

Another tip, which should pay attention: you can drive the car no earlier than a month after removal of BPH.

In general, the postoperative period lasts about a month, after which the patient can already return to the usual life. However, experts strongly recommend a healthy lifestyle, in order to avoid the re-occurrence of the disease.

Micturition after surgery

Almost immediately after the operation, the urine stream becomes stronger, and the emptying of the bladder occurs more easily. After removal of the catheter, pain may occur for some time during urination, the reason for this is the passage of urine through a surgical wound.

Experts do not exclude the occurrence of urinary incontinence or urgent urge to urinate during the postoperative period, these phenomena are completely normal. The more you are disturbed by symptoms during illness, the longer your recovery period will be. Over time, all problems will disappear and you will return to the normal rhythm of life.

Some time after the intervention in the urine can be blood clots. This phenomenon is associated with wound healing. It is recommended to drink as much liquid as possible in order to properly wash the bladder. But with severe bleeding, you should immediately contact a specialist.

Forecasts

Prolonged retention of urine (in the event that treatment of prostate adenoma is not performed), in the end can lead to urolithiasis, in which the stones form in the bladder, and later the infection. In this case, the most serious complication that a patient can expect without proper treatment is pyelonephritis. This ailment further aggravates kidney failure.

In addition, prostate adenoma can give rise to malignant growth - prostate cancer.

Forecasts with adequate and timely treatment of the disease are very favorable.

Prevention of disease

The best prophylaxis of BPH is regular observation by specialists and timely treatment of prostatitis.

Also it is necessary to eat properly (reduce the amount of fried, salty foods, as well as spicy, spicy and smoked), stop smoking and alcoholic beverages. In general, a healthy lifestyle significantly reduces the risk of BPH.

So, now you know what BPH is. Symptoms of this disease, treatment, postoperative period and even prevention are described in detail above.

In any case, this knowledge will be useful to you. Be healthy!