The very name describes benign prostatic hyperplasia. Benign means benign. Unlike prostate cancer, benign prostatic hyperplasia do not metastasize. Hyperplasia is excessive growth of normal cells, unlike cancer, where abnormal cells. This means that the nonmalignant benign prostatic hyperplasia, excessive growth of prostate cells. It does not sound so bad until you remember that the urethra, the tube that urine comes out of the bladder, passes through the prostate. As the hyperplasia develops so gradually narrows the urethra, which leads to many unpleasant and distressing symptoms.
What is it?
Benign (non-cancerous) growth of cells in the prostate.
Description of disease
The frequency of BPH increases with age. It is customary to say that "all men get benign prostatic hyperplasia if you live long enough." Some degree of BPH is present in 80% of men older than 40 years, and this figure increases to 95% of men aged 80 years.
Do periuretralnoj BHP comes in and transition zone prostate, ie. tissue surrounding the urethra into the prostate. Growth begins in muscle cells and fibrous prostate, and later spreads to cells that secrete fluid. Part of the affected tissue BHP is in the form of nodes, and the second part is more diffuse. As the tissue affected by benign prostatic hyperplasia in the transitional and periurethral areas increases, pushing the surrounding tissue in the central and peripheral zones, and so long as it does not press the outer sleeve. Prostate cell growth continues even when there is no space in the prostate and it is increased when the pressure begins to push the urethra and lead to urinary obstruction. Other factors, such as muscle fibers around the urethra, as part of the process of contraction and contribute to BPH obstruction. How to hyperplasia occurs in the inner part of the prostate surrounding the urethra, the size of the gland has little or no impact on the development of symptoms. And a small prostate can be difficult clogged, large prostate can be fully serviceable.
There is still no satisfactory explanation for the occurrence of BPH. The male hormone may play a role, but nobody knows whether it stimulates hyperplasia or just provide a favorable environment for its development. Prostate cancer, BPH and normal prostate cells - all need to dihydrotestosterone (DHT) and other androgens for growth and maintenance. Castration improves symptoms of BPH. The following explanation for BHP would be that cell proliferation exceeds their deaths in a certain age men. Whatever the cause, BPH can adversely affect the bladder and the urinary system in general. As the tumor encroaches on the urethra, bladder emptying is difficult which requires a stronger contraction of the bladder wall muscle, detrusora, to lead to leakage. It works for some time, and then detrusor becomes thicker and stronger in order to successfully compensate for the increased effort.These changes are left behind after definitive surgical treatment of prostate, which explains why some women the symptoms persist even 12 months after surgery. At the end of the detrusor loses its ability to forcing urine through the narrowed urethra. The bladder can not be completely emptied and then most of the symptoms occurs. If this behavior is retained, the pressure within the bladder is increased through the urinary system transmits back to the kidneys that can cause them permanent damage, life threatening. Fortunately, this rarely happens because most men seek medical help before it comes to serious complications.
Who become ill?
At risk groups include older men. Some other factors may play a role in the development of BPH.There are interesting connections between BHP and smoking. There is less likelihood that smokers suffer from BPH. The same applies to men who have cirrhosis of the liver. In them, the incidence of BPH is lower than in men with a healthy liver, and doctors believe that this is due to higher concentration of female hormones. Whatever the reason, do not use this as an invitation to alcohol consumption and smoking as this will only replace a benign disease of two much more serious. Finally, it is common to question whether due to BPH increases the risk of prostate cancer. Unfortunately, studies have not managed to solve this problem. Some studies indicate an increased risk, some of the non-existence, and some at reduced risk. The best way to summarize these data to say that there is a strong link between BPH and cancer. However, it is clear that the same risk factors for BPH and prostate cancer - older age men. Often coexisting BPH and cancer, causing the tissue removed during surgical treatment of BPH, carefully reviewed.
Symptoms
Less than half of all men suffering from BPH have symptoms that include:
• slow or delayed urination
• low-flow
• incomplete evacuation (stimulus to urinate immediately after urination)
• abruptness (fine spray during the emptying of the bladder)
• drip (trickle of urine, which takes a few seconds at the end of urination, a sign that the detrusor can no longer maintain a strong jet)
• nocturia (the need to urinate 2 to 3 times during the night)
• dysuria (pain when urinating)
• hematuria (presence of blood in the urine)
• urinary retention (delayed urine)
• frequent urination
• urinary urgency (a strong and sudden stimulus to urinate)
• Incontinence (uncontrolled leakage of urine)
Prostatizam is often used as a term for a variety of symptoms caused by BPH. Symptoms of BPH can be divided into two categories - obstructive and irritative symptoms. Obstructive are a direct result of the impact on BHP urethra, and the irritative manifestations of instability due to obstruction detrusora. In some men with BPH obstruction but no symptoms - it's called. prostatizam silent.
Obstructive symptoms include slowed or delayed urination, weak stream, abruptness, incomplete emptying and dribble at the end of urination.
Irritative symptoms include frequency, night urination, urgent urination, incontinence, dysuria, hematuria, urinary tract infection and urinary retention.
None of these symptoms is not specific for BPH. Any of them can be a sign of another disease.Symptoms of obstruction can be caused by narrowing of the urethra, bladder neck tightening, stones in the bladder, or prostate or bladder cancer. Irritative symptoms may occur due to instability of the detrusor muscle-m.mjehura, urinary tract infections, prostate inflammation or diabetes.
BPH symptoms can be exacerbated by taking certain medications to treat other diseases. Stimulants, like some found in asthma medications, and the secession of the sinuses, can be further narrowed urethra. Other drugs, like many antispazmolitici, may reduce the ability of bladder emptying. Diuretics and alcohol can also worsen symptoms, and it is important to give your doctor a list of all medications taken by the patient (including counter drugs to prescription). Termination of taking these medications may be all you need to do to eliminate the symptoms.
What results can I do?
• Digitorectal examination (prostate finger through the rectum) revealed increased soft and prostate.
• Can be measured by the flow of urine (in men with BPH is lower than 10 ml per second).
• Measurement of residual urine (residual volume of urine in the bladder after urination).
• Pressure testing of urine during urination: one can measure the pressure in the bladder in order to confirm the diagnosis and found a blockage.
• It is possible to do urine analysis to check whether the blood contains, or whether the infection is present.
• Urine culture if infection
• Cistouretrogram
• Select the blood - prostate-specific antigen (PSA)
• Cystoscopy - watching the prostate and bladder
Treatment
Alpha 1-blockers:
Today's treatment of benign prostatic hyperplasia involves the application of alpha 1-blockers: doxazosin (PLIVA-Tonocardin), prazosin and terazosin, drugs that were previously only used to treat high blood pressure. These medicines may be used to treat benign prostatic hyperplasia because it relaxes the muscles of the bladder neck and facilitate urination. From the people who were treated alpha 1-blockers, 74% reported improvement in symptoms.
Finasteride:
This drug lowers the level of hormones in the prostate, thereby reducing its size. Increases speed of urine flow and reduces the symptoms of benign prostatic hyperplasia. Sometimes it takes six months to lead to more important improvements. However, possible side effects associated with finasteride use include decreased libido (3.3%) and impotence (2.5 to 3.7%).
OTHER REMEDIES:
Antibiotics can be used to treat chronic prostatitis, which usually follows a benign prostate hyperplasia. Some men have reported improvement of symptoms after a course of antibiotics.
OPERATIVE TREATMENT
Surgery is usually indicated in men with symptoms of incontinence, blood in urine, urine retention and recurrent urinary tract infections. The selection of a specific surgical procedure usually depends on the severity of symptoms and prostate size and shape. Surgical treatment included transurethral resection of the prostate, transurethral incision of the prostate and open prostatectomy. During the various tests to assess the effectiveness of other therapies such as hyperthermia, thermal therapy, braces for prostate and hormone therapy.
TURP:
Transurethral resection of prostate (TURP) is the most common surgical treatment for benign prostatic hyperplasia. It is performed by inserting uretroskopa through the urethra. The main advantage of this procedure is that the incision does not involve reducing the risk of infection. After the transurethral resection of the prostate to improve symptoms for 10 to 15 years occurred in 88% of men. Impotence was present in 13.6%, and urinary incontinence in 1% of men.
TUIP:
Transurethral incision of the prostate (TUIP) is similar to resection, but is usually performed in men who have a relatively small prostate. This is an outpatient procedure performed. Prostate make a small incision in order to increase the opening (lumen) and the mouth of the urethra m.mjehura, improving urine flow and reduce symptoms of benign prostatic hyperplasia. An improvement of symptoms occurred in 80% of treated men. Possible complications include bleeding, infection, urethral stricture, and impotence (11.7%).
Open prostatectomy:
Open prostatectomy is usually performed using general or spinal anesthesia. This procedure is time consuming and requires a stay in hospital for seven to ten days. Most men (98%) said that after open prostatectomy had improved symptoms. Possible complications include impotence (16% to 32% depending on the surgical approach), and urinary incontinence (less than 1%). However, all the more popular methods that do not damage the nerves, because they reduce the risk of these complications.
Self-help measures can be useful in a minimal degree of obstruction. Include hot baths, avoiding alcohol or excessive fluid intake (especially at night), urination during the first impulse, regular sexual activity and ejaculation. The frequency of urination at night, you will lower by not drinking for several hours before you go to sleep. Symptoms of urinary incontinence can be reduced by scheduling your fluid intake throughout the day. Avoid taking large amounts of fluids at once, but rather drink less during the meal. Do not buy medicines for colds and sinuses that do not go to the recipe, containing the means for separation of the nose because these drugs can worsen symptoms of benign prostatic hyperplasia.
Prevention
Benign prostate enlargement is a normal physiological process that occurs with aging. Although prepubertal castration certainly prevents the development of benign prostatic hyperplasia, it is not a viable option.
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