What is prostate adenoma in men: symptoms and treatment
Prostate adenoma, the symptoms of which are familiar to many men, is one of the most common diseases of the male reproductive system. Doctors reassure that this is not such a terrible diagnosis, it must be treated without delaying therapy.
An adenoma is a tumor that does not pose a direct threat to a man’s life. Appears from the glandular epithelial cells that line the prostate gland. In this state, it will not metastasize to nearby organs. If it degenerates into cancer, the lymph nodes located in the groin will be the first to suffer. Then other components of the reproductive and urinary systems.
The second name of the disease is benign prostatic hyperplasia. It often occurs in older men: according to medical statistics, every second suffers from it.
Every fifth young person can find signs of this phenomenon.
Benign prostate adenoma occurs as a result of the growth of the epithelium. New cells form a dense tissue that overlaps the ureters. They prevent the proper outflow of urine, so the first symptoms are problems with going to the toilet (pain, small portions of urine, etc.).
What leads to development?
Scientists and doctors have not fully established the cause of development. The mechanisms of growth are very complex, which gives impetus to them – it is difficult to establish.
The main reason for the development of adenoma in men, doctors call the imbalance of sex hormones. Over time, all biological processes in the human body slow down, including the production of hormones. The result of this slowdown is a decrease in the level of testosterone (male sex hormone), an increase in estrogen (the main female hormone).
Factors leading to the development of adenoma:
- vascular diseases (atherosclerosis, thrombophlebitis, etc.);
- inflammatory processes in the urinary tract;
- disruption of the kidneys and inflammation in them;
- rare or defective sexual contacts;
- long abstinence from sexual intimacy;
- low blood pressure.
In 95% of cases, hyperplasia develops if a man over 40 is overweight. This is due to adipocytes – substances that accumulate in the cells of adipose tissue. Adipocytes reduce testosterone production. And if there are a lot of fats in the body, then their norm increases several times, acting on the synthesis of sex hormones.
Alcohol abuse, smoking, lack of an active lifestyle can complement the negative impact. Hormonal imbalances occur in patients who are in a situation of stress for a long time, often experiencing moral upheavals.
The clinical picture of a neoplasm that affected the prostate gland is clear and understandable to every specialist. All manifestations occur gradually, and the signs that arose first intensify over time. Prostate adenoma may present with the following symptoms:
- violation of urination;
- feeling that the bladder has not been completely emptied;
- pain and burning in the urethra;
- long urination.
The first sign of adenoma is night trips to the toilet. At a young age, they were not there or the man woke up to urinate once a night. With the advent of this formation, trips become more frequent up to 5-7. He cannot claim that the man went to the toilet “normally”. To empty the bladder, he has to push very hard, although the desire to urinate is great. The stream of urine is weak, thin, sometimes intermittent. Often it is not even a jet, but drops, sometimes released involuntarily.
If the nighttime urge to urinate has become more frequent, but there is no violation in the strength of the urine stream, this is also a reason to contact a specialist for a thorough examination.
Additional signs of adenoma include a change in the smell of urine when emptying occurred uncontrollably. Sometimes this aroma becomes noticeable to people around. Patients with hyperplasia suffer from dull pain in the lower back and lower abdomen (in the region of the pubic bone). Another alarming sign is painful ejaculation.
Common clinical signs of inflammation of the genitourinary system:
- change in the composition and type of urine (visible presence of mucus, blood, sand, flakes, pus, etc.);
- dryness in the mouth;
- strong thirst;
- poor appetite;
- bowel dysfunction (constipation);
- lethargy, weakness, weakness;
In medicine, it is customary to subdivide the disease into types according to the place of its localization.
- subvesical , that is, tissues grow directly towards the rectum;
- intravesical, when cell growth is directed towards the bladder;
- retrotrigonal – the neoplasm is localized under the bladder triangle;
- multifocal – tissue cells affect several nearby organs at once
Stages of development
The tumor of the prostate gland has several stages of development.
Stage of compensation
This is the time when the tumor has just begun to grow, but has already managed to disrupt the functioning of the genitourinary system. At this stage, there are problems with the onset of urination – it is difficult. Weak stream of urine at the beginning of the process of emptying, although it should be strong. Emptying occurs completely, there are no residual effects yet.
To the already existing unpleasant manifestations, the feeling is added that the emptying did not occur to the end, and the urine stream is intermittent. The feeling is logical, since a certain amount of urine still remains in the cavity of the main organ of the excretory system.
Stage of decompensation
This is the last stage of tumor development, when the neoplasm has already interfered with the work of all departments of the inguinal region. This time is characterized by a change of periods: retention of urine and its release without control. This phenomenon is explained simply: with age, the walls of the bladder become thinner, and the resulting neoplasm presses on them with high force. After forty years, there is a decrease in the tone of the sphincters – the valves responsible for holding urine in the bladder and leaving it at the request of a man.
What threatens the development of pathology?
If a neoplasm in the prostate is not treated, it can turn into other, more severe ones, and lead to disruption of the work of many internal organs.
Treatment methods will be aimed at eliminating the manifestations of adenoma and restoring the functions of all affected body systems. Drug treatment will be very long, with strong drugs. It is important to consult a doctor in time and start treatment before complications arise.
These consequences include urinary retention in an acute form – this is a condition when even attempts do not help to empty, and the only way out is to install a catheter.
The installation of the catheter is always carried out by a nurse in the department, an ambulance paramedic.
Complications include possible infectious diseases of the genitourinary system and the inflammation that they provoke. Often, in addition to adenoma, doctors diagnose cystitis, urethritis, pyelonephritis and others, diseases of the bladder and ureters. A more severe pathology is urinary stones, the formation of which is facilitated by associated infections and hydronephrosis. A threat to life is such a possible complication as renal failure, which can become chronic. A harmless but serious condition where urine can be thrown uncontrollably from the bladder up into the ureters.
The initial diagnosis is set already in the urologist’s office – a man who has disorders in the urinary system will get to this doctor.
The doctor will collect an anamnesis: ask the patient in detail about his well-being, the symptoms that have arisen, and the existing chronic diseases. Be sure to clarify whether there were similar manifestations before. Does anyone in your family suffer from similar illnesses?
The doctor will make a diagnosis, which will need to be confirmed by laboratory tests. Only after receiving the results, the doctor will establish the final diagnosis, choose the method of treatment.
Pathology requires a complete examination. Laboratory tests of blood and urine will establish the inflammatory process or its consequences. Instrumental examinations will show the size of the growth, localization, possible pathologies of other organs, and more .
The first tests that the doctor will prescribe are a general (clinical) blood and urine test, a biochemical blood test, and a bacterial culture of urine for pathogenic microflora. These tests will show the degree of inflammation that has arisen, the general picture of the man’s health, the presence of harmful microorganisms, and their resistance to antibiotics.
The patient will need to:
- Digital rectal examination. His task is to establish the neoplasm, determine its consistency, the grooves between the lobes of the prostate, the pain of the tumor that has arisen.
- studies (cystography, uroflowmetry , urodynamics and others). These examinations determine the rate at which urine is released during urination, its total volume, and the duration of the process.
- Ultrasound examination of the urinary system. The procedure will establish the size of the adenoma, the uniformity of its structure, calcifications , if any. However, the main task of ultrasound is to answer the question of what quality the tumor is.
Your doctor may order a transurethral ultrasound and a PSA test. A prostate-specific agent is released when a prostate tumor forms, but too high levels are a symptom of the presence of cancer cells.
PSA norm by age:
- up to 50 years – less than 2.5 ng / ml;
- from 50 to 60 years – less than 3.5 ng / ml;
- from 60 to 70 years – less than 4.5 ng / ml;
- over 70 years old – 6.5 ng / ml.
An enzyme concentration of more than 10 ng / ml is evidence of an increased likelihood of tumor degeneration into cancer.
How to treat prostate adenoma depends on its size, stage of the disease and chronic diseases in the patient. There are two methods of struggle: medicinal and operational (surgical).
If the pathology is detected when the tumor is just starting to grow, has not yet had time to give complications, it is better to use medications.
Their main action will be aimed at relieving muscle spasm that blocks the outflow of urine. Medications are shown that slow down the growth of neoplasm tissues, improve the functioning of the ureters.
Pills that protect the liver (usually these are preparations of natural, herbal origin) will help supplement drug therapy. Immunomodulators will increase the defenses to combat pathogenic microflora.
For the treatment of benign prostatic hyperplasia, apply:
- Alpha-blockers ( Omnik , Omnik Okas ).
- 5-alpha reductase inhibitors ( Proscar ).
- Plant extracts ( Prostamol Uno).
- Antibiotics (cephalosporins, gentamicin) followed by the appointment of probiotics (bifidumbacterin, etc.).
- Immunity stimulants ( pyrogenal , reoferon and others).
- Drugs that improve blood circulation in the prostate gland ( trental ). They provide the necessary blood flow to create a therapeutic concentration of other drugs in the body. This is especially true for people with atherosclerosis.
If drug treatment fails, the question of surgical removal of the tumor will be decided. The surgical method of treatment is indicated for patients with an advanced state of pathology.
There are several types of intervention aimed at combating the tumor. Which one to choose, the patient will decide together with the doctor. He will advise the most correct option.
Complications after or during the operation are possible:
- Bleeding during the operation. Occurs in 2-3% of cases, refers to the most severe consequences, there is a need for blood transfusion.
- Bleeding after surgery. The blood clots that form as a result of the complication disrupt the normal outflow of urine. The consequences of the complication are eliminated by repeated intervention by the traditional or endoscopic method.
- Stagnation in urine due to urinary retention – occurs as a result of impaired functioning of the muscles of the bladder.
- Infection of the genitourinary system (acute inflammation of the prostate, testicles and their appendages, renal calyces and pelvis, tubular system of the kidneys) occurs in 5-22% after surgery.
- Incorrectly performed resection of prostate tissues – the remaining tissues disrupt the process of urination, making it even more painful than before the operation. Occurs in 2-10% of cases. Correction of the complication is carried out by repeated resection.
- Retrograde ejaculation – the ejection of sperm outside during ejaculation is impossible, as it is thrown into the urinary organ.
- Erectile disfunction. It occurs in 10% of cases, perhaps the complication is not associated with the consequences of surgery.
- Narrowing of the urethra. The complication occurs in 3% of cases and requires surgery.
- Urinary incontinence is a rare complication. If its cause is a violation of the muscles of the genitourinary organs, then the complication disappears without correction.
To prevent the disease and its development, the following measures must be observed:
- Eliminate a sedentary lifestyle, introduce physical education and sports. With physical activity, the risk of blood stagnation in the pelvic organs is reduced.
- Eliminate excess weight, if any.
- Refuse clothing that restricts blood flow in the pelvis: tight jeans, trousers, swimming trunks.
- Avoid promiscuity (for the prevention of STDs).
- After the age of 40, an annual visit to the urologist is required, a blood test for PSA for early diagnosis of the disease.
- Adjust diet:
- include vegetables and fruits in it (up to 50% of the total diet);
- foods rich in vitamins;
- refuse smoked meats, marinades, spicy and overly salty dishes;
- limit fatty, fried meat;
- reduce the amount of animal protein, cheese, strong tea and coffee.
- If the disease began to develop, actively consume dairy products, legumes, boiled or baked dietary meat.
After the end of treatment, the main task of the patient will be measures to prevent the recurrence of the disease. This is the rejection of bad habits, maintaining a healthy lifestyle and ways to take care of your own health.