Prostate adenoma: know your maneuver

If it were not for the increased advertising of prostatitis and prostate adenoma remedies, as well as medical centers for their treatment, most men would not even know that they have a prostate gland. For the time being: benign prostatic hyperplasia (adenoma) is one of the most common urological diseases of elderly and elderly men.

The prostate has the shape of a chestnut, is located in the perineum, below the bladder, and covers the initial parts of the urethra from all sides. Seminal vesicles are adjacent to its posterior surface. The prostate produces a liquid secret, which during ejaculation through the excretory ducts enters the lumen of the urethra and is thrown out. (In relation to internal organs, the word "secret" means "substances that are synthesized in the organ and released outside." Gastric juice, saliva, hormones of the endocrine glands – all these are the secrets of the relevant organs).

The prostate reaches its normal size by about the age of 20. After 45-50 years, in most men, it begins to increase in size again, and this process occurs until the end of life – some faster, some slower. After 60 years, the prostate is enlarged in almost every second man, and after 80 years – in almost 90%. In those 10-15% who were lucky enough to avoid adenoma, prostate atrophy develops in old age and senility.

The main symptoms of prostate adenoma are various disorders of urination due to the pressure of an enlarged prostate gland on the urethra. At the beginning of the disease, the urine stream becomes sluggish, the onset of urination is delayed, the urge to urinate becomes strong and frequent, especially at night. During this period, patients rarely consult a doctor, considering their symptoms to be inevitable companions of old age. Often the adenoma grows quite slowly and the inconveniences caused by it are not too great, so the patient thinks for years, it's time for him to go to the doctor or you can wait some more. Moreover, at the first stage of the disease, with a small increase in the prostate, complete emptying of the bladder is still possible: its muscular membrane strengthens in the fight against narrowing of the urethra and for the time being copes with its function.

Sooner or later, the tone of the muscular membrane falls in an unequal struggle, urination becomes difficult, the patient has to strain the abdominal muscles, but emptying the bladder remains incomplete. The frequency of urination increases day and night, and adenoma is characterized by the fact that urination is less frequent and difficult during the day than at night. There is a feeling of incomplete emptying of the bladder, intermittent urination, etc. If you continue to be afraid of doctors more than of disease, eventually adenoma leads to complete or almost complete urinary retention. Patients urinate in very small portions, and then involuntary urination occurs due to overflow of the bladder. (At a younger age, such symptoms may be caused by other causes – narrowing of the urethra, neurotic urination disorders, inflammatory processes.)

To assess whether you should take your prostate to the doctor or you can wait, the table proposed by the American Association of Urologists will help.

Assessment of the quality of urination
(all questions relate to the condition in the last 30 days before the assessment) Did not have

Total IPSS score=________________.

Circle one digit in each row – in the column whose title most corresponds to your condition. If the total is 7 points or more, go to a urologist. And the more points you scored, the faster: the number of points from 0 to 7 corresponds to minor disorders in the urological sphere, 8-19 – moderate, more than 20 – severe symptoms of the disease.

But urination disorders are an intermediate consequence of prostate enlargement and the cause of much more trouble. They can lead to a violation of the outflow of urine from the bladder and kidneys (and thereby contribute to the development of infections of the genitourinary tract – cystitis, nephritis, prostatitis, epididymitis, etc.), the formation of kidney stones and bladder, the development of kidney failure. A common symptom of prostate adenoma is bleeding from the dilated veins of the neck of the bladder, sometimes so severe that the urethra is clogged with blood clots.

I hope it is now clear to everyone that the doctors' call for every man after 50 years to go to a urologist once a year for a two–minute procedure – a finger examination of the prostate through the rectum - is not a luxury, but a necessity? If everything is still not clear, remember that (ugh-ugh) prostate cancer in the early stages is treated with very satisfactory results.

In most cases, you will be offered to come again in a year – and sleep peacefully. If the finger examination gave reason to suspect something was wrong, be glad that this "something" was revealed in time. And prostatitis, and adenoma, and in general any disease is treated the sooner, the easier. If necessary, the size of the prostate is assessed using a transrectal (i.e. also through the place through which everything is done in Russia, even the glands are removed :) ultrasound examination.

The size of the adenoma does not always correspond to the severity of the symptoms: with a large adenoma, urination disorders may be insignificant, and vice versa. Therefore, the doctor will definitely check the usefulness of emptying the bladder (the presence of residual urine), make a general analysis and bacteriological urine culture. Patients over 50 years of age with symptoms of adenoma must undergo a blood test for prostate-specific antigen (PSA) to exclude prostate cancer. Be sure to pay attention to this. For doctors, this is an elementary truth, and if a urologist or andrologist starts treating a man of pre–retirement age and older from prostatitis or adenoma without this analysis, find a good doctor. The PSA test is inexpensive, and the benefits from it are huge: the same restful sleep, if everything is in order, or timely detection and treatment of cancer. The principle of "the sooner, the easier" in oncology is especially true.

To clarify the diagnosis, other studies may be required (radiography, cystoscopy, biopsy, etc.). If as a result of the examination, the first eternal Russian question "who is to blame?" received an unambiguous answer: adenoma, you can answer the second traditional question – "what to do?".

For the treatment of adenoma, drugs from the group of alpha-blockers or 5-alpha-reductase inhibitors are successfully used. They have proven clinical efficacy and are recommended for the treatment of prostate adenoma as the first choice means, that is, in cases where you can try to do without surgery. (Just don't self-medicate! These medications can only be used as prescribed by a doctor and under his supervision!)

The development of medical methods has led to the fact that in the United States, only one in five of patients with prostate adenoma is operated on. If surgical treatment is still unavoidable, the patient can console himself with the fact that in most cases the development of microsurgery methods allows the operation to be performed transurethrally, using micro–tools, which, together with a light guide, are brought to the right place through the urethra using a cystoscope - a slightly curved metal tube thirty centimeters long and about the thickness of a pencil. The procedure for introducing a cystoscope is very similar to putting a worm on a hook, but it's better than an open operation with access to the prostate through the perineum or bladder.

To destroy the prostate tissue, laser vaporization (evaporation) of a part of the prostate gland is used, and thermotherapy methods – destruction of its tissue by deep cold or, conversely, heating with a microscopic emitter of ultrahigh frequency radio waves.

Prostate adenoma is a common and unpleasant disease, so you can make a lot of money on its treatment. There are a lot of remedies "for adenoma" offered, but none of the advertised dietary supplements, plant extracts and homeopathic remedies that "dissolve adenoma" have passed proper clinical trials and do not give any therapeutic effect other than psychological.

To date, there is no confirmed data on medical methods for the prevention of prostate adenoma. The main cause of this disease is an age–related decrease in testosterone levels in the blood and a change in the sensitivity of prostate cells to the action of sex hormones.

Hormone therapy was used for the treatment of adenoma at one time, but its effectiveness turned out to be low: with the help of hormones, at best, it is possible to stop the growth of the prostate, but it has never been possible to achieve its reduction. But the side effects were frequent, pronounced and undesirable. Doctors have long abandoned this method of treating prostate hyperplasia. Moreover, there is no point in trying to change the balance of hormones with injections and pills to prevent future disorders.

Those who want to slow down the growth of their prostate gland have to make do first of all with general recommendations for a healthy lifestyle. However, the advice not to smoke, drink in moderation, jog, eat more vitamins and less smoked meat, etc. is so stuck in the teeth of both doctors and their current and potential patients that almost no one pays attention to them. But in vain. After all, a change in the balance of sex hormones is a sign of approaching old age, and the best prevention of adenoma is, first of all, maintaining your body in good shape.

And more about prevention. Do you know why the prostate is called the "second heart of a man"? Its functions –

• production of prostatic juice, which is at least 1/3 of the volume of ejaculate;
• synthesis of testosterone, especially in old age;
• the production of biologically active substances – prostaglandins, which, although not in the full sense of hormones, but regulate many physiological functions of the body;
• the role of the valve that closes the exit from the bladder during erection;
• participation in the mechanism of sperm ejection;
• participation in the formation of the sensation of orgasm due to the developed innervation system.

Any organ, if it is kept in good shape and regularly exercised, will age more slowly. Is the hint clear?

Alexander Chubenko
Portal "Eternal youth" http://vechnayamolodost.ru01.06.2010