Types and methods of treatment of prostate adenoma. How to recover from this disease.
Prostate adenoma – benign tumor growth of the prostate.
Treatment of prostate is complex and can be medical, non-surgical and surgical.
Drug treatment is only effective in the early stages of the disease, when the patient is free to urinate and urine be evacuated from the bladder. Today, there are many medications that can help ease the disease and to reduce the volume of enlarged prostate. However, if you experience complications of the disease can only help the operation.
Conservative methods of treatment — medication
Drug therapy is the most simple method of treatment of benign tumors and control moderate symptoms of BPH.
The pharmaceutical market provides professionals and patients with a wide range of drugs for the treatment of BPH. The choice of drug and treatment appoint a doctor based on the patient's condition, age and features of the disease. Depending on this can be assigned to the following groups of drugs.
This group of drugs has a significant impact on the blood vessels of the prostate, normalizes their condition and significantly improves blood circulation. Also blockers reduce the tone of the back of the urethra, the smooth muscle of the bladder neck and prostate.
Medicines due to the expansion of the cystic artery completely eliminate the lack of oxygen (hypoxia) of the bladder and improve the metabolic processes in his wall.
However, despite the high efficacy of alpha-1-blockers in the treatment of patients with BPH, these tools do not stop the growth of adenomatous tissue and reduce the volume of the breast. Therefore, they should be combined with inhibitors of 5-alpha-reductase, which have the ability to affect growth of the prostate tissue.
Blocker alpha-1-adrenoretseptorov prescribed if the assessment of the degree of BPH I-PSS corresponds to 13-19 points, and the urine flow rate equal to from 10 to 15 ml/sec. are Particularly effective agents in patients with strong night and day urination and urgency to it. Apply appropriate blockers for almost all patients with adenoma with the exception of those who are recommended surgery.
We must remember that for the typical blockers adverse reactions: ingestion may cause dizziness, palpitations, pressure drop, nausea, etc.
Hormones and their analogues
The use of hormones for treatment of BPH is based on the fact that the increase in breast tissue is regulatedthe level of sex hormones. In the development of BPH (benign prostatic hyperplasia) is an important role for sex hormones – estrogens, androgen and tissue growth factors.
The limitation of the effects of androgens (male sex hormones) is achieved with the help of hormonal drugs that block the synthesis of testosterone by the testicles, which prevent the androgenic action on the prostate.
Despite the significant decrease in prostate volume and improvement in incontinence, because of the frequency of various side reactions (reduced libido, impotence, etc.) hormones are not prescribed for all patients. However, if the treating doctor finds a high risk of cancer, without the use of hormonal therapy is not enough.
Drugs groups finasteride and polypeptides
Currently the most effective treatment for BPH is the drug belonging to the group of finasteride is an inhibitor of 5-alpha-reductase.
In the cells of the prostate testosterone is metabolized under the influence of the enzyme 5-alpha-reductase to 5-alpha-dihydrotesterone; in the cytoplasm of cells it binds to androgen receptor protein and result in androgenreceptor forms a complex that enters the nucleus of the cell and activates the DNA.
This in turn leads to a differentiation and increase in the prostate cells. As finasteride prevents the conversion of testosterone to dihydrotestosterone. 5-alpha-reductase is not associated with the receptor and gives adverse reactions that are characteristic of hormonal drugs.
Preparations of polypeptides (vitaprost, prostatilen, etc.) – medicines obtained from the prostate gland of bulls. They significantly improve the processes of microcirculation in the gland. Polypeptides often administered to patients with BPH, which is burdened with symptoms of chronic prostatitis.
These drugs bind to sterols in the intestine, inhibit the processes of their absorption (dissolution, absorption) and resorption (absorption) and affect the metabolism of lipids and cholesterol.
This reduces the level of serum estrogen, which improves the performance of urine separation and reduces the volume of residual urine.
Medicinal plants since ancient times is taken for treatment of the adenoma. Earlier often used the charges, which included celery, parsley, cranberries, nettle, pumpkin, St. John's wort, etc.
Currently, the possibility of herbal medicine has increased significantly thanks to the emergence of ready-made preparations containing plant extracts in the form of tablets, solutions, capsules, etc.
- inhibit the growth of hyperplastic (enlarged) prostate cell;
- blockthe action of androgen receptors;
- have an inhibitory effect on several enzymes involved in hormonal metabolism;
- affect tissue growth factors, prostate, etc.
The mechanism of action of homeopathic remedies for prostate cancer are still not understood.
We only know that they have anti-inflammatory action and diuretic effect on the prostate.
Surgery is an effective method of treatment. However, there is a risk of impotence, narrowing of the urethra and uncontrolled leakage of urine.
Surgery is indicated for patients with adenoma, only if the medications do not bring improvement, when there are such factors as:
- bleeding from the urethra;
- urinary retention;
- stones in the bladder etc.
Surgical intervention is contraindicated in patients with concomitant diseases such as liver cirrhosis, diabetes mellitus, severe kidney disease, heart, lungs, a serious mental disorder.
Transurethral resection of the
Transurethral removal of a section of the prostate gland is the most commonly used in the treatment of prostate surgery.
TURP is performed under General anesthesia or spinal anesthesia, under the influence of which completely blocked the sensitivity below the belt.
Surgeon the urethra enters the endoscopic tool and a special blade scrapes overgrown prostate tissue. After TURP, patients remain in the hospital for 3 more days.
In the normal course of the postoperative period of 7-8 days, and sometimes later can be minor hematuria (blood in urine), which is due to the process of recovery of the tissue after exposure of the resectoscope and the rejection of the scab from the back of the urethra. In these cases, the patient is recommended bed rest, intake of hemostatic drugs and excessive drinking.
One of the types of surgery is the open prostatectomy to remove an enlarged prostate. There are two approaches to performing this operation.
First step is removal of the prostate via penetration through the cross section in the tissues of the bladder. Second – perineal method, in which the removal of the prostate through the incision in the perineum, between the anus and scrotum.
Currently, surgeons use innovative techniques through which you can improve the efficiency and result of the operation. One such method allows to preserve the function of the nerves that is responsible for the process of erection.
If you still cannot save to native nerve fibers, the doctor makes a substitution, leads to the place prostatectomynerves from other areas.
After surgery, the patient is in the hospital for 3-6 days. On the first day the patient is sometimes translated in a sitting position, and the food is exceptionally lightweight, liquid to stomach food.
On the second day the patient is transferred on a special diet, and in the absence of blood in the urine can be extracted the catheter. On the third day after the examination the attending physician removed the drainage and if you don't have any complications, the patient is discharged home. Within a month the patient gradually recovered and returned to his former life.
Cure adenoma can and without surgery.
Balloon expansion of the prostatic part of the urethra
In the urethra administered long folded balloon of an elastic plastic. Focusing on the length of the urethra, or under the control of ultrasound, the specialist reaches the prostate gland and inflates the balloon, pushing adenoma tissue. Procedure to widen the urethra and improve urine flow.
In the later stages of the disease, when the process involved the sphincter of the bladder and the neck, depending on the lumen of the urethra, the resistance to the flow of urine does not change much. In addition, the improvement may be short-lived, so carry out the procedure must be repeated several times a year.
Stenting — the preservation of the lumen of the urethra self-retaining the stents (dilators). With the help of a stent in the prostatic part of the urethra is always dilated, which creates good conditions for the excretion of urine.
In medicine is used 2 types of stents:
- permanent (installed for a long period of time);
- temporary (installed for a short time for emptying the bladder).
The stent, mounted in the outpatient setting using disposable special tool, deals on their own. A positive effect is observed in 95% of patients.
However, after removing the extender can be painful and frequent urination, which usually disappears several weeks later without any additional treatment.
The method is based on different types of thermal exposure with the use of high temperatures. The temperature inside the prostate gland increases, and the surrounding tissue stays cool.
For thermal effects prostate cancer use different devices that work in different modes – from 42 to 1000C, with access through the rectum or urethra using microwaves, ultrasound and radio waves.
The vaporization is called evaporation of the tissues of the gland, under influence of strong local electric discharge. Due to the high energy impact is provided by the instant vaporization of prostatic tissue to a certain extent. The cavity is created, which improves the way the flow of urine.
There are more than 9 different types of laser fibers for vaporization and destruction. For them are characteristic different exposure angles, profiles, beam divergence and deflection, the power density, the size of the current spots, the thermal effects, energy loss, etc. is most Often used lasers are of 3 types – holmium, neodymium and diode.