The prostate is a gland is a part of the male reproductive system with a fibro muscular structure that surrounds the base of the bladder. With age, the prostate tends to grow in size and the medical term for this occurrence is benign prostatic hyperplasia. The growth of the different structures of the prostate determines the type of prostate adenoma. This is one of the most common benign tumors found in men over 60 years. Due to its localization around the urethra, once the prostate grows in size it can cause problems with urination.
Symptoms and causes
The symptoms for prostate adenoma are the result of the sub bladder obstruction that is a hesitant start of urination, the patient has to wait a while before the urination begins
- Interrupted or Intermittent flow of urine
- Difficult urination in which the person struggles to empty his bladder
- Urine blockage – Long time to urinate due to the week urine flow
- Pseudo incontinence – because the bladder is too full
- Nocturia – frequent urinations or urges to urinate at night time
- The imperious urge to urinate, the sensation of urgency to urinate
- Pain or burn like sensation during urination
Investigation and diagnosis
From statistics most men cope with the above symptoms for a long period of time before going to see a doctor, but it is better to visit a doctor and get the right treatment soon. To reach the diagnostics, a general physical examination and a digital rectal examination are the first steps required. Other investigations that are involved are urine analysis and urine flow test. Also the PSA test is required to give information related to the evolution of the adenoma, but can’t be used on its own to confirm the diagnosis. In some cases, post void residual test and cystoscopy are requested.
Treatment and prevention
There are several treatment options for patients with prostate adenoma:
Medication, minimal invasive procedures, surgery Etc. The treatment strategy will be decided by the consulting doctor for each patient individually, taking into consideration his general health, age, how big is the prostate and how much disturbance the symptoms provoke.
Usually alpha blockers (is meant to make the prostate tissue relax) and 5-Alpha (is to cut off the production of the hormones that stimulate prostate enlargement) reductase inhibitors are prescribed. The patient may be prescribed one or the other or a combination of the above two.
Non-invasive treatment options:
- TUMT (transurethral microwave thermotherapy) a common procedure performed to treat some of the urinary tract symptoms
- TUNA (transurethral radio frequency needle ablation) is a technique that uses radio frequency energy to eliminate the prostate tissue in excess; – Stents are sometimes inserted in the urethra to eliminate the discomfort of the symptoms, but most of the times is a compromise solution for patients who can’t take medication or don’t want to go to surgery.
- TURP (transurethral resection of the prostate) is the most common and recommended of procedures and is also the one that is thought to deliver the best results and success rate;
- TUIP (transurethral incision of the prostate) a procedure almost identical to the one before, a newer option that presents more benefits;
- Laser Surgery presents less risks post-surgery and a faster recovery for the patient;
- Prostatectomy is recommended when the adenoma is very big and it is an open surgery that will be performed through an incision while the patient will be under general or spinal anaesthesia.