Growth of a benign tumor in the prostate gland as a result of aging. It produces urinary symptoms such as difficulty starting urination, weak stream, frequency, urgency, needing to get up to urinate at night, or incontinence.
La prostate It is a male reproductive gland that contributes to the production of seminal fluid, which carries sperm during ejaculation. This gland surrounds the urethra, the tube through which urine leaves the body.
From the age of 30, the prostate gland begins to grow progressively. As the gland grows, it can press on the urethra and cause urinary symptoms.
An enlarged prostate is generally called benign prostatic hypertrophy or hyperplasia (BPH)It is not cancer and does not increase the risk of prostate cancer.
What are your causes?
The exact cause of hyperplasia is unknown. Factors related to aging and testosterone (the male hormone produced by the testicles) may play a role in the gland's growth. Men who have their testicles removed at a young age (for example, as a result of a Testicular cancer) do not develop hyperplasia.
Some facts about prostate enlargement are:
- The likelihood of developing hyperplasia increases with age.
- Hyperplasia is so common that all men will have benign prostatic hyperplasia (BPH) if they live long enough.
- Hyperplasia affects many men over 40 years of age and more than 90% of men over 80 years of age.
What symptoms does it present?
Less than half of men with hyperplasia develop symptoms of the disease, which may include the following:
- Weak urine stream
- Intermittent urinary stream
- Difficulty starting urination
- Dribbling at the end of urination
- Sensation of incomplete bladder emptying
- Urinary urgency
- Need to get up to urinate during the night
- Urgency that causes urinary incontinence
Hyperplasia can also lead to the development of complications such as:
- Bleeding of prostatic origin
- Recurrent urinary tract infections
- Urinary retention requiring bladder catheterization
- Development of calculus or diverticula
- Renal
Diagnostic tests
After listening to the patient and understanding their complete medical history, the doctor will perform a physical examination, which may include a digital rectal exam to palpate the prostate gland. The following tests may also be performed:
- A symptom questionnaire (IPSS) to assess the severity of symptoms
- Flowmetry urinary
- Ultrasound of the urinary tract (to determine prostate size)
- Estimation of post-void residual urine using ultrasound
- Urine analysis with culture to check for the presence of blood or infection
- Blood test with determination of prostate specific antigen or PSA to detect a possible hidden prostate cancer
- A voiding diary (recording frequency and volumes of urine) to rule out nocturnal polyuria
Additionally, in specific cases, it may be necessary to perform a urethrocystoscopy (inserting a camera through the urethra to rule out a possible urethral stricture or to assess the bladder) or when there is doubt about whether or not surgery is advisable, of a urodynamic study or from a pressure-flow studyOccasionally, it may be advisable to perform an intravenous urography or a CT urogram.
Treatments
The choice of appropriate treatment is based on the severity of the symptoms, the degree to which they affect daily life, and the presence of any other conditions. Treatment options include regular checkups, lifestyle changes, medication, or surgery.
If you are over 60, you are more likely to experience symptoms, but many men with an enlarged prostate have only mild symptoms. Lifestyle changes are usually enough to make you feel better.
If you suffer from hyperplasia, you should have an annual examination to monitor the progression of symptoms and determine if changes in treatment are needed.
Changes in lifestyle
For mild symptoms:
- Urinate when the initial urge arises. Also, go to the bathroom whenever the time and place allow, even if you don't feel the need to urinate.
- Avoid alcohol and caffeine, especially after dinner
- Do not drink excessive amounts of fluids at once. Distribute your fluid intake throughout the day and avoid drinking fluids two hours before bedtime.
- Try NOT to take over-the-counter cold or sinusitis medications that contain decongestants or antihistamines, as these drugs can increase the symptoms of hyperplasia or trigger urinary retention.
- Stay warm and exercise regularly, as cold weather and lack of physical activity can worsen symptoms
- Reduce stress. Nervousness and tension can lead to more frequent urination.
Pharmaceutical products
- Phytotherapy, medicines based on plant extracts, with prostatic decongestant and anti-inflammatory action (Saw Palmetto, Sabal serrulata, etc.)
- Alpha-1 blockers (doxazosin, prazosin, tamsulosin, terazosin, and afluzosin) are medications that relax the muscle fibers in the bladder neck and prostate, allowing for easier urination. Most people treated with alpha-1 blockers report relief of their symptoms.
- 5-alpha reductase inhibitors lower the levels of hormones produced by the prostate gland, reduce the size of the prostate gland, increase urine flow, and alleviate the symptoms of BPH. Symptom improvement usually occurs 3 to 6 months after starting treatment.
Urological stent
In this urological stent The procedure involves placing an elastic stent on an outpatient basis under sedation. The five-minute operation leaves the stent in the prostate for five days, during which time the device reacts by making three small incisions in the prostate gland. After five days, the device is removed. This simple procedure allows men to maintain and regain urinary function impaired by an enlarged prostate. Furthermore, it does not interfere with the patient's sexual function, significantly improving their quality of life.
Surgery
Prostate surgery may be recommended if you have:
- A significant impact on quality of life despite treatment with medication
- Obstruction demonstrated in the urodynamic study
- Recurrent urinary retention requiring catheterization
- recurrent urinary tract infections
- Hematuria (bleeding) of prostatic origin
- Renal
- Bladder stones or diverticula
The classic treatment options were the open prostatectomy and transurethral resection of the prostate. With the advent of the laser prostate surgery We have abandoned these traditional options and specialize in laser treatment for benign prostatic hyperplasia. There are two options, la photovaporprostate lysis and prostatic enucleation endoscopicBoth allow the treatment of hyperplasia with minimal surgical risk, minimal hospital stay, and a quick return to normal life.
