Features of the symptomatology and treatment of BPH

Benign prostatic hyperplasia (BPH) is characterized by the formation of nodes with a tendency to increase. Prostate adenoma – benign neoplasm, which mainly develops after age 50, its appearance is due to hyperplasia of the paraurethral glands. It is noteworthy that the eunuchs and castrated men, the appearance of BPH (adenoma) is not fixed.

The main clinical picture pathology

The symptoms of BPH – decreased sexual function and the emergence of problems with urination; this is what primarily makes men go to the doctor.

Symptoms of pathology is divided into:

• Irritative.

Appear in the form of symptoms of irritation (frequent urination and urges the blank), men tend to need frequent visits to the bathroom during the night, which in the norm is not observed. Often when the adenoma is incontinence (leakage) of urine. In the formation of the symptoms of the disease plays a great role as a chronic inflammation of the prostate and pathological processes in the prostate and bladder (changes in the functions of the sphincter and detrusor). Irritative symptoms in men though reduce the quality of life, but the skillful conduct of conservative treatment can be significantly reduced.

• Obstructive.

Beginning of difficult urination, a thin and sluggish stream, intermittent. The patient must naturalise to "pour everything", but the feeling of incomplete emptying in the adenoma still remains.

Important! Clinical symptoms of BPH in men is extremely diverse in their formation involved the causes of mental, somatic status, they depend on the degree of progression of the disease.

In practical urology, widespread separation of symptoms of BPH on irritative and obstructive. In the first case, the symptoms in men determine a characteristic clinical picture of irritation, the second joined by symptoms of compression of prostatic Department of the urethra and bladder neck. As a consequence of a gradual accumulation of residual urine and extreme manifestation of this state believe paradoxical Isuzu.

Unfortunately, many men see the primary symptoms of the disease as age and seek medical attention only when there are signs of acute urinary retention.

Treatment of BPH performed, depending on the stage of the disease:

1. 1 degree is treated very successfully by a conservative with drug therapy, exercise, diet;
2. 2 the degree requires both conservative therapy and surgical intervention, all depends on the severity of symptoms;
3. Stage 3 – only urgent hospitalization with the use of surgical treatment, otherwise complications threatenthe lethal outcome.

Therapies

There are the following varieties:

Non-specific (supportive) therapy

To aid in the treatment of men includes the following methods:

• Physiotherapy and minimally invasive surgery (laser photocoagulation, microwave therapy, transurethral needle ablation, pelotherapy).
• Massage.
• Diet.
• Physiotherapy.

Specific therapy of the disease

Treatment of BPH are reduced to the following events:

1. Drug therapy.
2. Surgical treatment.
3. Minimally invasive (HIFU) therapy.

However, the main method of treatment of the disease remains operational; it is indicated for patients who have intravesicularly obstruction. The success of the operation depends on the presence of complications and stage of the disease.

The percentage of patients who come too late and have the symptoms of disorders of urodynamics (from acute urinary retention to disorders of the kidney, requires a long preparation to the radical operation was efficiently and without complications.

To bring back to normal the flow of urine is cystotomy, and in combination with anti-inflammatory treatment it provides a significant improvement in the patient's condition and accelerates rehabilitation.

Surgery

Absolute indications for surgery:

• Urinary retention.
• Stones in the bladder.
• A urinary tract infection.
• Renal failure.
• Diverticula of the bladder.
• Returning massive hematuria.

The decision on radical surgery transurethral method regarding BPH should be taken in a planned manner and only after a full clinical examination of the patient.

Many men in any way trying to delay the time of surgery, with enthusiasm using the proposed conservative remedies or alternative treatment, end up "living" to acute urinary retention. In this case, it is necessary to impose nalogovy vesical fistula.

The "gold standard" treatment of the adenoma is recognized as transurethral resection (TUR). Treatment with the use of epidural anesthesia significantly reduced the number of contraindications to surgical intervention.

This technique is indicated for patients whose prostate volume does not go beyond 60 cubic cm, in other cases, carry out adenomektomii, open surgery

Drug therapy

Drug treatment of BPH is mainly carried out using symptomatic drugs. For the treatment of BPH are shown in the following ways:

1. Inhibitors of 5-alpha-reductase.
2. Adjuvants.
3. Antibiotics withthe subsequent appointment of probiotics.
4. Herbal preparations.
5. Alpha-adrenergic blockers.
6. Drugs that improve blood circulation in the prostate in men (Trental).

As auxiliary methods for men are widely used folk medicine, hardware effects and alternative medicine. In some cases, experts use the method "cautious waiting", when there is asymptomatic pathology. But in this case requires a rigorous annual monitoring.