Benign prostatic hyperplasia ( BPH ) : causes, symptoms, treatment , complications
Urology / / August 12, 2017
prostate adenoma video
BPH - what is it?
Causes of benign prostatic hyperplasia
Symptoms of BPH
diagnosis of benign prostatic hyperplasia
Treatment of BPH
Lifestyle changes - general recommendations
Medications that worsen the symptoms of BPH
Training the muscles of the pelvic floor
Herbs and Supplements
medications for the treatment of prostate adenoma
Surgical treatment of benign prostatic hyperplasia
BPH - pathology, characterized by increasing the size of the prostate and bladder functioning disorder.The actual size of the prostate do not necessarily indicate the severity of the disease.
Some men with minimally enlarged prostate may have pronounced symptoms, while others - with a much enlarged gland may experience minimal symptoms.BPH is common in older men (affecting about 60% of men after 59 years and 80% of men after 79 years).
Hyperplasia - is a common medical term that refers to an abnormal increase in cells.BPH - Benign enlargement of
prostate gland (pancreas) - genital organ in men, which is a muscle-glandular formation and releasing the secret involved in sperm formation.
Promotion sperm from the testes to the penis through the urethra occurs, which also serves as the excretion of urine from the bladder.
A significant proportion of men with BPH suffer progressive increase in the size of the prostate, which causes problems with urination and becomes a cause of lower urinary tract symptoms (LUTS).
The representatives of a strong half, with the symptoms of BPH and LUTS, quality of life is significantly reduced.Not all men suffering from BPH have symptoms of lower urinary tract, and not all men with LUTS, BPH amazed RV.
prostate gland. (RV) is located in the pelvic area below the bladder and in front of the rectum is a shape of a walnut.It wraps around the urethra (the tube that carries urine through the penis).
Prostate provides the following functions:
- Glandular cells produce secret.During ejaculation, the smooth muscles contract and there is ejection of fluid secretion into the urethra.There it mixes with sperm and other fluids, contributing to the formation of sperm.
- Iron contains the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone, the other a male hormone, which has a significant effect on the prostate.
prostate gland undergoes many changes during the life of the person.At birth, it is about the size of a pea, and before the onset of puberty varies slightly.It is with the onset of puberty its size begin to grow rapidly, and to 20 years it reaches the size and shape of an adult male.Some of the stronger sex resumes its growth due to intensive breeding cells after '41 (hyperplasia).
process urination . urination process is carried out is quite difficult:
It begins with a fluid output from the kidneys of two long tubes called ureters.The ureters enter the bladder, which lies on top of the pelvic floor muscle structure similar sling running between the pubic bone and the base of the spine.
brain regulates the muscles of the urinary tract.On admission of fluid into the bladder, nerves start to send signals from the bladder to the brain of its filling.
Out from the bladder sphincter tightly closed are two - the sphincter of the bladder and urethra sphincter.The process of urination is regulated by the sympathetic and parasympathetic nervous system.The sympathetic nerves, exciting, promote peristalsis of the ureters and the bladder walls to relax.So, there is a strengthening of compression sphincter (the ring-shaped muscle bundles) and the bladder is filled.The parasympathetic nerves cause the opposite effect, they contribute to the reduction of the walls of the bladder, sphincter to relax and release of urine from the bladder.
Causes of benign prostatic hyperplasia (BPH)
doctors do not have enough facts, explaining the reasons for benign prostatic hyperplasia (BPH).Age-related changes in hormonal levels, regulating sexual function of men are likely to play a role in the increase of the prostate gland.
androgens (male sex hormones) affect the enlargement of the prostate.The most important androgen is testosterone produced in the testicles during a person's lifetime.Prostate testosterone turns into another potent androgen - dihydrotestosterone (DHT).
DHT contributes to the growth of cells in the tissue, it was he who causes the growth of the glandular epithelium of the prostate is the main cause of its rapid increase, which occurs during puberty in adolescence.DHT is also a major culprit in prostate enlargement and later in adulthood.
With age, male testosterone levels drop, and the level of estrogen (female sex hormones increases, which can also be zapusknoe pancreatic growth mechanism
-.. Age Age is a major risk factor.. the development of BPH More than half of men develop BPH aged 60 years and about 85% of men have BPH aged 85 a rarity is the appearance of symptoms of the disease to 41 years
-. Family history family history of BPH.It is likely to increase a person's chances of developing this disease
-.. heart disease Some evidence suggests that the risk factors associated with heart disease may increase the risk of developing BPH They include obesity, high blood.pressure, low HDL ( "good" cholesterol), diabetes and peripheral arterial disease.
lifestyle factors that are harmful to the heart (eg, physical inactivity, smoking and poor diet) also increases the risk of BPH tons or worsen its symptoms.
symptoms of benign prostatic hyperplasia (BPH)
BPH are often, but not always, is the cause of lower urinary tract symptoms, causing problems with urination.Other diseases associated with bladder problems, may also exhibit similar symptoms.
symptoms associated with BPH RV collectively called lower urinary tract symptoms (LUTS).As a rule, they are classified as "obstructive" symptoms and "annoying" symptoms associated with bladder filling.
Common symptoms include:
- Strong and persistent urge to urinate;
- Fluctuations and intermittent urination, inability to empty the bladder completely, despite strong desires;
- voltage during urination;
- weak or intermittent urine stream;
- jerky and tense urine emissions at the end of urination;
- Increased frequency of urination (every few hours);
- Pain or burning during urination.
Urinary retention (inability to urinate) is a serious symptom of a severe form of BPH, which requires immediate medical attention.
Some men may be a slight manifestation of BPH symptoms or their absence.prostate size does not determine the severity of the symptoms.enlargement of the prostate may be accompanied by only a few symptoms, while severe LUTS may be present with normal or even a small-size prostate.
diagnosis of benign prostatic hyperplasia (BPH)
doctor makes a diagnosis of BPH on the basis of existing symptoms, medical history, physical examination and a variety of blood and urine tests.If necessary, your doctor may refer you to a urologist for more complex examination procedures.
Some diagnostic tests are intended to prevent cancer of the pancreas or bladder.Symptoms of prostate cancer may sometimes be similar to the symptoms of BPH.Research can also identify kidney injury caused by BPH.
- history of the disease. The doctor will ask about your personal and family medical history, including concomitant diseases observed in the past and taking place in the present.The doctor will also ask you about the medications that you take, can cause problems with urination.
- medical examination. medical examination includes a rectal palpation.The doctor introduces a gloved lubricated finger into the patient's rectum and prostate size and estimates available knots.This procedure is quick and painless enough, and can detect an enlarged prostate.
test helps rule out prostate cancer or problems with the muscles in the rectum that can cause the same symptoms, but it may underestimate the size of the prostate.Therefore, this kind of research is not the only means for diagnosis of BPH or prostate cancer.
Also doctor will palpation of the sides of the abdomen to detect abnormalities in the kidneys or bladder.The doctor may check your reflexes, sensation and motor reaction in the lower part of the body to avoid possible neurological bladder dysfunction.
- prostate-specific antigen (PSA) .Evaluation PSA content of the patient's blood is widely used as a screening test for the detection of prostate cancer.High PSA levels can indicate pancreatic cancer.Also BPH typically increases PSA levels, and certain drugs for the treatment of BPH can reduce PSA.
- Urinalysis. Urinalysis can detect signs of bleeding or an infection.The analysis includes the physical and chemical examination of urine samples.This analysis also allows to exclude bladder cancer.
- Uroflowmetry .When difficulty urinating used electronic test - uroflowmetry, which measures urine flow rate.
To perform the test, the patient urinates into a specially designed tube fitted with a measuring device.Reduced flow may indicate BPH.However, the obstruction of the bladder can also be caused by other factors, including weak bladder muscles and problems in the urethra.
- Cystoscopy. Cystoscopy, also called urethrocystoscopy - kind survey conducted by a urologist, to identify problems in the lower urinary tract, including the urethra and bladder.A doctor can determine the presence of structural problems, including an enlarged prostate, obstruction of the urethra or bladder neck, anatomical abnormalities or bladder stones.The survey may also identify bladder cancer, causes the presence of blood in urine and the presence of infection.
In this procedure, a thin tube (cystoscopy), having at the end of a light source and a video camera, is inserted into the bladder through the urethra.Your doctor may insert tiny instruments through cystoscopy and take small samples of tissue (biopsy).Cystoscopy is usually performed on an outpatient basis.The patient local or general anesthesia may be given.
- Ultrasound. Ultrasound is a painless procedure that can give an accurate picture of the size and shape of the prostate gland.It can also be used to detect kidney damage, tumors, stones in the bladder.The ultrasound of the pancreas typically use one of two methods:
transrectal ultrasonography (TRUS) uses a rectal probe to evaluate the prostate.It accurately determines prostate volume.
Transabdominal ultrasound uses a device that evaluates the condition of the prostate through the anterior abdominal wall.It can give an accurate measurement of residual urine and can be used to check the kidney damage caused by severe BPH.
- volume of residual urine . volume of residual urine is measured by the amount of urine remaining in the bladder after emptying.As a rule, the norm is about 50 ml or less of urine;200 ml of a sign violation.A common method of measuring - by means of a catheter, a soft tube that is inserted into the urethra or ultrasound.
- Exclusion of other reasons. Not only BPH, but also other factors may cause LUTS, similar to those associated with BPH:
- Structural abnormalities.Abnormalities in the urinary tract can cause symptoms similar to BPH.These disorders include narrowing of the urethra, bladder, and the weakening of muscle contraction.These factors can produce obstruction to break or weaken the detrusor muscle surrounding the bladder or cause other damage affecting the genitourinary system.
- Prostatitis.Prostatitis - an inflammation of the prostate, which can be caused by bacterial or non-bacterial factors (the most common form of prostatitis, which is often referred to as - "chronic pelvic pain syndrome").
Symptoms include severe and frequent urination, especially at night worrying.Pain may occur in the lower back, in the rectum, or it may develop after ejaculation.
- Medicines.Many drugs can cause retention of urine or LUTS, deteriorating thus the symptoms of BPH.These types of drugs include antihistamines, decongestants, diuretics, tricyclic antidepressants and opiates.
treatment of benign prostatic hyperplasia (BPH)
- Expectant management . Since BPH rarely causes serious complications, men usually choose watchful waiting, which includes lifestyle changes and an annual survey.When this tactic is still necessary to conduct a survey to rule out other disorders.BPH frequently
progressive disease, and it may lead to deterioration of urinary tract infections, bladder and kidney damage.Your doctor should monitor your condition in time to begin treatment if necessary.
main objectives of the treatment of BPH is to improve urine flow and decrease symptoms.There are many options.These include drug therapy, or for reducing the relaxation of the prostate, a minimal amount of invasive procedures that use lasers to reduce the excess tissue of the pancreas, and surgery to remove part of the prostate.
- The choice between treatment and watchful waiting . choice between expectant management and treatment usually depends on the severity of the symptoms.It proposed seven questions to assess the patient's urinary symptoms within a month.
- How often do you experience a feeling of incomplete emptying of the bladder after urination is complete?
- How often have you had to urinate less than 2 hours after urination?
- How often do you interrupt urination during the further continuation?
- How often do you experience difficulty to urinate?
- How often have you seen a weak urine stream?
- How many times have you had to push or strain to begin urination?
- How many times do you get up to urinate during the night?