Almost 16% of urology consultations are determined by prostate adenoma. After 40 years, over 50% of men suffer from a form of prostate adenoma , the number increasing in direct proportion with advanced age, reaching 90% at 85 years.
The prostate is a structure, part of the male reproductive apparatus that surrounds the bladder. In men with normal androgen production, along with age, the gland tends to increase its overall volume (benignant hyperplasia), more pronounced in some areas, resulting in prostate adenoma that can cause strangulation of the urethra and urination problems.
Prostate Adenoma Causes
Prostate adenoma is the most common noncancerous tumor of the over 60 years male, developed due to a deficiency in testicular activity. Prostate adenoma does not manifested in patients with reduced activity of the pituitary gland or in those who underwent vasectomy surgery (resection of the vas deferens through which sperm reach from the epididymis into the posterior urethra ) before the age of 40 years. The appearance of prostate adenoma is considered therefore an metabolism alteration, one of the factors being represented by testosterone.
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Natural evolution of the prostate adenoma allows classification into three stages:
- Microscopic phase
- Macroscopic phase
- Clinical stage (manifested)
The treatment attitude for prostate adenoma is varied. There are drug and surgical treatments, preventive and surveillance procedures.
Prostate Adenoma Symptoms
The Prostatic capsule is elastic and when the gland increases in size it compresses the urethra (the channel through which urine is eliminated from the bladder). Expulsion of urine from the bladder is achieved with muscle contraction and abdominal muscles pressure. The appearance of prostate adenoma leads to changes in natural urination so, urination becomes more difficult, more frequent, but incomplete (drop by drop, the bladder does not empty completely). Normally bladder residue liquid is 20-40 cm, but in benign prostatic hyperplasia when there so-called combat bladder, can reach 100 cm. Of course, the presence and persistence of this unevacuated remnant of urine favors bacterial infections. Other symptoms
- Urinary frequency (frequent urination urge)
- Intermittent urinary flow
- Nocturia (frequent nighttime urination)
- Urinary incontinence
- Urinary retention
- Dysuria (burning discomfort when urinating )
- Sometimes hematuria (presence of blood or red blood cells in urine). People who have nocturia do not rest properly due to the frequent interruption of sleep to go to the toilet. Prostate adenoma, as well as all lower urinary tract diseases (acute and chronic prostatitis, prostate cancer, cystitis, urethritis) can lead to limitation of normal daily activities and lifestyle involves adapting according to urinary problems. Complications of the disease include: bladder stones, which is the result of stagnation of urine in the bladder and the presence of an obstacle on the path of discharge, inflammation of the prostate adenoma, urinary tract infections, acute epididymitis, etc..
Prostate Adenoma Prevention
Prostate Adenoma Treatment
10-15% of patients with benign prostate adenoma need surgery, the rest can benefit from medication to reduce the urinating disorders. The immediate goal is to reduce the gland volume for urinating ease, bladder evacuation, and most important for reducing the risk of stones, polyps, diverticulitis, infections or cancer, local problems that can eventually lead to loss of kidney function.
Adenomectomy- pathological tissue is removed from the prostate.Complications during surgery or postoperative complications include: bleeding, infections, urinary incontinence and dysuria, retrograde ejaculation with secondary infertility, but without consequences on sexual potency. Endoscopic treatment. Transurethral resection of the prostate adenoma uses a electrical wire for fragmentation of the adenoma. If it occurs, postoperative syndrome is the result of absorption of irrigation fluid (used continuously during the procedure), which enters the circulation causing hypervolaemia and sometimes hemolysis. Transurethral electro-vaporization of the prostate – similar to that described above, the difference consisting in the loop used in this intervention with a current intensity of around 290 watts for vaporizing the tissue, dissection and hemostasis (bleeding stoping). The procedure is superior due to handling facility and the absence of bleeding risk.
Because prostate adenoma is an androgen dependent process, pharmacological treatment aims at the hormonal component of the disease. Finasteride is responsible for inhibiting 5-alpha reductase, the enzyme responsible for conversion of testosterone to dihydrotestosterone (DHT), and significantly reduces symptoms. Alpha-adrenergic blockers quickly determines a rise in urine output. Anti-aromatase enzyme complex is responsible for transforming the androgen hormones in estrogen.
A study at the University of Arizona showed that a 200 mcg tablet with selenium (mcg) taken daily did not only greatly reduce the risk of prostate cancer, but other types of cancers too. A group of researchers in Finland has demonstrated the importance of an increased intake of vitamin E as a protective factor against prostate malignancies. After 50 years, each man should consume at least 240 IU (international units) of vitamin E.