What are the common symptoms of an enlarged prostate. How is BPH diagnosed and treated. Can lifestyle changes help manage BPH symptoms. What medications are available for treating benign prostatic hyperplasia.

Understanding Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate, is a condition that affects many men as they age. This non-cancerous growth of the prostate gland can lead to various urinary symptoms and discomfort. While the exact causes remain unclear, hormonal changes and aging are believed to play significant roles in its development.

The prostate gland, located just below the bladder, produces fluid for semen. As men age, this gland tends to grow larger, potentially causing pressure on the urethra and leading to urinary issues. It’s important to note that BPH is not cancer and does not increase the risk of developing prostate cancer.

Prevalence of BPH

How common is BPH among older men? Studies show that more than half of men over age 60 experience some degree of prostate enlargement. By age 85, up to 90% of men have symptoms associated with BPH. However, it’s worth noting that only about one-third of men with an enlarged prostate find their symptoms bothersome enough to seek treatment.

Recognizing the Symptoms of an Enlarged Prostate

Understanding the signs and symptoms of BPH is crucial for early detection and management. While some men may not experience noticeable symptoms, others might face significant discomfort and disruption to their daily lives.

Common BPH Symptoms

• Frequent urination, especially at night (nocturia)
• Difficulty starting urination
• Weak urine stream
• Dribbling at the end of urination
• Inability to completely empty the bladder
• Urinary urgency
• Straining while urinating

Why do these symptoms occur? As the prostate enlarges, it puts pressure on the urethra, making it more difficult for urine to pass through. This pressure can cause the bladder to contract more forcefully, leading to frequent urges to urinate, even when the bladder isn’t full.

Potential Causes and Risk Factors for BPH

While the exact causes of BPH remain unclear, researchers have identified several factors that may contribute to its development.

Hormonal Changes

How do hormones affect prostate growth? Hormones, particularly testosterone, dihydrotestosterone (DHT), and estrogen, are believed to play a significant role in prostate enlargement. As men age, the balance of these hormones in the body changes, potentially contributing to prostate growth.

Age-Related Factors

Age is the most significant risk factor for developing BPH. The prostate gland continues to grow throughout a man’s life, with symptoms typically not appearing before the age of 40. However, the likelihood of experiencing BPH symptoms increases dramatically with age.

Other Potential Risk Factors

• Family history of BPH
• Obesity
• Lack of physical activity
• Diabetes
• Heart disease

It’s important to note that factors such as vasectomy and sexual activity do not increase the risk of developing BPH.

Diagnosing Benign Prostatic Hyperplasia

Proper diagnosis of BPH is essential for effective treatment and management. Healthcare providers use a combination of methods to assess prostate health and rule out other potential conditions.

Initial Evaluation

During the initial evaluation, your doctor will likely:

1. Discuss your medical history and symptoms
2. Perform a physical examination, including a digital rectal exam (DRE)
3. Conduct urine and blood tests

Advanced Diagnostic Procedures

Depending on the initial findings, your doctor may recommend additional tests such as:

• Prostate-specific antigen (PSA) blood test
• Urinary flow studies
• Post-void residual volume test
• Transrectal ultrasound
• Prostate biopsy (if cancer is suspected)
• Cystoscopy

Why are these tests important? These diagnostic procedures help healthcare providers assess the severity of BPH, rule out other conditions with similar symptoms (such as prostate cancer or urinary tract infections), and determine the most appropriate treatment approach.

Treatment Options for Enlarged Prostate

The treatment of BPH depends on the severity of symptoms and their impact on quality of life. Options range from watchful waiting to medications and surgical interventions.

Watchful Waiting

For men with mild symptoms, watchful waiting may be the best approach. This involves regular check-ups and monitoring of symptoms without active treatment. Up to one-third of mild BPH cases may see symptoms improve on their own over time.

Lifestyle Modifications

Simple lifestyle changes can often help manage BPH symptoms:

• Limiting fluid intake, especially before bedtime
• Reducing consumption of alcohol and caffeine
• Practicing double voiding (urinating, waiting, then trying to urinate again)
• Maintaining a healthy weight
• Exercising regularly
• Managing stress

Medications

Several types of medications can help alleviate BPH symptoms:

1. Alpha-blockers: These drugs relax the muscles in the prostate and bladder neck, improving urine flow.
2. 5-alpha reductase inhibitors: These medications can shrink the prostate by blocking the production of DHT.
3. Combination therapy: Some men benefit from taking both alpha-blockers and 5-alpha reductase inhibitors.
4. Phosphodiesterase-5 inhibitors: Originally developed for erectile dysfunction, these drugs can also help with BPH symptoms.

How effective are these medications? While results can vary, many men experience significant symptom relief with medication. However, it’s important to discuss potential side effects with your healthcare provider.

Surgical Interventions for Severe BPH

When medications and lifestyle changes are insufficient, surgical options may be considered for severe BPH cases.

Minimally Invasive Procedures

• Transurethral needle ablation (TUNA)
• Transurethral microwave therapy (TUMT)
• Water vapor thermal therapy
• Prostatic urethral lift

Traditional Surgical Approaches

1. Transurethral resection of the prostate (TURP)
2. Open prostatectomy
3. Laser therapy

What factors determine the best surgical approach? The choice of surgical intervention depends on prostate size, overall health, and the specific symptoms experienced by the patient. Your urologist can help determine the most appropriate option based on your individual case.

Living with BPH: Long-term Management and Outlook

While BPH is a chronic condition, many men can successfully manage their symptoms and maintain a good quality of life with proper care and treatment.

Regular Monitoring

Even with successful treatment, it’s important to continue regular check-ups with your healthcare provider. This allows for ongoing assessment of prostate health and adjustment of treatment plans as needed.

Potential Complications

If left untreated, severe BPH can lead to complications such as:

• Urinary tract infections
• Bladder stones
• Bladder damage
• Kidney damage
• Acute urinary retention

How can these complications be prevented? Early detection and appropriate management of BPH symptoms are key to preventing these serious complications. It’s crucial to seek medical attention if you experience any changes in urinary habits or discomfort.

Outlook and Quality of Life

With proper treatment and management, most men with BPH can maintain a good quality of life. Advances in medications and surgical techniques continue to improve outcomes for those living with this condition.

Remember, BPH is a common and treatable condition. By working closely with your healthcare provider and following recommended treatments and lifestyle modifications, you can effectively manage symptoms and reduce the risk of complications associated with an enlarged prostate.

Visual Guide To BPH

Medically Reviewed by Nazia Q Bandukwala, DO on November 25, 2022

An enlarged prostate occurs when men’s prostate gland slowly grows bigger as they age. More than half of men over age 60 have this condition, also called benign prostatic hyperplasia (BPH). Some men have symptoms and others don’t. The exact causes are unknown, but one thing is sure: BPH is not cancer and it does not lead to cancer. The prostate sits below the bladder and produces fluid for semen.

Do you have to pee more often these days? Especially at night, when you’re trying to sleep? That’s a common symptom of BPH. It happens when the growing prostate presses on the urethra, the tube that carries urine out of your body. The bladder has to contract more strongly to get urine out. As a result, the bladder may start to contract even when it only contains a little urine, which makes you get the urge to go more often.

With an enlarged prostate, it may take you longer to get the flow of urine going, and the flow may be weaker than it used to be. You may dribble urine or feel as if there’s still some inside even though you’re finished urinating. These symptoms happen because the pressure on the urethra makes it narrow, so your bladder must work harder to pass urine.

This can happen when advanced BPH blocks your urethra entirely — or as a result of a bladder infection. Bladder muscles also may become too weak to force urine out of the body. From any cause, it can lead to permanent kidney damage. You can prevent this by seeing your doctor as soon as you notice symptoms. If you suddenly can’t urinate, go to a hospital emergency room immediately.

Most men get an enlarged prostate as they age. The prostate gland grows throughout most of a man’s life, first at puberty and then from about age 25 on. It usually doesn’t cause symptoms before the age of 40. But by age 85, up to 90% of men have symptoms. Only about a third of men with an enlarged prostate are bothered by symptoms.

No one knows for sure. It is believed that different hormones such as testosterone, dihydrotestosterone (DHT), and estrogen may play a role. It is also unclear why some men with BPH will have symptoms while others do not. Vasectomy and sex do not raise the risk of having BPH.

BPH symptoms can be similar to those of other conditions. If you have symptoms, it’s important to see your doctor, who can rule out other possible causes, such as an infection or cancer.

Symptoms of BPH can be scary because some of them are the same as those for prostate cancer. But an enlarged prostate is much more common than prostate cancer. And if you have BPH, you are no more likely than other men to develop prostate cancer. Because the two conditions share some symptoms and can occur at the same time, however, your doctor will need to evaluate you.

Your doctor will ask about your symptoms and may do these tests:

• A digital rectal exam to check for prostate enlargement or irregularities
• Lab tests of urine and blood
• An ultrasound scan and a prostate biopsy if concerned about cancer
• A urine flow study to measure the strength of your urine stream in some men
• A cytoscopy, in which a thin tube inserted through the penis allows the doctor to view and evaluate the urethra and the bladder

Whether you need to treat BPH depends on your symptoms. If your symptoms are not severe, you probably won’t need treatment. But difficulty urinating, recurring infections, kidney damage, or a leaky bladder can really impact your quality of life. In these cases, medications or sometimes surgery will help.

If your symptoms are mild, you and your doctor may choose to monitor your condition. With this approach, you’ll probably need to visit the doctor one or more times a year. And if your symptoms don’t get worse, that may be all you ever need to do. Up to a third of all mild cases of BPH have symptoms that clear up on their own.

These strategies may help:

• Cut down or cut out alcohol and caffeine.
• Drink small amounts all day rather than large amounts all at once.
• Avoid fluids at bedtime.
• Avoid decongestants and antihistamines.
• Go when you have the urge and when a bathroom is handy.
• Double void: Empty your bladder, wait a moment, then try to empty it again.
• Relax. Stress can trigger the urge to pee.
• Exercise regularly.

Sometimes prescribed for high blood pressure, alpha blockers help relax the muscles in the prostate gland and bladder. This allows urine to flow more freely.

A class of medications known as 5-alpha reductase inhibitors help stop the prostate from growing or even shrink it in some men. They lower the production of DHT, a hormone involved in prostate growth. However, these medications can also lower sex drive and cause erectile dysfunction. And it can take 6 months or more to feel the benefits.

Some men benefit from taking more than one medicine for their enlarged prostate. In fact, combining a medicine that relaxes the bladder muscles with one that slows prostate growth may work better than either drug alone. Medicines used to manage an overactive bladder may also be added to standard BPH medications.

In early studies, saw palmetto extract showed promise in treating BPH symptoms, such as frequent urination and trouble starting and maintaining flow. However, newer research has shown no benefit. There is some evidence that beta-sitosterol and pygeum may help symptoms. The American Urological Association does not recommend saw palmetto or other complementary medicines for BPH.

When medication doesn’t do the job, a number of procedures can remove excess tissue from the prostate, easing obstruction of the urethra. These outpatient procedures are less invasive than surgery and may take no more than an hour. They include transurethral microwave therapy (TUMT) which may require the temporary use of a catheter after treatment. Prostate artery embolization is when a catheter is inserted through the artery through a small puncture in the groin to plug up the artery, blocking blood flow to the enlarged prostate. Water Vapor Therapy uses the natural energy stored in water vapor, or steam, to remove excess prostate tissue that is pressing on the urethra. In a prostate urethra lift procedure (PUL), an instrument is inserted into the urethra to separate the enlarged prostate lobes to widen the urethra wider, so that it is easier to urinate. Photoselective vaporization of the prostate (PVP) uses a cystoscope with a laser inserted into the penis to burn away excess tissue blocking urine flow through the prostate.

The most common surgery is a transurethral resection of the prostate, or TURP, which is done under general anesthesia. An instrument is inserted through the tip of the penis and into the urethra to remove parts of the enlarged prostate, relieving pressure on the urethra.

There is some evidence that older men with severe BPH symptoms may be more likely to have problems in the bedroom, compared to other men their age. Some of the medications commonly used to treat BPH have been associated with problems getting an erection and ejaculating. If you develop sexual issues, talk to your doctor. A change in medications may be enough to correct them.

Some men never even know they have BPH. Others are never troubled by it. But if you have bothersome symptoms, there are many options for treating them to help you maintain a high quality of life. The most important thing is to discuss your symptoms with your doctor so you can come up with an effective plan/

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REFERENCES:

American Academy of Family Physicians: “Benign Prostatic Hyperplasia.”
American Urological Association: “Benign Prostatic Hyperplasia,” “Diagnosis of BPH,” “Management of BPH. “
Harvard Healthbeat: “4 tips for Coping With an Enlarged Prostate.”
Johns Hopkins Health Alert: “BPH and Sexual Dysfunction: What’s the Link?”
National Cancer Institute: “What You Need To Know about Prostate Cancer: Symptoms,” “Prostate Changes That Are Not Cancer.”
National Institute of Diabetes and Digestive and KidneyDiseases: “Prostate Enlargement: Benign Prostatic Hyperplasia,” “Urinary Retention.”
The Prostate Institute: “BPH Symptoms.”
University of Maryland Medical Center: “Benign prostatic hyperplasia –Lifestyle Changes,” “Saw Palmetto.”

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What is the prostate?

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

What are prostate diseases?

There are many types of prostate diseases:

• Prostatitis is inflammation (swelling and pain) in the prostate gland. It’s the most common type of prostate problem in people under than age 50. There are different types:
  • Chronic prostatitis is also called chronic pelvic pain syndrome. It’s the most common type of prostatitis.
  • Acute bacterial prostatitis starts suddenly from a bacterial infection and is treated with antibiotics. It is not common.
  • Chronic bacterial prostatitis happens when a bacterial infection keeps coming back. The symptoms usually start slowly. It may take longer to treat than acute bacterial prostatitis.
  • Asymptomatic prostatitis has no symptoms and usually doesn’t need treatment. You may learn you have it after having tests for other health problems.
• Enlarged prostate is also called benign prostatic hyperplasia (BPH). The prostate gland tends to grow larger with age. That’s why enlarged prostate is very common in older people and rare in those who are under age 40. When the prostate grows larger, it may press on your urethra and cause problems with urination.
• Prostate cancer happens when cancer cells form in the prostate gland. Prostate cancer is a common type of cancer in those aged 50 and older. Most prostate cancers grow slowly and may never cause health problems. But certain prostate cancers are serious.

Who is more likely to develop prostate diseases?

Anyone with a prostate can develop prostate problems. But some people are at higher risk.

You may be more likely to develop prostatitis if you have:

• A lower urinary tract infection, also called a UTI. An infection in your lower urinary tract (bladder and urethra) may lead to acute or chronic bacterial prostatitis.
• Nerve damage in your lower urinary tract from surgery or an injury. This may lead to chronic prostatitis.
• Emotional stress, which can lead to chronic prostatitis.

You may be more likely to develop an enlarged prostate (BPH) if you:

• Are age 40 or older.
• Have family members who have had BPH.
• Have certain health conditions such as:
  • Obesity.
  • Heart disease and problems with blood circulation.
  • Type 2 diabetes.
• Don’t get enough physical activity.

You may be more likely to develop prostate cancer if you:

• Are older than age 50.
• Have a parent, sibling, or child who has or had prostate cancer.
• Are African American.

What are the symptoms of prostate diseases?

The symptoms of prostate problems include:

• Needing to urinate a lot.
• Needing to rush to the bathroom, but not being able to urinate or only going a little.
• Leaking or dribbling urine.
• Having a weak urine stream.

Other symptoms depend on the type of prostate problem you have and may include:

• Not being able to urinate at all. This is a medical emergency.
• Any problems, starting or controlling urine flow.
• Waking up often to urinate.
• Blood in your urine or urine that has an unusual smell or color.
• Fever, chills, or body aches.
• Great discomfort or pain:
  • While urinating or after ejaculation.
  • In your abdomen (belly), between your scrotum and anus, or in your scrotum or penis.

Contact your provider if you have any of these symptoms.

How are prostate diseases diagnosed?

To find out if you have a prostate problem, your provider will:

• Ask about your medical history and symptoms.
• Ask about your family health history.
• Do a physical exam. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to feel the general size and condition of your prostate.
• Order tests, if needed. Tests may include:
  • Blood and urine tests to look for infection.
  • Urodynamic testing to see how well you can hold and release urine.
  • Cystoscopy to look inside your urethra and bladder.
  • Ultrasound pictures of your prostate and urinary tract.
  • A PSA blood test (prostate-specific antigen test).
  • Prostate biopsy to diagnose or rule out cancer.

Treatment depends on what prostate disease you have and which symptoms bother you most.

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Prostate adenoma – symptoms, methods of treatment

• General information
• Prostate adenoma. What is this?
• Complaints for prostate adenoma
• Prostate adenoma. Symptoms
• Causes of prostate adenoma
• Treatment of prostate adenoma
• Get a qualified diagnosis

Prostate adenoma. What is this?

Prostate adenoma – a benign tumor of the prostate, also called BPH – benign prostatic hyperplasia (enlargement).
Due to hormonal changes, about a third of men over 40 have an enlarged prostate gland. Prostate adenoma in men begins to develop actively after the age of 50, every second man of this age is diagnosed with prostate adenoma.

Due to the fact that the urethra (urethra – lat. urethra) passes through the center of the prostate, and the prostate tissue in adenoma grows inside the gland (see figure), there is a possibility that the urethra may be completely or partially clamped, due to Why do you have complaints about urination? Complaints occur only when the prostate becomes so enlarged that the muscles of the bladder are no longer able to push urine through the narrowed urethra. The stream of urine becomes weaker and the man needs more time and effort to start urination, and false urge to urinate is also possible.

BPH complaints

In order to pump all the urine out of the bladder through the urethra compressed by the prostate gland, the muscle tissues of the bladder have to work extra, but they do not always cope well with this, which leads to the accumulation of a large amount of residual urine in the bladder . As a result, inflammation of the bladder, ureters and kidney problems can occur. 25% of men over the age of 50 have complaints about urination. This is a characteristic sign of prostatic hyperplasia.

Prostate adenoma. Symptoms

In order to pump all the urine out of the bladder through the compressed urethra by the prostate, the muscle tissues of the bladder must work extra, but are not always good at this, which leads to the accumulation of a large amount of residual urine in the bladder. Subsequently, such unpleasant diseases as inflammation of the bladder, ureters and kidney problems may occur. 50% of men over 50 years of age have complaints about urination. This is a characteristic sign of prostatic hyperplasia:

• Difficulty (or impossible) to hold urine
• Weak urine stream
• Frequent urination
• Small amount of urine when urinating
• Takes time to start urination
• Feelings o Burning when urinating
• Cloudy or bloody urine
• Leaking after urination
• Feeling of incomplete emptying of the bladder
• Frequent urge to urinate at night

Causes of prostate adenoma

The prostate in men grows from childhood and stops growing by the age of 20-25. The normal volume of the prostate is 23-25 ​​cm3, the normal weight of the adult male prostate is approximately 20 grams. After 40 years, the prostate begins to grow again in all men – this is a natural process. The growth of the prostate is associated with age-related hormonal changes in the body of a man.

An enlarged prostate is not a problem for all men due to the individual physiological characteristics of each. In some men, the prostate begins to grow later, and in some the urethra is naturally wider than in others, as a result of which the patient does not experience symptoms of prostate adenoma.

Treatment of prostate adenoma

Treatment of prostate adenoma involves several types of treatment. In the initial stages, drug treatment can be effective, however, practice shows that in most cases the symptoms of prostate adenoma return after a while. In this case, surgical removal of prostate adenoma is indicated.

Read detailed information about the treatment of BPH

Get a qualified diagnosis

Do you have symptoms of prostate adenoma and doubts about the diagnosis? It is important to remember that prostate cancer makes itself felt only in the later stages of development, when effective treatment is unlikely, therefore, timely diagnosis is vital. An extended urological examination will give you a complete picture of the state of health of the prostate gland

treatment, symptoms and diagnosis of prostate adenoma (BPH) in Moscow, prices at the IMMA clinic

Prostate adenoma is an insidious disease that is typical for men after 45-50 years. It does not sell well with treatment and significantly reduces the patient’s standard of living. IMMA clinics carry out preventive urological examinations to detect the disease at an early stage. Doctors with extensive experience treat prostate adenoma in men at all stages of pathology development.

In our clinic you can:

• Consult a urologist;
• Complete a course of prostate massage;
• Use the services of a pediatric urologist;
• And much more.

For more details and any questions, please contact the number listed on the website

Prostate adenoma affects more than 50% of men over fifty and almost 90% over eighty. The disease can develop over the years. The first symptoms do not cause much discomfort, so the man does not pay attention to them. The lack of regular preventive examinations and the unwillingness to consult a doctor with complaints that have arisen leads to the fact that the disease is detected at a later date and is difficult to treat. Over time, the disease is complemented by complications.

About Physiology

The prostate is a small organ that is similar in size and shape to a walnut. It is located below the bladder, closer to its bottom. Its back wall is pressed against the large intestine, so it can be easily palpated during rectal examination. The prostate consists of glandular and connective tissues, performs three main functions:

• secretes a fluid that dilutes sperm and creates favorable conditions for sperm activity;
• helps to control the process of urination;
• protects the bladder and kidneys from ascending infection.

Any pathology of the organ leads to a violation of the process of urination, the development of inflammation, problems in the genital area. The peculiarity of the structure of the prostate gland is that the ureter passes through it. Prostate pathologists lead to disruption of the bladder emptying process.

Adenoma is a benign tumor formed as a result of growth of glandular or connective tissues. At the first stages of development in a man of prostate adenoma, nodules appear in the tissues of the organ, which begin to grow gradually. Growth time is long. Sometimes for a number of years a man does not know about the problem, does not pay attention to the first symptoms.

An enlarged gland compresses the urinary canal, preventing the release of the bladder. The tissue grows towards the intestines or towards the bottom of the bladder, gradually wedging into it.

Causes of the disease

Despite the prevalence of the disease, the exact causes of the disease have not been identified. There was a relationship between the disease and the age of patients. This phenomenon is associated with hormonal changes: a decrease in male sex hormones and an increase in female ones. Estrogen promotes the growth of glandular tissue.

The following reasons aggravate the situation:

• sedentary lifestyle;
• overweight;
• heredity, the presence of the disease in close relatives.

Recent studies have shown that such phenomena as promiscuity, their absence, the presence of bad habits, infections do not provoke the development of adenoma.

Prostate adenoma should not be confused with prostatitis – these are two different diseases. The first is characterized by tissue growth, the second – by the development of an inflammatory or infectious process.

Scientists have found a link between eating habits and the risk of adenoma. Eating a large amount of fatty, smoked, salty foods exacerbates the development of the disease.

Interesting! There is a racial predisposition to the disease. For example, representatives of the Negroid race are more likely than others to suffer from adenoma. Asians are the least affected.

Diagnostic methods

Diagnosis of the disease is carried out in several stages. First, the doctor conducts a survey, fills out a special questionnaire. It was developed in 1996 by WHO representatives. Each answer is given a score. The total amount helps to assess the intensity of symptoms, to make a preliminary diagnosis. Questions about the process of urination.

The second source of information is rectal palpation of the prostate. The procedure is as follows. The doctor inserts the index finger into the anus. Determines the position of the prostate gland, its size, elasticity, pain. Such an examination allows you to make a preliminary diagnosis. It must be confirmed using highly accurate diagnostic methods:

• Ultrasound of the prostate, bladder; kidneys;
• TRUS, ultrasound examination with a device through the anus. The method provides a more accurate assessment of the state of the prostate;
• examination of urine, blood.
• roentgen;
• uroflowmetry;
• urethrocyscopy.

X-ray studies are more revealing than ultrasound data, they provide information about the condition of the ducts, urinary canal and ureters. Ultrasound is effective in determining the presence of bladder stones and residual urine that is not expelled during urination.

Uroflowmetry allows you to determine the features of urine output:

• flow rate and intensity;
• volume;
• process interrupt facts;
• duration.

This information shows the intensity of symptoms of prostate adenoma. The patient gradually gets used to the violations, so the data are more objective than the information during the survey. For the study, a special device with a funnel is used. The patient drinks a sufficient amount of injections in advance – about a liter. Then he urinates into a funnel, at the same time the process is analyzed in the form of a diagram or curve.

One of the most important methods for diagnosing diseases of the prostate gland is an analysis of the amount of prostate-specific antigen in the blood. High values ​​indicate a significant increase in the organ, and may also indicate the occurrence of malignant foci.

Development of the disease

The nature of the symptoms of prostate adenoma in men allows us to distinguish three stages of the disease. The first phase, or compensatory form, begins with subtle signs. A man may notice that urination begins with a slight delay. The jet becomes weaker, begins to fall with less force. To start or completely end the process, you have to strain your abdominal muscles. The disease can develop very slowly, it can take several years before the signs of pathology intensify. Drug treatment of prostate adenoma at the first symptoms in men will stop the growth of the tumor and avoid surgery.

As the prostate enlarges, the urethra is blocked. The symptoms of the disease are getting worse. Nighttime urge to urinate is repeated up to three times. Gradually, the number of daily urination increases, while the volume of excreted fluid falls. There is an incomplete release of the bladder. But due to the compensatory capabilities of the muscles, the possibility of urination remains.

At the next stage, these opportunities are no longer enough. Intense symptoms of prostate adenoma in a man require immediate treatment. The capacity of the bladder is not enough, urine regularly remains in it, its volume can exceed 200 ml. The bladder begins to stretch, pathological changes affect the upper urinary tract, affect the normal functioning of the kidneys. There is a risk of kidney failure.

The process of urination undergoes significant changes. Due to a violation of the activity of the sphincter of the bladder, the act of urination occurs due to the tension of the abdomen. Urine is released with a delay, the intensity of the jet drops significantly. The duration of the process is significantly increased due to the fact that urine comes out in portions with alternating periods of amplification and rest.

Dryness of the skin, constant thirst indicates a violation of the kidneys, pathological dilation of the ureters.

There is a sharp increase in the number of urges at any time of the day, often there is a false desire to go to the toilet. Problems in the work of the intestines may begin due to constant stress.

In the absence of treatment, the third phase, or decompensation, occurs. It is characterized by disorders in the functioning of the bladder. The organ can no longer cope with the large amount of remaining urine, greatly stretches and loses the ability to be released. It can be seen during an external examination of the patient as a bulge in the area below the navel.

The patient cannot urinate in a stream, urine drips, sometimes spontaneously, incontinence develops. A man is tormented by pain in the lower abdomen, radiating to the penis and lower back. An enlarged prostate prevents the bladder from emptying.

Due to the accumulation of urine, general intoxication of the body develops with characteristic symptoms:

• nausea;
• vomiting;
• general weakness.

Significant impairment of kidney function occurs, there is a threat of kidney failure. There is a mortal danger for a person. At this stage of development of prostate adenoma, surgery is indispensable.

Possible complications

If left untreated, prostate adenoma can be life threatening. Even at an early stage of development, complications may appear sharply, requiring urgent hospitalization.

Acute urinary retention. This complication can occur at any time, even at the initial stage of the development of the disease. The essence of the phenomenon is that the patient completely loses the ability to urinate. Urine begins to accumulate in the bladder, stretching it to the limit. General intoxication begins, the defeat of all body systems. In the absence of prompt medical attention, a fatal outcome is possible. The main methods of treatment are the placement of a catheter or emergency surgery.

Several factors can provoke acute urinary retention:

• drinking alcohol;
• hypothermia;
• constipation;
• overwork;
• arbitrary delay in the process of urination.

There is a sharp swelling of the prostate tissue, completely blocking the urethra.

Important! A man should not expect that the phenomenon will pass on its own. In order to avoid a sharp deterioration in the condition, it is urgent to consult a doctor.

Hematuria. Changes in the tissues of the prostate gland are accompanied by an expansion of the veins located nearby. There are violations in their work, the fragility of the walls of blood vessels develops, the penetration of erythrocytes into the urine is observed. The intensity of the phenomenon can be different: from the minimum, detected as a result of laboratory tests, to the appearance of clots, urine staining red. Significant bleeding occurs as a complication after medical manipulations when the walls of the vessel are damaged. In this case, surgical treatment of prostate adenoma is required.

Bladder and kidney stones. As a result of insufficient emptying of the bladder, stagnation of urine, stones begin to crystallize. They are able to bring significant pain, get stuck in the ureter, narrowed by the prostate. In addition to the pain syndrome, signs of urolithiasis are frequent urges, a periodic stop in the output of urine during urination.

Renal failure. At the third stage of the development of prostate adenoma, there are violations in the work of the kidneys. The disease begins imperceptibly, but over time, the symptoms intensify, there is a threat to life. In this case, renal replacement therapy is required.

Infectious and inflammatory processes. Stagnant processes, accumulation of urine, medical interventions cause inflammation and reduce resistance to infection. Localization of the lesion can be in all organs of the small pelvis. The most typical diseases: cystitis, prostatitis, pyelonephritis and others.

Treatment of the disease

The choice of strategy for the treatment of prostate adenoma in men depends on the stage of the disease. Drug therapy is used in the early stages of disease detection. But quick relief from taking medications should not be expected, an accumulation effect is necessary.

Conservative treatment of prostate adenoma occurs with two types of drugs with different mechanisms of action. To reduce the tone of smooth muscles, alpha-adenoblockers are used. As a result of their action, the ducts of the urinary tract expand, which facilitates the process of emptying the bladder.

The second type of drug reduces the conversion of testosterone to its active form, which prevents the growth of the prostate gland.

The courses of receptions are of considerable duration, but do not completely solve the problem. The main goal of drug treatment is to prevent the progression of the disease, to achieve remission.

Surgery

Surgical treatments for BPH are varied. This may be a strip operation involving the complete removal of the gland, intervention with punctures, through the urethra.

Minimally invasive methods are also possible: excision of overgrown prostate tissue using laser therapy, radio waves, cryodestruction.