Prostate adenoma – causes, diagnosis, treatment

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An adenoma of the prostate gland is a glandular hypertrophy of the prostate gland. The result of this hypertrophy is pressure on the urethra, making it difficult to pass urine and causing it to remain in the bladder. The consequence of this condition is the formation of inflammation of the bladder.

Prostate adenoma – definition

Prostate adenoma is otherwise prostate hyperplasia – that is, its glandular hypertrophy. The result of adenoma is pressure on the urethra, which causes problems in patients urinating with urine remaining in the bladder. The consequence is inflammation of the urinary bladder.

Residual urine contributes to the inflammation of the bladder. When it builds up, it stretches the bladder and causes high blood pressure within the bladder. Only increasing the pressure in the bladder allows a small amount of urine to pass through the urethra to the outside, and as a consequence the pressure in the bladder drops and the bladder cannot be emptied any further. After some time, the residual urine in the bladder causes the pressure to rise again, allowing you to pass more urine, etc.

The causes of prostate adenoma

The cause of the ailment in the form of prostate adenoma is not fully known. It is said, however, that problems with urinating are a consequence of male menopause and appear after the age of 40. When the hypertrophy of the prostate adenoma is excessive, we can suspect an early prostate cancer.

It is caused by hormonal changes characteristic of andropause, genetic conditions or an improper diet. The exact mechanism by which the disease develops is unknown. Early stage prostatic hypertrophy poses no threat.

Symptoms of prostate adenoma

Symptoms of prostate adenoma vary greatly from patient to patient due to the reasons why it occurs. We include among them:

1. frequent, painful urination in small amounts,
2. incomplete emptying of the bladder, i.e. residual urine in the bladder,
3. reduction in the intensity of the urine stream,
4. repeatedly urinating at night
5. intermittent urination
6. longer amount of time needed to urinate
7. kidney disorders,
8. inflammation of the urinary tract may occur.

Less common symptoms of prostate adenoma that can be observed clinically include:

1. bladder stones,
2. kidney stones,
3. bladder muscle overgrowth,
4. passing urine in small amounts,
5. hematuria,
6. bladder dilatation due to residual urine
7. urinary tract infection.

With time, more and more constriction of the urethra and urine retention in the bladder causes its greater stretching, increased painful urge to urinate, retrograde stretching of the ureters, and sometimes even hydronephrosis.

Diagnosis of prostate adenoma

The diagnosis is made by the doctor. It is important to consult a urologist as soon as possible, because the earlier the disease is diagnosed, the sooner appropriate treatment can be initiated. Men should remember that any donation problems should prompt them to see a doctor.

Prostate adenoma – treatment

There are several treatments for prostate adenoma.

1. Drug treatment – the most commonly used preparations are the so-called α-blockers (e.g. tamsulosin, terazosin, doxazosin and others). They are designed to block the α1-adrenergic receptor, relax the smooth muscles of the urinary tract and make it easier for the patient to urinate. In addition, doctors recommend taking 5α-reductase inhibitors, which are enzymes that convert testosterone into dihydrotestosterone. These types of preparations inhibit the size of the prostate gland within a few months.

2. Minimally invasive methods – are based on the use of laser treatments that differ from each other in the laser beam and technique used. The most popular laser treatment is transurethral laser coagulation. It is used to induce thrombotic necrosis in the glandular tissue of the prostate. The operator performing the procedure should have extensive experience, because such methods cause a high percentage of complications, such as irritation of the genitourinary tract and the need for long-term catheterization after the procedure. In addition to the exchange method, there are also treatments using thermal energy (carried out during a one-day stay in the hospital), including: transurethral needle ablation and local transurethral microwave hyperthermia.

3. In the case of more significant gland hypertrophy and persistent, abundant urine retention in the bladder and its recurrent inflammation, it is necessary to surgery. The most common surgical procedure is transurethral resection of the prostate, which involves endoscopic access to the urethra and insertion of an electrical loop into it, which removes a part of the adenoma mass. In the case of a larger volume of the adenoma, an inflammatory resection of the prostate adenoma is performed (this type of procedure requires long hospitalization). An alternative solution (when the volume of the adenoma is small) is a transurethral incision of the prostate, which has a lower complication rate compared to the two previous methods.

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