Description prostate enlargement
It is a benign disease of men, manifested difficulty in urination, which becomes a laborious, time-consuming, with a low pressure stream, in severe cases, to a mere ukapáváním urine and feeling inadequate emptying of the bladder, leading to more frequent visits to the toilet.
At the age of 50 years is a common disease, but the exception is not much younger men (13% of men aged 40-49 years has been certain symptoms). After the 70th year this disease affects approximately 90% of all men.
There are three forms (microscopic, clinical, symptomatic),the first two do not show difficulties third yes. It therefore follows that although after the 70th year of life suffer from this disease, 90% of men, it does not mean that they must all show significantly. It manifests in approximately 30% of them.
Hyperplasia is a multiplication of cellularity. More precisely, it is a so-called nodular hyperplasia, where the multiplication of cells is concentrated only in certain districts and thus are formed in the prostate node (nodules).
These are created in the central part of the prostate through which passes urethra. There may then compress the outside, which is one cause of difficulty in urination and further leads to the fact that the prostate presses against the bladder below and changing its shape and which has an increased sticking of urine in the bladder.
In this disease there was no evidence associated with the development of prostate cancer.
Only about 5 to 10% of people with this disease leads to symptoms such as requiring surgical treatment.
The causes of prostate enlargement
Prostate (prostatic gland) is the institution placed under the bladder, at the bottom urges. It passes through the urethra, into the mouth of which there vas deferens. Sam prostate glandproduces secretions that is part of semen (about 30%) and contains substances needed for proper semen composition. This secretion is formed prostate glands which contains gland. His work is influenced by testosterone (male sex hormone), respectively. its effective form (the metabolite),dihydrotestosterone (DHT). It affects the amount of glands and controls their secretion.
When the disease occurs that will increase the sensitivity of the prostate to DHT, which occurs on the basis of increased production of estrogens, which increases with age. Thus, DHT and whereas it is in excess increasingly stimulates growth, leading to enlargement of the prostate. The growth rate is different, the problem may not occur at all, but may also lead to rapid deterioration, leading to a significant restriction on the flow through the urethra.
Risk factors for prostate enlargement
Risk factors include age, unfortunately, especially, an instable factors, as well as increased production of testosterone. Also can play the role of hereditary factors, as has been reflected in a higher incidence of benign prostatic hyperplasia in some families.
Of the probable risk factors are especially obesity, high blood pressure (hypertension), diabetes(diabetes mellitus) and then classically bad eating habits and poor lifestyle.
Quite interestingly, they may have an influence also called phytoestrogens in the diet, which are chemical substances produced by some plants which are in the intestine converted into substances with estrogenic activity. These are mainly soy, legumes (especially young) and alfalfa. So it is good to exaggerate them too, if you’re a man. In women, these compounds may have a beneficial effect on the contrary, especially in menopause (the transition). Phytoestrogens recently subject to massive studying, so certainly in the near future we can look forward to interesting insights and information about their action.
Preventing prostate enlargement
Adhere to the principles of proper diet, ie. To avoid excess stress, regular rest and sleep soundly and regularly eat, smoke, and regularly indulge your body movement, it is a measure which can without much difficulty to master each.
Of those, for which it is well to note that they are then already mentioned phytoestrogens in the diet, which is at higher age maintain good when eaten temperance.
For diabetics and adherence to diet and your doctor’s instructions in the use and dosage of insulin for diabetics on insulin independent after regular use of diabetes drug prescribed by a doctor.
In addition to the above principles, adherence to a healthy lifestyle today there are counter drugs that contain natural substances that have been shown to be effective at alleviating disease progression. These are mainly the following herbs, respectively. Extracts thereof.
They are pumpkin seeds, nettle, poplar, rye, spruce, marigold, small-flowered Willowherb, třepatky purple and narrow-leaved, flower white pine, plum African, African tomato, cactus flower and dwarf palms. The-counter products contain a combination of these herbs.
Signs and symptoms of prostate enlargement
The severity of disease was not evaluate or so, depending on how the prostate is large, but mostly depending on whether and what causes problems with urination. Technically they are called LUTS(abbreviation for lower urinary tract symptoms).
I quite markedly enlarged prostate may not bring trouble, while smaller nodes at locations around the urethra may occur very soon.
To what, then there …
By nodes presses against the urethra from the outside leads to the fact that narrowing the lumenand a consequential several problems that may appear. First, there is a weakening of the urine stream, or the stream is intermittent and it follows an increased effort during urination (sometimes a man urinating to sweat …) But beware, these efforts should be accompanied by burning or cutting, in which case things must think of infection urinary tract; which may be a complication of prostate hypertrophy, in any case should soon be zaléčena.
Further, one may have a feeling of incomplete voiding after emptying, which is due to the fact that the prostate from below pushes the bladder in which the prostate region forms a substantially mound. For this rampart remains pocket, which is then filled with urine chronically, that through this wall is not able to overflow. For this reason, it can also occur frequent urge to urinate, which is often accompanied by an urgent need to urinate.
In some cases, such attacks can cause urge incontinence (failing, bladder) urine.
One of the symptoms, although not as specific is called. Nocturia, which is a frequent need to urinate in the night during sleep.
It also includes known. Postevakuační dribbling when there is little leakage of urine after emptying the bladder, usually at a time when a person takes off from the toilet.
Treatment of prostate enlargement
If this disorder get to the doctor, you will first fill in a questionnaire concerning your difficulties. It is precisely constructed so that the results can assess the severity of your illness.
The treatment itself is divided into conservative (medical, ie. Drug) and operational.
Recently medicine leans more toward medical treatment, mainly because they were discovered drugs that act primarily and it was only on the prostate.
However, surgical treatment is still the most effective. During the early detection and timely deployment of drugs but it is often not needed. Surgical treatment also has more risks, and many people feared.
Anyway, the choice of method depends on the doctor, who must take into account the severity of symptoms and other parameters to ensure optimum effectiveness of the therapy.
Of the drugs used primarily inhibitors of 5 alpha reductase. 5 alpha reductase is an enzyme that promotes the conversion of testosterone to dihydrotestosterone. Given that DHT is about 10 times more potent than testosterone, the drug greatly slows the progression of disease (ie, prostate growth, which then decreases).
The most commonly used drugs are known. Alpha blockers (alpha-1 adrenolytics). They act on bladder muscle which relaxes and hence to facilitate the exit of urine and less sticking of urine in the bladder. Their onset of action is relatively fast, which is a great advantage for the patient (1-2 weeks).
These drugs may also be combined, it is thus that in case of need are affected by both components of the difficulties, which of course brings patient comfort.
For surgical treatment, there are several interventions that can remove excess prostate mass. Their choice depends on the attending physician, which is always the chosen method, which given patient carries the least risk and greatest benefit.
Generally these performances, when through the urethra into the prostate introduced tool, which is then part of the prostate, blocking the free flow eliminate (eg. TURP – transurethral resection of the prostate). But no need to worry about during these performances, the patient is given an epidural or general anesthesia (depending on performance), so do not feel the surgery.
Furthermore, even though nowadays a much lesser extent, the physician may resort to the classical open surgery through the abdominal wall. It depends on the assessment of the condition of the prostate and potential complications.
Complications of prostate enlargement
Although it is a benign disease, its complications can lead to serious health consequences.
Zbytňování prostate can occur up to a stage where almost entirely or completely repress the lumen of the urethra. Then the risk of stasis of urine in front of an obstacle, it is in the bladder, and if even that is filled, then the ureters and the kidney itself.
This will ensure that the kidneys begin to fail and threaten them irreversible damage. This can lead, if not eliminate the problem very quickly, that person will end up on dialysis (artificial kidney).
From the not so serious, but very unpleasant complication here include frequent recurrent urinary tract infections, which occur because the urine remains in the bladder and continuously neobměňuje. First, there can breed bacteria and secondly, due to the small current, these bacteria may enter from the outer part of the tube.
Tube is so intensely neproplachuje. They can also form stones in the urinary bladder and may cause bleeding in the urinary tract.
The bladder is due to the pressure of urine can form pouches, possessing the detection of infection or rupture, because in the places of their formation leads to weakening of the bladder wall.
In case of signs of advancing prostatic hyperplasia You should seek medical attention.
Other names: prostate, prostatic hyperplasia, prostatic hyperplasia, benign prostatic hyperplasia