Benign prostatic hyperplasia (BPH) , formerly called prostate adenoma, prostate adenoma, is a benign growth that develops from glandular epithelium or the stromal component of the prostate.
At the same time, a small nodule (or nodules) is formed in the prostate, which grows and gradually squeezes the urethra. As a result of such compression there is a violation of urination. BPH has a benign growth, that is, does not metastasize. This fundamentally distinguishes BPH from prostate cancer. The main guideline for the onset of malignant prostate degeneration is the level of prostate specific antigen.
According to statistics, half of men older than 40-50 years go to the doctor for BPH. In rare cases, benign prostatic hyperplasia develops in younger men. With increasing age of a man, the risk of illness increases significantly. It is believed that over time it develops in 85% of men. In 15-20% of men of elderly and senile age, instead of developing BPH, an increase in the gland in varying degrees or its atrophy is observed.
BPH is the most common urological disease of older men.
The reasons for the development of BPH to date are not fully understood. It is believed that the development of BPH is one of the manifestations of male menopause. Risk factors include only the age and level of androgens in the blood. With age, the physiological balance between androgens and estrogens is disturbed in the man’s body, which leads to impaired control over the growth and function of prostate gland cells. There was no significant association between the occurrence of BPH and sexual activity, sexual orientation, tobacco and alcohol use, and inflammatory and venereal diseases of the genital organs.
Based on the characteristic complaints of men (for their standardization using the International Scale of Prostate Symptoms – I-PSS), clinical examination of the patient and such research methods as:
- Finger (palpatory) rectal examination of the prostate gland – gives an idea of the size and consistency of the prostate gland, pain, the presence of grooves between the prostate lobes (it should be normal).
- Laboratory tests – include urinalysis, biochemical blood analysis, determination of PSA (prostate specific antigen) levels in the blood.
- Instrumental research methods:
- Ultrasound – allows you to give an idea about the size of each lobe of the prostate gland, the state of its parenchyma (presence of nodules, stones), the presence of residual urine.
- An ultrasound modification of the prostate gland is transrectal ultrasound (TRUS).
- Uroflowmetry – objectively assesses the rate of urination.
- Radiographic methods of research – methods of panoramic X-ray (without contrast) and excretory urography (using contrast) allow you to determine the presence of complications of prostate adenoma: kidney stones and bladder, the expansion of the renal pelvic system and the formation of their diverticula.
There are many methods for treating benign prostatic hyperplasia. They are diverse and highly effective. These methods can be divided into three groups:
- Drug treatment
- Surgical treatment
- Non-operational methods
At the first symptoms of prostate adenoma, drug treatment is applied.
If the treatment of BPH is not performed, a long urinary retention contributes to the appearance of urolithiasis with the formation of stones in the bladder and the accession of infection. The most serious complication is pyelonephritis, which aggravates renal failure. In addition, a benign prostatic hyperplasia that exists for a long time without treatment can malignize (give rise to malignant growth) with the development of prostate cancer.
With timely and adequate treatment, the prognosis of the disease is very favorable.
An effective positive result is manifested if in the daily regimen there are classes of well-trained physical culture. This is a gymnastics aimed at improving blood circulation in the pelvic region, in combination with an exercise program with diaphragmatic breathing, vigorous walking or running in the fresh air, active swimming. The benefit of the movement is enhanced by the subsequent relaxation.
Directed to the timely treatment of prostatitis and regular monitoring by a doctor. Rational nutrition (reduction of fried, fatty, salty, spicy, smoked, increase in the share of vegetable and raw food), refusal of smoking, alcohol; control body weight, cholesterol levels; healthy mobile lifestyle.