Methods used for the treatment of BPH. The medical and surgical.
Thanks to new medical research causes and characteristics of disease and progress in medical techniques and technology, treatment of BPH is constantly improving and becoming more efficient.
Methods of treatment of prostatic adenoma
- Dynamic monitoring;
- Non-surgical methods of treatment;
- Treatment with a laser;
- Surgical methods of treatment.
Many patients with BPH there is a different degree of severity of the disease, its minor progression. Therefore, in men with no indications for surgical intervention referred to as dynamic monitoring.
At this time, patients should follow a specific mode, to avoid prolonged sitting, hypothermia, constipation, etc. as laxatives-do not use aloe and the Seine, as they can cause a rush of blood to the rectum.
It is recommended to completely eliminate from the diet of spices, spices, smoked products, canned food, alcoholic beverages, etc. Also during this period the specialists to their patients individually, can prescribe certain medicines or herbal preparations.
Prescription drugs depends on the clinical picture of the disease, from the qualifications of the attending physician and from the appearance in the medical market new drugs.
Drugs used in the treatment of BPH can be divided into the following groups:
- to eliminate the side effects of the cancer;
- used to treat the adenoma.
Group of drugs prescribed for BPH:
Drugs that help to reduce the tone of the posterior urethra, the smooth muscle of the bladder neck and prostate. Through this means weaken or eliminate disorders associated with urination.
Blockers also restore the sphincter and the detrusor of the bladder, which helps normalize the act of the outflow of urine. It should be noted that these drugs not only reduce the tone, but also eliminate the lack of oxygen (hypoxia) of the bladder and improves the metabolic processes in the walls.
Inhibitors of 5-alpha-reductase
A means of reducing the activity of the enzyme reductase, which participates in the formation in the prostate of the male hormone dihydrotestosterone.
When prescribing this group disrupted the formation of excess DHT, and consequently, reduced the amount in the prostate, thereby reducing prostate volume,eliminated compression of the bladder, and normalizes urination.
Herbal medicinal preparations – herbal remedies
Extracts of certain plants have long been used in the treatment of disorders of the outflow of urine caused by benign prostatic hyperplasia.
Herbal preparations are able to exert anti-edematous and anti-inflammatory; reduce the activity of androgens; damage giperplazirovannah prostate cells; influence factors of the growth of tissues and normalize the tone of the detrusor.
The growth and development of the prostate depends on testosterone production.
To mitigate the effects of androgens on the prostate prescribe hormone treatment 3 groups:
- drugs that block the synthesis of testosterone by the testes;
- steroid antiandrogens;
- the means which prevent the action of androgens on the prostate.
Hormones help to significantly reduce prostate volume.
Represent extract prostate cattle are peptide bioregulators, therefore, the use of these funds refers to bioregulatory therapy.
Tissue drugs have anti-inflammatory, anti-edematous action, increase the intensity of immune reactions and improve blood circulation in the prostate.
To non-operative methods of treatment include:
The preservation of the lumen of the urethra with a special extender, called stents.
Currently use 2 types of stents:
- permanent, established for a long time, in some cases for life;
- temporary installed for short term bladder.
The influence of heat
Treatment with high temperatures. The method is based on different types of thermal effect in a wide temperature range. Source of energy for heating prostate tissue is focused ultrasound, radiofrequency or microwave radiation.
Used source of energy is supplied to the prostate via the urethra or rectum. To preserve the mucous membrane of the rectum and the urethra are separate cooling system.
Thermal treatment method. The temperature in the prostate is maintained in the range of 40-44°C. Energy is supplied to the prostate by using a rectal antenna, which is equipped with its own cooling system to prevent damage to the mucous membrane of the rectum.
This temperature regime allows us to treat enlarged prostate cells while keeping the healthy tissue intact.
Thermotherapyprovides temperature in the range from 45 to 70°C. During this procedure, the deep tissues of the prostate the impact occurs. The mucous membrane of the urethra, through which is injected energy source is integral.
Focused ultrasound thermoablation
This method involves thermal destruction of prostatic Department of the urethra and adjacent portions of enlarged prostate. The treatment is carried out using the emitter, which is inserted into the rectum.
Thermoablation – effects on the prostate tissue temperature from 70 to 1000C. As a result of the impact destroyed the gland tissue through the urethra.
Thermoablation most often used in the prostate adenoma with pronounced symptoms of obstruction of the bladder.
Treatment with laser
As a result of thermal laser action occurs reducing the volume of benign prostatic hyperplasia. Laser radiation delivered to the gland via is inserted into the urethra the endoscope light guides. Upon contact of laser beams with the prostate tissue releases heat.
As a result of laser exposure on the tissues of the gland such changes occur:
- at temperatures over 40°C there is denaturation of protein (i.e. the change of its properties);
- if the temperature reaches 60°C and higher appears the of protein coagulation (clotting);
- temperature above 100°C leads to changes in tissue structures;
- at a temperature of 250°C and above noted charring of the tissue;
- temperature 350°C leads to the immediate removal of tissue at a specific site.
Types of operations used in the removal of BPH:
Surgical removal of the adenoma glands in the first few hours after patient admission to the clinic with acute urinary retention, to hit it with any type of infection.
In the first stage of the operation is nepasarea (troickoe) urinary diversion, that is, by puncturing the bladder through the abdominal wall above the pubic bone.
Then after 7-10 days is adenomectomy. This type of surgery is rarely performed and is a necessary measure, as the majority of patients seeks help immediately after voiding.
This type of operation is performed partially, in men suffering from concomitant diseases: acute or chronic renal failure, purulent diseases of the kidney, cardiovascular disorders, diabetes, circulatory failure, etc.
The first stage
At this stageassumes overlay epicystostomy (suprapubic drainage of the bladder), that is, through the incision of anterior abdominal wall introduced into the bladder drain tube for continuous flow of urine.
The duration of wearing of the catheter is determined by the attending physician individually for each case.
The second phase of the operation
This radical removal of the prostate. It is held 2 months after the first stage.
The most common type of surgery is transurethral resection of the prostate.
The TOUR is a variation of the electrosurgical endoscopic sinus surgery to the resection (removal) of tissue and the cauterization is carried out by electric current of high frequency by using an endoscopic instrument, the resectoscope, carried out through the urethra.
The choice of treatment depends on the signs of the disease, the degree of severity and presence of concomitant diseases, so it is important timely treatment for medical help.