Adenoma of the prostate - the most common urological disease in older men. Thus, the age of 50 around 25% of men have symptoms of prostatic hyperplasia and aged 65 - 50% already med-blog.com. Over time, the disease occurs in 85% of men.
The histologic (microscopic) symptoms of BPH are found, starting from 30-40 years of age.
Adenoma significantly impairs the patient's quality of life, forced to change their lifestyle, to limit drinking, getting up during the night to urinate, to limit the social and sexual activity.
Causes of BPH is not exactly known, but assumed that it polietiologic (depending on many factors) disease. Let's look at the basic theory of the disease:
Increasing the enzyme activity of 5-alpha-reductase in the prostate tissues: testosterone penetrating the prostate cells, transformed into the most active form of 5-alpha-DHT by the enzyme 5-alpha-reductase. DHT binds to the corresponding receptors of the nucleus and activates its individual genes. Thus there is increased synthesis of substances known as growth factors which enhance cell division and maturation of cells of the parenchyma and stroma of the prostate. Different authors found that adenomatous cells increased the activity of 5-alpha-reductase.
Another possible factor in the development of BPH is a change in relation to the age androgens and estrogens in the male body.
In the formation of benign prostatic hyperplasia in the pathological process involves not only glandular, but also muscle and connective tissue, whereby it can be not only adenomatous (glandular) and fibrotic (scar) or myoma (Muscle) character. The abnormal nodules of the connective tissue is usually more than a healthy glandular tissue. Nodes hyperplasia, as they grow, displace and replace the healthy breast tissue.
Symptoms of filling (as a consequence, the neuromuscular system of the bladder disorder): frequent urination, urination at night, pressing (mandatory, imperative) urge to urinate;
Emptying symptoms (as a result of narrowing of the lumen of the urethra enlarged prostate: difficulty urinating, the need to express the anterior abdominal wall voltage to start urination, a weak urine stream, intermittency urine flow, prolonged urine drop by drop at the end of urination, feeling of incomplete emptying of the bladder.
Benign prostatic hyperplasia (BPH) - is a slowly progressive disease. Often, during the initial stages of the disease without developing any symptoms. Over time, a gradual growth of the prostate, increased symptoms.
To hyperplasia is characterized by undulating course - the symptoms worse, then subside even without treatment. Worsening of symptoms often associated with such provoking factors such as cooling, alcohol intake, stress, aggravation of chronic prostatitis.
The degree of urination depends not only on the size of the prostate, but also on the growth areas of hyperplasia, as well as on the degree of dysfunction of the bladder.
When sprouting from the back of the iron group, increased the average percentage of the prostate, urethra hanging over a valve, can cause marked impairment of micturition. At the same time, a large adenoma, growing from the side of the periurethral glands back toward the rectum, can be a long time not to give any clinical manifestations of the disease.
Acute urinary retention in stage I and II disease is triggered by prolonged abstinence from urinating, constipation, diarrhea, hypothermia, errors in diet, alcohol intake, exhaustion, mental stress, bladder catheterization.
Hematuria (blood in urine) due to injury varicose veins in the neck of the bladder with an increase in pressure therein urine or bladder stones. In the latter case, hematuria usually occurs after walking or exercise.
Bladder stones are formed as a result of stagnation of urine in it (residual urine). It is also an important role in the formation of bladder stones plays an inflammatory process in the urinary bladder (cystitis), which also contributes to the appearance of the presence of residual urine.
False diverticula of the bladder - due to high pressure in the bladder muscle layer it will atrophy, and between the muscle fibers thinned out squeezed bladder mucosa. False diverticula of the bladder often have multiple character.
Vesicoureteral reflux - a throw urine from the bladder into the ureter, which develops as a result of acute or chronic urinary retention. In turn, the ingress of urine from the bladder to the kidney can cause the development of hydronephrosis, pyelonephritis and chronic renal failure even.
Cystitis - residual urine, which appears in the second stage of the disease, promotes the growth of bacteria and increases the likelihood of infection in the bladder.
Chronic prostatitis - develops as a result of circulatory disorders and outflow of secretion of the prostate, due to excessive proliferation of the prostate.