Prostate Adenoma Treatment
Prostate adenoma refers to the most common pathologies encountered in older men. By the age of 70-80, almost 90% of men have some degree of proliferation of connective tissue of the prostate gland. Strictly speaking, now this condition is referred to as a variant of the age norm, and is considered one of the manifestations of male menopause.
Currently, the term "prostate adenoma" is replaced by another name - benign prostatic hyperplasia. It more accurately reflects the essence of the problem. The benign quality of the disease is manifested in the absence of metastasis, and this is the main difference between adenoma and prostate cancer.
Hyperplasia, i.e. an increase in the number of cells in the organ leads to compression of the urethra and disruption of the urination process. Also, the result of excessive proliferation of the glandular epithelium of the prostate is a violation of blood circulation in the prostate and damage to the nerve endings in the bladder. Violation of the conductivity of nerve impulses leads to difficulty urinating and does not allow the bladder to be completely empty.
As a result, the classic symptomatology of prostate adenoma develops - difficulty and frequent urination, especially at night, reduced strength of the stream, incomplete emptying of the bladder and a feeling of dissatisfaction after the act of urination. In the future, the symptoms increase, and the kidneys may be involved in the process.
The disease proceeds for a long time and is divided into several stages, depending on the degree of disturbances in the urinary system. Adenoma of the prostate gland significantly affects the quality of life, makes patients often wake up at night, and creates uncomfortable conditions for an active social life.
Treatment methods for prostate adenoma
Modern treatment of prostate adenoma is represented by several methods:
- Conservative (drug) treatment,
- Inoperative methods of treatment.
As auxiliary methods, physiotherapy, traditional and alternative medicine, as well as hardware exposure, are used.
Timely treatment of prostate adenoma that has been started allows avoiding surgical intervention and in most cases gives a stable positive result.
Treatment of prostate adenoma depending on the degree of the disease
Grade 1 prostate adenoma is successfully treated conservatively. The patient is prescribed a course of drug treatment in combination with therapeutic exercises and dieting. However, the patient, according to his desire, can also choose surgical treatment at the 1st degree of the disease.
With an adenoma of 2 degrees, depending on the severity of the symptoms, both conservative and surgical treatment can be prescribed.
Grade 3 prostate adenoma requires urgent hospitalization and surgical treatment, otherwise the disease is fatal.
The main component of the conservative treatment of prostate adenoma is drug therapy. Numerous clinical studies have proven the high effectiveness of certain drugs in relation to benign hyperplasia at the I-II stage. This allowed delaying surgical treatment and applying it only in rare cases, for example, in the late diagnosis of the disease, when there are serious difficulties in urinating, or when the kidneys are involved in the process.
Indications to use medicines are:
- Minor or moderate urinary disorders without the addition of renal complications,
- The old age of the patient, when the operation is contraindicated for health reasons,
- Re-development of prostate adenoma after surgery
- Refusal of surgical intervention for personal reasons.
Contraindications to drug treatment:
- A significant violation of the function of urination and a decrease in the flow rate of urine to 10 ml / s and below,
- The volume of residual urine (urine that remains in the bladder after urination) is more than 100 ml,
- The presence of blood in the urine,
- Acute urinary retention,
- The formation of stones in the bladder due to the progression of the disease.
Drug treatment is not mandatory, the patient may refuse it in favor of the operative correction of the disease. This is due to the fact that in some cases, drugs have a side effect, which is considered by patients as extremely undesirable for any reason.
Preparations for the treatment of prostate adenoma
Alpha1-adrenergic receptor antagonists
Medicines from the group of alpha1-adrenergic antagonists have a relaxing effect on the muscle fibers of the bladder and prostate. They quickly relieve muscle spasm and normalize the process of urination. The most commonly used are Omnic, Dalphaz, Kornam, Kardura, Segetis.
During treatment with alpha1-adrenoreceptor antagonists, blood pressure can significantly decrease, therefore, these drugs are not used for patients with low blood pressure.
However, Omnik and other tamsulosin-based drugs (Adenorm, Flosin, Fokusin, Lokren) do not have a pronounced hypotensive (pressure-lowering) effect. This makes it possible to use them in the treatment of elderly and senile patients with numerous concomitant pathologies (diabetes mellitus, bronchial asthma, hypertension, etc.).
Another significant advantage of tamsulosin-based drugs is their high effectiveness even at low dosages. The daily dose of these drugs can be 10 times lower than other alpha1-adrenergic antagonists. In addition, the number of side effects of tamsulosin funds is minimal.
Often, alpha1-adrenergic antagonists are prescribed in combination with Picamilon. It enhances the action of the main drug and contributes to a more rapid restoration of blood circulation in the genitourinary organs. In addition, Picamilon normalizes blood pressure, which allows to expand the patient population in relation to which alpha1-adrenergic antagonists can be used.
5 alpha reductase inhibitors
The most popular representative of this group is the drug Finasteride (Proscar, Penester). It inhibits the production of the hormone dihydrotestosterone, which helps to stop the progression of the disease, reduce the size of the prostate and normalize urination.
In the early stages of the disease, when the prostate gland is slightly enlarged, finasteride has the best effect, so the drug is used mainly in stage I of adenoma. Treatment with 5alpha-reductase inhibitors is continuous and lasts at least 6 months. The effectiveness of such treatment is quite high - more than half of the patients no longer need surgical intervention.
Of the side effects of Finasteride, it should be noted a decrease in sexual desire and erection (occurs after drug withdrawal), as well as a decrease in the level of prostate-specific antigen in the blood, which threatens the belated diagnosis of prostate cancer.
In the treatment of benign prostatic hyperplasia, an extract from the palm-shaped fan - Perixon - has proven itself well. It has an effect similar to Finasterin, but does not have its side effects.
An extract from the bark of African plum, Tandenan, is also widely used. It normalizes the function of urination, increases the flow rate of urine, relieves inflammation in the tissues of the prostate. In this case, sexual desire and potency remain at the same level.
The homeopathic medicine Afala, which showed good clinical results in patients with I-II stage of prostatic hyperplasia, is also deprived of side effects. Afala reduces the severity of inflammation in the prostate gland, relieves tissue swelling and eliminates the manifestations of urination disorders. In addition, the use of this agent leads to a significant reduction in pain and discomfort in the pelvic organs.
Afala can be used as monotherapy or in combination with other drugs. The duration of the drug should be at least 4 months, if necessary, the course of treatment can be repeated.
Physiotherapy in the treatment of prostate adenoma is used exclusively as an adjuvant. Properly selected physiotherapeutic procedures together with medicines can have a lasting positive result, and in some cases ensure a full recovery.
Such procedures as UHF, inductothermy, microwave and ultrasound therapy for prostate adenoma are not used, because can contribute to increased proliferation of glandular epithelium.
Specific methods of physiotherapeutic influence are safer and at the same time effective.
- microwave thermotherapy
- laser coagulation of the prostate,
- transurethral needle ablation.
In fact, these techniques are on the verge between physiotherapy and surgery and have a local effect on the tissues of the prostate gland. Details of these techniques are described in the section on minimally invasive surgical interventions and non-surgical methods of treatment.
In addition to specific methods of physiotherapy, quite often used mud applications (peloid therapy). With prostate adenoma, local or cavity applications with different types of mud - peat, silt, sapropelic - are most effective. Local dirt is applied to the area of the projection of the prostate gland, and when using the cavity technique, mud tampons are inserted into the rectum. The goal of the mud therapy is to activate blood circulation in the pelvic organs. The duration of the course of treatment is from 10 to 15 procedures. Peloid therapy is prescribed with caution, only in the very early stages of prostate adenoma.
Proper nutrition cannot, of course, cure the disease, but it is quite possible to alleviate the condition through diet.
Fresh vegetables and fruits, cereals, bran, which contribute to regular bowel movements, should predominate in the diet. The intestinal motor activity is stimulated by: grapefruit, apples, cherries, apricots, carrots, beets, tomatoes, pumpkin, cabbage. They can be consumed fresh or prepared from them salads, juices.
- Porridge is best prepared from oat, barley, buckwheat.
- Bakery products are preferred from wholemeal or rye flour.
- It is advisable to consume dairy and dairy products every day, but not more than 200-300 g.
- Low-fat varieties of meat and sea fish are allowed in food no more than 1 time per day.
- Greens, salads seasoned with vegetable oil can be consumed in unlimited quantities.
- Of the liquids allowed to drink green tea, weak black tea and coffee, juices and mineral water. Drinking regimen should not exceed 1.5 liters per day.
All types of spices, bitterness, canned and smoked products should be completely excluded from the diet. The same applies to beer and spirits.
Therapeutic gymnastics is very important for patients with prostate adenoma. With the help of simple daily exercises, you can slow down, and in some cases prevent the further progression of the disease.
A set of mandatory exercises has been developed, which should be performed daily by people with prostate adenoma. It is most correct to perform it in the morning before eating, immediately after a hygienic shower. It is important to ensure that your feet do not get too cold during charging, otherwise the effectiveness of these measures will be minimized.
The complex consists of the following exercises:
- Crawl on all fours for 5 minutes. This exercise relaxes the lumbar muscles well and enhances blood circulation in the pelvic organs.
- “Walking” on the buttocks for at least 3 minutes allows you to massage the area of the prostate gland and normalize blood and lymph circulation in it.
- Stretching exercises on the internal muscles of the thighs and pelvic floor. The simplest exercise is to sit on the floor, bend your knees, spread your knees to the sides and connect the soles of the feet. Place your hands on the floor behind your back. Performing springing movements with his legs, try to touch the knees of the floor.
- Static tension of the muscles of the abdomen and hips. To perform this exercise, you need to take a sitting position, lean your hands on your knees and squeeze them strongly with your palms. Tighten all thigh muscles as much as possible. At the same time, tighten the abdomen and tighten the abdominal press. Hold in this position for at least 30 seconds, and then relax. The number of repetitions of the exercise can be from 3 to 5, but over time it is desirable to bring them to 10 at a time.
- Lie on your back, raise your legs at an acute angle to the floor and stay in that position for as long as the physical form allows. After each lift, take a break for 1 minute and repeat at least 3-5 times.
- Simultaneous raising of arms and legs while lying on your stomach. This exercise strengthens the muscles of the back and activates blood circulation. The number of repetitions, as in the previous exercise.
It is advisable to add push-ups to the complex of exercises. You can do push-ups from the floor, bed, chair, wall. The multiplicity of exercises build up gradually, as you get used to the loads.
Running helps activate blood circulation, tones the body and promotes the reverse development of symptoms of prostate adenoma.
But long riding a bicycle or in a car has an extremely negative effect on the condition of the prostate. The same applies to continuous sitting in one place.
We must not forget that a long delay in the emptying of the bladder has a very negative effect on the condition of the prostate gland, bladder and kidneys. Therefore, at the first urge to urinate, you need to immediately empty the bladder.
Surgical treatment of prostate adenoma
All currently existing methods of surgical treatment of prostate adenoma are divided into standard surgical interventions and minimally invasive surgical interventions. Which of the methods is suitable for a particular patient, the doctor can decide on the basis of examination and comprehensive examination, taking into account the age and stage of the disease, as well as the existing concomitant pathology.
An indication of the need for surgical treatment are:
- Acute urinary retention,
- Blood in the urine
- Frequently recurring urinary tract infections,
- The formation of stones in the bladder.
These conditions are absolute indications for surgical treatment. Also, the operation is indicated for those patients for whom medication did not bring relief, or they initially abandoned the drug.
The gold standard for surgical treatment is transurethral resection (removal) of the prostate gland (TURP), and in advanced cases open adenomectomy.
- The most traumatic treatment is open adenomectomy. In this case, surgical access is formed by dissecting the anterior abdominal wall and the bladder.The method is shown only with significant sizes of the prostate gland.
- There is another access to the prostate gland - through the urethra. This method of removing prostate hyperplasia (TURP) is more gentle, because there is no need to open the abdominal cavity. All manipulations, as well as control over the course of the operation, are carried out through an endoscope - a flexible probe with a camera.
The TURP technique is resorted to in the case of:
- The young age of the patient, when it is important to maintain potency,
- Suspicion of malignant pathology in the prostate,
- Numerous concomitant diseases of the cardiovascular, endocrine systems, as well as obesity,
- Unsuccessful minimally invasive surgical treatment,
- The lack of effect of prolonged drug treatment,
- The combined pathology of the prostate is a combination of adenoma with prostatitis or stones in the prostate gland.
The severe general condition of the patient, the acute period of diseases of any nature, reduced blood coagulation - all this refers to contraindications for TURP.
Another operation, in the sense of very similar to TURP, is transurethral incision (dissection) of the prostate (TUIP). An endoscope is inserted into the urethra and, with the help of a current or a laser beam, the tissue of the prostate gland is dissected (not removed) in the area where it adjoins the bladder. Due to this, the normal outflow of urine from the bladder is restored.
The operation can be recommended for men who want to maintain potency and have relatively small sizes of the prostate gland. The operation is faster and tolerated by patients much easier than TURP. Contraindications for surgery are the same as for TURP.
Minimally invasive surgery
The last word in medicine today is considered to be minimally invasive techniques that are carried out endoscopically. These methods include laser vaporization, radio wave needle ablation and prostatic artery embolization.
Minimally invasive techniques are to a much lesser extent accompanied by complications, both during surgery and in the postoperative period. In addition, for patients with severe internal diseases, especially with very high blood pressure, diabetes mellitus, bronchial asthma, these methods are almost the only possible surgical method of treatment.
- Laser treatment - transurethral vaporization of the prostate - involves heating and evaporation (vaporization) of water from the tissues of the prostate gland. Along with vaporization, tissue coagulation (coagulation) and bleeding stop also occur. The method is used for small adenomatous growths and is characterized by the least morbidity, low risk of postoperative complications and rapid restoration of organ function. Sometimes, to achieve a stable positive result, several similar operations are required. A huge advantage of this technique is the possibility of its application in relation to people with bleeding disorders.
- Transurethral needle ablation (TIA) is indicated for patients with a slightly enlarged prostate gland. The essence of the method consists in exposure to overgrown prostate tissue using high-frequency radio waves. A hollow instrument called a cystoscope is inserted into the urethra, and an electrode with needles at the end that transmit radio waves is passed through it. As a result, heating and destruction of adenomatous growths occurs. The operation lasts no more than 45 minutes, is performed under local anesthesia. Full recovery of the body occurs in about 1-2 weeks.
- Of the latest developments in the field of urological surgery, the method should be called embolization (blockage) of the prostatic artery. It can significantly reduce the volume of the prostate gland by reducing blood flow in the organ. This technique does not entail negative effects, such as impotence, decreased libido, urinary incontinence, and the risk of postoperative infection. Most patients can leave the hospital the day after surgery. It is also important that one month after embolization, some patients no longer need medications to relieve symptoms of prostatic hyperplasia.
Treatment in the recovery period after removal of the prostate adenoma
After removal of the prostate adenoma by the transvesical method (open adenomectomy), patients are always prescribed antibacterial drugs in prophylactic dosages, as well as painkillers for a period of intense pain.
Mandatory is the daily washing of the bladder with disinfectant solutions (furatsilin) or saline. This is necessary so that blood clots do not accumulate in the bladder and healing of the postoperative wound proceeds faster. The procedure is performed through two thin catheters, which are constantly located in the bladder and urethra during rehabilitation.
The sutures on the anterior abdominal wall are daily treated with hydrogen peroxide and disinfectants (alcohol tincture of iodine, fucortsin, diamond greens). A sterile gauze dressing is applied over the wound, which is changed daily until the sutures are removed.
The timing of removal of sutures can vary slightly, but on average 7-8 days after surgery. A catheter is removed from the bladder on approximately 3 days, and from the urethra on 5-7 days. Immediately before removing it, the bladder is filled with saline or furacilin, and then the patient is asked to urinate.
The recovery period after TURP (endoscopic removal of adenomatous growths) practically does not differ from that with open adenectomy, with the only difference being that only one catheter in the urethra is used for washing, and the discharge from the hospital is shortened to 4-5 days. However, a full recovery, both in the case of TURP and with open removal of the adenoma, occurs by 3-4 weeks after the operation.
After minimally invasive surgery, antibiotics and pain medications are also prescribed. A urinary catheter can be left for 2-3 days to prevent thrombosis and disinfect the bladder. Full recovery occurs in 10-12 days.
All patients without exception are advised to get out of bed earlier, perform light gymnastic exercises to activate blood circulation and a laxative dietary supplement for the prevention of postoperative constipation. The amount of fluid you drink should be increased to 2-2.5 liters, so that there is an active washing of the entire urinary system. In addition, an increase in the volume of fluid drunk helps prevent complications such as stricture (narrowing) of the bladder.
In the recovery period, lifting heavy weights of more than 2 kg is prohibited.
Aspen Bark Treatment
The use of a decoction, tincture and extract from aspen bark has anti-inflammatory, analgesic, diuretic, antimicrobial and immunostimulating effects due to the presence of flavonoids, tannins and resinous substances in the bark of this tree.
The most healing is the bark of aspen, which was collected in the spring during the period of active sap flow (from April 20 to June 1). For treatment, you can use both the bark removed from the trunk and the bark from the branches. After collection, it must be dried at a temperature of 40-60 o C (in the oven or oven), previously crushed to pieces up to 3-4 cm. The collected raw materials should not be dried under the sun, since under their influence it will lose its healing properties .
To prepare a decoction of aspen bark, pour 100 g of dry bark 1 liter of boiling water, simmer for 10-15 minutes on low heat, strain. Take a decoction of 1 glass 30-40 minutes before a meal. This tool will help to cope with urinary incontinence, painful urination and inflammation in the tissues of the prostate gland.
To prepare tinctures from aspen bark, you will need 200 g of bark and 500 ml of 40 o alcohol or vodka. Pour the bark into a liter glass container and pour vodka over it. Close the container with a lid and insist in a cool, dark place for 2 weeks, occasionally shaking. Shake the container vigorously before use and take 20 drops of tincture with 70 ml of water three times a day for 3 months, half an hour before eating. This tool will help normalize the process of urine excretion, reduce painful manifestations and, in some cases, will achieve a reduction in the size of the prostate adenoma.
Contraindications to the use of aspen bark:
- frequent constipation
- chronic gastrointestinal diseases,
- intestinal dysbiosis.
Treatment with propolis and bee subpestilence
Preparations and preparations prepared at home based on propolis and bee subpestilence can be used not only for treatment, but also for the prevention of prostate adenoma in men older than 40-45 years. They provide a gradual resorption of the tumor and reduce the risk of its malignant transformation.
To prepare a decoction of propolis and bee subpestilence, you need 2 tablespoons of bee subpestilence (use only fresh dead bees without an unpleasant odor and mold) pour 0.7 l of boiled water. The water is brought to a boil, and then continue to boil over low heat for about 2 hours. The broth is allowed to cool, filtered and 2 teaspoons of 10% alcohol tincture of propolis and honey are added to it. The resulting broth is stored in the refrigerator (up to 1 month). Take a tablespoon twice a day, half an hour before breakfast and dinner. The course of treatment is a month and a half, the break is a month, it is necessary to carry out 3 courses per year.
Pumpkin Seed Treatment
Due to the high content of bioactive substances, vitamins and minerals, pumpkin seeds have a beneficial effect on the prostate gland and can be used both for treatment and for prevention of prostate adenoma.
It is recommended to eat 100-120 g per day of dried raw pumpkin seeds (they must always preserve the green shell after removing the peel). They can also be used as seasoning for salads and other dishes.
Fasting treatment - in recent years, the use of therapeutic fasting for the treatment of prostate adenoma has been successfully practiced.
The principle of this technique is that against the background of a complete rejection of food in the body, a number of processes are launched that contribute to:
- improving overall health and strengthening immunity,
- reduction of pain
- losing weight
- reduce pressure on the bladder,
- decrease in tumor volume or its disappearance.
For the treatment of prostate adenoma, a 21-day refusal of food is generally recommended. The patient is allowed to drink only boiled water.
Medical starvation can be carried out only after the exclusion of all contraindications to it (some diseases, advanced age) and under the constant supervision of a specialist who owns this method of alternative treatment.
In the process of fasting, the patient may be prescribed some types of physiotherapeutic procedures, the effectiveness of which, as practice shows, increases significantly. During the course of treatment with hunger, the patient may feel depressed mood, dizziness, heaviness in the limbs, discomfort in the joints and internal organs. For a more comfortable implementation of this treatment technique and to improve well-being, it is recommended:
- drink plenty of water
- Do not brush your teeth with toothpaste, but use decoctions of herbs to rinse your mouth,
- minimize physical activity,
- to make you feel better, take a warm shower.
After completing the course of fasting, it is necessary to gradually step out of hunger, observing all the instructions of a specialist.
Yoga therapy - is used for prostate adenoma in the form of a set of gymnastic exercises that can reduce pain and help restore lost functions of the genitourinary system.
The complex of gymnastic exercises includes not only physical exercises, but also proper breathing techniques. Continuous yoga therapy classes can not only weaken the manifestations of prostate adenoma, but also contribute to the activation of the body's immune forces and normalization of the psychoemotional state.
For this, static exercises are used that contribute to:
- strengthening muscles in the pelvis and abdomen,
- elimination of congestion in the bloodstream of the pelvic organs,
- normalization of the tone of the muscles of the pelvis.
Yoga therapy classes are conducted under the supervision of a specialist who selects a set of exercises for each patient, teaches proper breathing techniques and monitors the correctness of their implementation. After several classes, a set of exercises can be performed at home.
A few recommendations for patients:
- you can not conduct classes at elevated temperatures,
- classes should be postponed for the period recommended by the instructor if the operation was postponed or there was an exacerbation of some chronic disease,
- classes should not be accompanied by unpleasant sensations and lead to a deterioration in overall well-being after they are completed,
- Before performing this or that exercise, it is necessary to familiarize yourself with contraindications to it and fully master the technique of its implementation,
- you can’t increase the number of exercises recommended by the instructor,
- You should not get up sharply after exercises that are performed while lying down.
Yoga therapy may be contraindicated in people who have malignant tumors, mental disorders, blood diseases, significant disorders in the proportions of the skeleton.
Prostam is a vibromassage type device that was developed to treat patients with acute and chronic diseases of the genitourinary system by treating prostate tissue with transrectal access. This device can be used both in inpatient or outpatient settings, and at home (the patient can use it on his own).
Prostam is used for:
- improve tissue microcirculation in the surrounding tissues and prostate,
- getting anti-inflammatory effect,
- elimination of stagnant processes,
- reduction of edematous and spastic components,
- pain relief.
It can be used to treat patients with prostate adenoma in combination with drug treatment and enhances the effect of drugs. This is facilitated by those properties of the apparatus, which are laid down in the principle of its operation:
- hyperthermia - helps to improve microcirculation and stimulates the immunity of tissues surrounding the gland,
- local action of the magnetic field - helps to reduce pain, inflammation, swelling, regeneration of damaged tissues,
- mechanical microvibration - restores the tone of the muscles of the pelvic floor, helps eliminate stagnant phenomena in the prostate and surrounding tissues.
Before using this device, the patient should consult a doctor, because in some cases its use is contraindicated:
- acute and chronic prostatitis in the acute stage,
- malignant tumors of the prostate,
- active prostate tuberculosis or suspected tuberculosis infection,
- acute inflammatory processes of the rectum,
- malignant tumors of the rectum.
The full course of treatment with the Prostam device is, as a rule, up to 10 procedures that are carried out once a day for 30 minutes. You can repeat the course of treatment after 2-3 months.
Thermex-Turapy (Tempro) is a unique bipolar radio frequency technology that allows a urologist to thermally treat prostate adenomas and chronic prostatitis of varying severity with the help of special thermal electrodes. When treated with Thermex-Turapy, the use of a cooling system and measurement of rectal temperature are not required.
This innovative device allows you to individually approach the treatment of each patient: in the process of radiofrequency thermotherapy, the temperature regime can change to a high, medium and low level, localization of the effect on a particular area of the prostate is controlled. After the procedure, all data is stored on the machine and can be printed.
Radiofrequency thermal therapy on this unit is carried out in a hospital. A catheter with a thermoelectrode and balloon is inserted through the patient's urethra. In the bladder, the balloon is inflated and the electrode is fixed at the level of the prostate that needs exposure. A second electrode is attached to the patient’s back. The device, controlled by a urologist, begins the generation of radio waves that increase the temperature of the prostate to 42-52 o C (the temperature is selected by the doctor individually for each patient). Under the influence of this temperature regime, only actively growing cells of the prostate are selectively destroyed, because the tissues to which the radiation is not directed remain “cold”. According to statistics, this procedure allows you to achieve improvement in the quality of urination in 51-90% of patients, and a decrease in the size of the prostate occurs in 45-80%.
Indications for treatment on the device Thermex-Turapy (Tempro):
- prostate hyperplasia with signs of difficulty urinating,
- the patient has contraindications for the surgical treatment of prostate adenoma,
- sexually active men in whom the medication used to treat adenoma causes erectile dysfunction,
- ineffective medication for prostate adenoma.
Contraindications for treatment on the device Thermex-Turapy (Tempro):
- metal prostheses in joints
- the presence of a pacemaker,
- bleeding disorders
- suspected malignant prostate tumors,
- prostate cancer,
- peptic ulcer of the stomach and duodenum in the acute stage,
- mental disorders
- diseases and infections of the urethra and bladder.
Before the procedure, the patient must undergo a series of examinations:
- clinical tests of urine and blood,
- blood biochemistry (creatinine, urea),
- blood test for PSA (determination of the level of prostatic specific antigen),
- Ultrasound of the prostate and urinary system.
The cost of treating prostate adenoma
The price of treatment for prostate adenoma depends on the stage of the disease, concomitant pathologies and the effectiveness of the prescribed course:
- drug therapy
- minimally invasive endoscopic techniques,
- type of surgical treatment.
The price of drug therapy will depend on:
- the duration of the course of therapy,
- prices for drugs and or their analogues (depending on the manufacturer),
- treatment effectiveness.
Prices for treatment using minimally invasive techniques (stenting, balloon dilatation, thermotherapy) depend on the stage of the disease, the clinic in which they are conducted, the number of necessary procedures. For example, prices for urethral stenting also depend on the type of stent used and can range from 15 to 180 thousand rubles.
The prices for surgical treatment of prostate adenoma depend on the technique of performing the operation to remove the prostate and the clinic in which the operation is performed. For example, a transurethral resection of prostate adenoma in Russia can cost from 65 to 90 thousand rubles, in Israel up to 10-12 thousand euros, in Germany about 15 thousand euros, and in Turkey 5-6 thousand. Euro.
An open prostatectomy in Russian clinics can cost about 117-140 thousand rubles, in Israel - up to 12 thousand euros, in Germany - 16 thousand euros, and in Turkey - 8 thousand euros.
Laparoscopic removal of the prostate will cost patients in Russia 80-100 thousand rubles, and a lateral adenomectomy - about 85-93 thousand rubles.
In recent years, the leading Russian and foreign clinics have performed embolization of the prostate arteries. In Russia, such an operation can cost about 50-60 thousand rubles, in Germany - 24-26 thousand euros, in South Korea - 18 thousand euros, and in Turkey - about 10 thousand euros.
Prices for alternative methods of treating prostate adenoma depend on the methodology used and the duration of its use. They are different in different clinics.
What is prostate adenoma
Prostate adenoma is the most common cause of urinary disorders in men after 45 years and later. The main symptoms: frequent urination, frequent nightly trips to the toilet, involuntary urination, a weak stream of urine, a spray of the stream, a feeling of incomplete emptying, pain during urination. These symptoms develop as a result of compression of the hypertrophic (swollen) prostate of the urethra, through which urine passes when urinating, as shown in the figure on the left. Prostate adenoma develops in people after 45 years. Prostate adenoma occurs in 50-60% of men after 60 years of age, as well as in 80% of men aged 80 years.
References to sources:
Failure in the venous outflow system of the testes, as well as a local increase in testosterone levels - more than 100 times higher than the concentration in the blood serum
Testosterone is the main cause of prostate adenoma. So in men neutered before puberty, prostate adenoma does not develop. However, the level of existing testosterone (in non-neutered men) is not associated with a risk of prostate adenoma. Why? And because prostate adenoma occurs as a result of a malfunction in the system of venous outflow in the testes. As a result of such a violation, hydrostatic pressure rises, and the local level of testosterone rises (100 times higher than in blood serum). That is why a change in the level of testosterone in the blood does not affect the risk of prostate adenoma - in non-neutered men.
Reviews on the treatment of prostate adenoma
Analysis of patient reviews indicates that in most cases, timely and adequate medication, physiotherapy, alternative and alternative treatment of prostate adenoma in the early stages provides good and lasting results.
With severe prostatic hyperplasia in stage II, good results are achieved with a combination of drug therapy, physiotherapy and minimally invasive endoscopic techniques (FUVI, cryodestruction, TUMT, etc.).
Techniques such as balloon dilatation and urethral stenting significantly alleviate the patient's condition. But the duration and severity of the effect of these methods of modern treatment depends on the patient's prostate condition and the rate of progression of prostatic hyperplasia. As a rule, these treatment methods are used only to postpone surgical intervention and if there are contraindications to one or another method to remove the prostate.
In the later stages of the disease, patients are recommended surgical intervention, which, in their opinion, becomes the only acceptable option for the treatment of advanced cases. According to statistics, timely operations to remove the prostate at the I-II stage give good results and only in rare cases cause complications.
Enlargement of aromatase and 5-alpha reductase enzymes
Aromatase and 5-alpha reductase enzymes increase with age. Aromatase and 5-alpha reductase are responsible for the conversion of testosterone to estrogen and dihydrotestosterone, respectively. As a result, estrogen and dihydrotestosterone levels increase. Estrogens play a key role in the growth of prostate cells. And dihydrotestosterone is an anabolic hormone, many times more powerful than testosterone itself. Such synergistic effects of estrogen and dihydrotestosterone cause prostate adenoma.
Lifestyle changes can reduce the symptoms of prostate adenoma. It is necessary to reduce the use of alcohol, caffeine (due to its diuretic properties), as well as reduce the use of fluids before bedtime. Palmetto supplement, which has not shown effectiveness in research, is actively advertised in the press.
What is prostate adenoma
Prostate adenoma is a common male disease, manifested in the form of nodular growth of tissues, the appearance of neoplasms, and enlargement of the gland. This disrupts the ability of the normal physiological process of urine output due to narrowing of the sphincter.
But the difficulty in committing the act of urination is not the only nuisance that arises with prostate adenoma, and patients with this disease also get kidney failure, which increases the poisoning of the body by toxins. The work of the stomach worsens, disturbances in the activity of the liver and excretory system occur. Signs of gastritis, cholecystitis, colitis and other diseases appear.
The urinary system ceases to function normally, which causes the accumulation of harmful nitrogenous substances in the body. For the treatment of benign prostatic hyperplasia, various methods are used, non-surgical are gentle for the body.
Minimally invasive treatments
- Urethral expansion using a can, which expands the urethra and contributes to the normal outflow of urine. The duration of the effect of the procedure is up to 6 months.
- Stenting. It differs from the insertion of the cannula in that an elastic durable stent is inserted into the urethra, which expands the urethral lumen, improving the ability to excrete urine. The stent is installed for a different period of use, both temporarily and permanently.
- Local thermal effects on specific areas of the gland. With the help of devices with various types of radiation: ultrasound, radio and microwave. The radiation temperature is selected individually in the range of 40 - 120 ° C and destroys only the focus of diseased cells without damaging healthy tissue.
- Thermal ablation provides for the action on the iron of ultrasonic waves of a certain range - from 50 to 100 kHz. This method destroys diseased cells, they die after the procedure.
- Laser vaporization based on exposure to the problem area of the directed laser beam. As a result of the procedure, liquid evaporates from the cells, the surface of the wound heals, and the size of the gland decreases.
- Embolization of the prostate arteries - The latest non-surgical treatment. When used with special medical spherical devices, they block the arteries, stopping the access of nutrients to the gland. Due to a decrease in nutrition, the iron “loses weight” and is blown away.
Urologist selects minimally invasive methods for treating prostate adenoma individually for each patient.
In the treatment of adenoma, various medications are used:
- Alpha blockers. They act on the muscles around the urethra, relaxing them and promoting the excretion of urine. Improvements are noticeable just a few days after treatment with omnichrome - a new effective drug.
- 5-alpha reductase inhibitorswhich reduce the production of the hormone dihydrotestosterone, which affects the growth of prostate cells. Preparations of this group are taken for a long time - 3-4 months.
- IN mistletoe used drugs based on white mistletoe. The plant is rich in alkaloids and activates the immune system, which destroys swollen and inflamed cells.
- With photodynamic treatment, intravenous use sensitizing drugsthat linger in tumor cells longer than in healthy cells. Further, under the influence of a laser beam of a certain length, a biochemical reaction occurs in these cells with the formation of oxygen free radicals that locally destroy the tumor.
- In the system peptidotherapy biologically active substances are used - peptides. Drugs with their content contribute to the restoration of the antitumor immune defense of the body and reduce the risk of the dynamics of the disease. Active peptides kill tumor cells.
Treatment of prostate adenoma with folk remedies
Alternative medicine is diverse, and their recipes are passed on by word of mouth for hundreds of years. Here are some recipes for treating prostate adenoma subject to an established diagnosis:
- Fir oil gives a good result. 5-6 drops of oil are added to body cream, and the crotch is lubricated daily with this mass. Ointment is not applied to the scrotum and anus.
- Decoction of fir bark: 2 tbsp. tablespoons of shallow bark pour - 200 ml of water, warm in a water bath for 35 - 40 minutes, cool. Drink 0.5 cups 30 minutes before meals twice a day for 14 days.
- Herbal mixture of white mistletoe, burdock root, corn stigmas, goose cinquefoil, pepper mountaineer. Mix 15 g of each herb, and pour 1 tablespoon of the mixture with boiling water 200 ml. Cool naturally. Take up to 3 glasses daily for a month.
- There are pumpkin seeds. They contain a trace element zinc. It interferes with cell growth and swelling of the gland.
Surgical methods are used in cases of large prostate size and the duration of the disease, as well as at a later stage of tumor development. They are produced in stationary conditions after examination.
There are the following methods for surgical solution of the problem:
- Transurethral resection (TUR). This method is more effective than other options for surgery, a positive result is observed in 90 out of 100 patients. Tumor cells are removed under anesthesia with a special device, and urination improves 3-4 days after surgery.
- Transurethral incision (TUI) is used with a small enlargement of the gland and is considered a gentle surgical procedure - after it, patients have no complications. At the time of surgery, several incisions are made on the prostate gland, with the help of which the cause of difficulty urinating is eliminated. Sometimes a repeated procedure is required to completely cure the patient.
- Open adenomectomy is effective in cases of large prostate size. In addition, experts recommend the use of such treatment if the patient has complications: stones in the bladder, tissue damage by stones, narrow lumen of the urethra. When performing a surgical operation, the doctor performs a skin incision in the lower abdomen to "get" to the diseased gland. Adenomectomy involves the removal of the inside of the gland.
α-blockers reduce the tone of smooth muscles in the prostate gland, mediated through α-1-adrenergic receptors
α-blockers reduce the tone of smooth muscles in the prostate, mediated through α - 1 adrenergic receptors. As a result the urethra does not squeeze, and urine easily leaves the bladder. However, α-blockers do not affect the growth rate of prostate adenoma and do not reduce it in size. α-blockers act after 3-5 days, but as soon as treatment is stopped, the symptoms return.
There are five main α-blockers: terazosin, doxazosin, tamsulosin, alfuzosin and silodosin. Of these five drugs, tamsulosin, alfuzosin, and silodosin have fewer cardiovascular side effects. All five drugs are equally effective. All of them have these side effects:
- dizziness (in 5-10% of cases)
- weakness (in 5% of cases)
- headache (in 5% of cases)
- asthenia (in 5-10% of cases)
- nasal congestion (in 5% of cases)
- retrograde ejaculation - the release of sperm does not occur in the external environment, but in the opposite direction (in 3-10% of cases)
The most interesting drug from this group is silodosin super-selective α-blocker. It blocks α1a-adrenergic receptors and, to a lesser extent, α1B-adrenergic receptors and α1d-adrenergic receptors. Due to the fact that it acts mainly on α1a-adrenergic receptors silodosin most safe for cardiovascular effects. There are minor effects on heart rate. Side effects include:
- infections of the upper respiratory tract (in 2-19% of cases),
- diarrhea (in 2-7% of cases)
- dizziness (in 3-5% of cases)
- orthostatic hypotension (in 3% of cases).
- retrograde ejaculation (in 20% of cases)
5-alpha reductase inhibitors
There are two main drugs in this group: finasteride and dutasteride (trade name is Avodart)
The second main class of drugs for the treatment of prostate adenoma are 5-alpha reductase inhibitors. These drugs are aimed at suppressing 5-α-reductase (5-AP), the enzyme responsible for converting testosterone to dihydrotestosterone (DHT). 5-alpha reductase inhibitors inhibit the conversion of testosterone to dihydrotestosterone (DHT). And dihydrotestosterone (DHT) is the main stimulator of prostate adenoma growth. When dihydrotestosterone is suppressed, then the prostate is reduced in sizeor its growth slows down. But this decrease does not occur of course immediately, but after 4-6 months. In fact, only this group of drugs treats prostate adenoma, and does not suppress its symptoms.
There are two main drugs in this group: finasteride and dutasteride (trade name is Avodart):
- finasteride inhibits (blocks) type 2 only isoforms of 5-alpha reductase. Reduces the synthesis of dihydrotestosterone in the prostate by 70% or more (less than dutasteride)
- dutasteride inhibits (blocks) both 1st and 2nd types of isoforms of 5-alpha reductase. Due to the double blockade, dutasteride reduces the synthesis of dihydrotestosterone in the prostate by 90% or more.
- Violation of ejaculation (in 1-5% of cases),
- decreased libido (in 5% of cases)
- gynecomastia - an increase in the mammary glands in men (in 1% of cases)
Finasteride 1 mg per day is also an effective treatment for male pattern baldness.
Phosphodiesterase 5 Inhibitors (PDE-5 Inhibitors)
How Phosphodiesterase Inhibitors 5 Work
This class of drugs helps to relax smooth muscles and arteries, dilate blood vessels, improve blood circulation, and increase erection - by inhibiting the degradation of cyclic guanosine monophosphate (cGMP). From this group of drugs, we consider tadalafil, sildenafil, vardenafil. Studies have shown that treatment with tadalafil is safe and can statistically significantly improve the symptoms of prostate adenoma. The drugs of this group also do not change the size of the prostate adenoma, but are symptomatic treatment - as a replacement for α-blockers. It is important that these drugs, unlike other groups, increase erection. After all, sildenafil is also a drug for erection, and we know it as Viagra. The action of tadalafil begins after 2 weeks. These drugs have minimal side effects (headache, back pain, facial flushing, dyspepsia, and nasopharyngitis). Many effects of this group of drugs, when used correctly, are beneficial to health and can potentially prolong life.
Symptoms of adenoma
Symptoms of a disease that signal a disease:
- Difficulty in the physiological process of urination, especially at the beginning
- Frequent “requirement” of the body to empty the bladder
- Feeling of incomplete bladder emptying
- Weak pressure of the urine stream during the act of urination, or interrupted process, urinary retention
- Pain during urination
- Uncontrolled urination, frequent nightly urination, urinary incontinence
Causes and factors causing prostate adenoma disease
There are many reasons for the occurrence of prostate adenoma, here are the most common ones:
- Age changes
- Hormonal malfunction in the body as a result of complications after diseases
- Decrease in the amount of produced sex hormones
- Inherited genetic predisposition
- Individual physiological features of the structure of the genitourinary system
- Hypothermia, chronic inflammation of the kidneys, ureters, bladder
There is a risk of developing the disease if the patient:
- There is no regular sex life
- Genital Injury
- Drinking a lot of alcohol
- Low physical activity
- Taking a large number of medicines and reducing the protective response of the body's immune system
Stages of Prostate Adenoma
According to medical analyzes and clinical studies, three stages of the development of the disease are revealed:
Stage 1 - compensated - is determined by a weak stream of urine during urination. There is a frequent desire to go to the toilet, especially at night. Complete bladder emptying occurs with the help of the detrusor - the muscular wall of the bladder and its ability to perform compensatory contractions. The duration of the first stage is purely individual, sometimes up to 10-12 years.
Stage 2 - subcompensated. At this stage, significant compression of the bladder disrupts the urinary system, does not evenly "pulsate" the walls of the bladder at the time of emptying. Symptoms of "not empty" bladder are manifested, the act of urination is performed in several stages, in small portions, spontaneous excretion of urine and its incontinence appear. At this stage, kidney failure begins to develop.
Stage 3 - decompensated - is manifested by stagnation of a large amount of urine in the bladder, the walls of which are stretched because of this, involuntary emptying, - drop by drop, pain. The general condition of the body worsens, weakness, blood loss, weight loss, lack of appetite, constipation, anemia, and the release of urine vapor with breathing appear.
To prevent and detect prostate adenoma, urologists recommend the use of the following preventive measures:
- Be sure to visit a urologist once a year.
- Remove fried, greasy and spicy foods from your diet.
- Refuse high-energy food.
- Stop drinking alcohol and smoking.
- Increase motor activity - daily exercise, after a day of classes in the pool or gym, walking.
- Keep track of weight, avoiding the appearance of fatty deposits.
The main condition for treating prostate adenoma is a timely visit to a doctor and treatment. From the video below you will learn about modern medical bio-therapeutic methods for treating the disease.
If you have additional useful information about the methods of prevention and the experience of curing prostate adenoma, share in the comments.