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2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14
Adenomatous prostatic hyperplasia is nothing more than an adenoma - a benign formation that develops in the prostate gland. In this case, as a result of the growth of tumor nodules, an obstruction of the urinary tract occurs.
That is why adenoma of this type is often called nodular. Consider what types of hyperplasia are most common and for what reasons it manifests itself.
Why does prostate hyperplasia occur?
As in other cases of the development of oncology, it is impossible to accurately indicate the cause of the appearance of the tumor.
Nevertheless, the provocateurs of the disease are known to medicine, which become a certain impetus to the development of pathology:
- Age-related changes are among the main provocateurs. They lead to hormonal imbalance, to a higher concentration of estrogen in the blood, rather than testosterone. Such changes cause disorders of the prostate function and stimulate the growth of mutated cells;
- Another reason for the development of a tumor in the tissues of the gland is inflammatory processes in the prostate. Especially often men with chronic prostatitis are susceptible to hyperplasia during the period of its exacerbation;
- In addition, this type of adenoma is often a concomitant disease of such problems as hematuria, urolithiasis, cystitis, orchiepididymitis, urethritis, pyelonephritis.
Hyperplasia of the prostate of any kind proceeds with practically the same symptoms. We can say that there is a general clinical picture that every man should familiarize himself with.
Symptoms of prostatic hyperplasia
It should be noted that at the initial stage of development, prostate adenoma is practically not manifested by symptoms.
Then characteristic signs begin to appear, which completely depend on the stage of the oncological benign process.
- So, already at the first stage, a man may complain of frequent urination and difficulty emptying the bladder. This happens as a result of the growth of a tumor that constricts the ureters. The increased urge to urinate is usually noted at night. Even in the absence of treatment, the first stage of the pathology persists for 2-3 years, which makes it possible to identify the disease during an annual preventive examination.
- In the second stage, urinary problems worsen. After visiting the toilet, the man has the feeling that not all urine has come out. This is indeed so - the tumor, which constricts the ureter, prevents the outflow of all the accumulated fluid. Part of it remains in the bubble. This phenomenon poses a serious threat to health, since stagnation gradually develops in the remaining urine, which leads to the rapid multiplication of pathogenic microorganisms. At the same time, kidney dysfunction is possible. Due to stagnation, urine becomes cloudy and may contain blood. Spontaneous excretion of urine is not excluded, since the walls of the bladder become much thicker.
- With hyperplasia of the third stage, the reflex to urination disappears, although there is a drip of fluid from the urethra, which is explained by the expansion of the urinary duct. The patient has anemia, odor of urine from the mouth, and weight loss. If no urgent care is provided, the overflowing bladder will burst and its contents will spill into the abdominal cavity.
In addition to the main symptoms, with the development of pathology, constipation can constantly occur - a growing tumor compresses the rectum, preventing the movement of feces.
Types of prostatic hyperplasia
Adenoma of the prostate gland is differentiated into 4 types:
- glandular stromal.
Consider how these types of benign prostate tumors differ.
Diffuse prostatic hyperplasia. Diffuse changes in the gland mean a violation of the structure. At the same time, the diffuse type is not an independent problem - it is a consequence of inflammation, the development of a cyst, an abscess. Structural disorders are associated with the proliferation of connective tissue, impaired blood flow, compaction.
Hyperplasia of the gland means an enlargement of the organ as a result of tissue overgrowth. In addition to mechanical compression of nearby organs, the pathology is not manifested in anything. It can be detected at the initial stage only during an ultrasound scan. However, there is a risk of degeneration of a benign process into a malignant one.
Focal type. The only difference between the focal type is the localization of the proliferation of fibrous tissue in a certain area of the gland. The development of symptoms and tumor growth occur according to the scheme given above.
Glandular hyperplasia. In this case, the structure of tissues in the prostate is disturbed due to the proliferation of the glandular epithelium.
Stromal glandular type. It is diagnosed with the growth of not only glandular epithelium, but also stromal cells.
Depending on the direction of tumor growth in the gland, 4 forms of hyperplasia are distinguished.
- intravesical - there is an increase in the formation towards the bladder;
- subbubble - grows in the direction of the rectum;
- retrotrigonal - the tumor is located between the internal opening of the urethra and the orifices of the ureters. In this case, the ureters are compressed, which provokes a violation of the outflow of urine.
- The multifocal form is characterized by multiple lesions in the prostate.
Treatment of changes in the prostate gland is carried out according to an individual scheme, for the compilation of which it is important to assess the patient's condition.
A test was developed specifically for this, which takes into account the patient's complaints.
Assessment of the condition of the prostate gland
There are several methods for assessing the condition of the gland, but the I-PSS scale is the most popular. The test is a questionnaire containing 7 questions, which must be answered by the patient himself. The questions characterize the violation of urination. The greater the number of points scored, the more pronounced the process of violation.
Simultaneously with the tests, clinical studies are carried out, including blood biochemistry, laboratory study of urine, rectal digital examination, determination of a specific antigen in the blood serum - PSA. The size of the tumor in the gland, its borders, the amount of residual fluid in the bladder are detected using ultrasound.
Violation of urination and, therefore, the problem of gland hyperplasia can be judged by the results of uroflowmetry - a method for assessing the flow rate of urine. If the reading is below 15 ml / s, urinary retention is evident.
Depending on the results of the examination, a decision is made on the need for treatment of the gland. Indications for therapy or surgical intervention are chronic or acute delay in urine output, severe symptoms, renal failure, stones in the bladder cavity, relapses of infectious and inflammatory processes.
In the case of an unexpressed clinical picture, expectant tactics with periodic monitoring of changes in the prostate gland are preferable.