Prostate adenoma: diagnosis, methods, PSA analysis

In newborn boys, the prostate has the size of a pea. Its growth in childhood is very small, but in adolescents there is a surge in development and then the growth of the prostate becomes obvious and rapid. By about 20 years of age, the prostate acquires all its mature characteristics. And her growth stops. Further, after 25 years, the repeated growth of the prostate gland in the part where it surrounds the urethra often begins. Accordingly, the muscle tissue of the prostate begins to exert pressure on the urethra and the outflow of urine through its natural course is inevitably disrupted.

Adenoma of the prostate, or benign prostatic hyperplasia affects more than 50% of men in the age range - from 60 to 70 years. And after reaching 80 years of age, this sad percentage increases to 90%.

The causes of prostatic adenoma

The causes of repeated growth of the prostate gland to accurately understand, yet can not. It is believed that the prostate gland with increasing age becomes more and more sensitive to male hormones. Hormones act so that the prostate tissue begins to grow. Of course, there is a hereditary predisposition and lifestyle of a man. It is noticed that married men are more prone to prostate adenoma than non-married men. The latter can not be explained.

Of all the sick men, half turn to the doctor. And, approximately, half of the rest have minor symptoms.

Manifestations and symptoms of prostate adenoma

1. It seems to have finished emitting urine and dressed, but suddenly urine again begins to oozing.
2. Urine follows a weak stream.
3. It is not possible to completely empty the bladder.
4. At night, very often I want to go to the toilet in a small way.
5. The urge to urinate can be not only a frequent occurrence, but also intolerable.
6. When urine is emitted, its jet is intermittent or breaks off and then resumes again.

It should be noted that benign prostatic hyperplasia begins to create a real threat when it interferes with the emptying of the bladder. After all, this leads to its stretching, to diseases and the bladder and kidneys.

Another point - prostate adenoma, once emerged, may not always continue to grow. Statistically, from all cases of moderate development of prostate adenoma - 20%, when it continues to increase, 20% - its manifestations and symptoms decrease. The remaining 80% is when the growth of the prostate remains in the same pore.

Appeal to the doctor

When communicating with a doctor, you simply need to consistently and clearly state your problems. Listen to the doctor and answer correctly for the questions asked. Do not hesitate to contact a urologist, a surgeon with problems with urination. Because a doctor who has good practical experience, can help you in time and effectively. The main thing to determine is that benign prostatic hyperplasia does not threaten your health.

It also happens that the above manifestations and symptoms of prostate adenoma can refer not to an adenoma, but to some other disease of the genitourinary sphere - infectious and inflammatory processes, stone formation, neurology, prostatitis, cancer.

In addition to a detailed conversation with the patient, the doctor begins to perform a digital or rectal examination of the prostate gland to increase it, assigns a urine test and a PSA test.

How is prostate adenoma diagnosed?

Diagnosis of prostate adenoma

Diagnosis of the disease always begins with an anamnesis. In 1997, in Paris at the meeting of the International Committee on prostate hyperplasia, a standard algorithm for diagnosing patients with prostate adenoma was adopted. This algorithm includes a cumulative assessment of all symptoms using a simple questionnaire called (IPSS) and a Quality of Life Assessment Scale (QQL). Scores are used to evaluate IPSS and QQL. IPSS 0-7 points, means a slight severity of symptoms. At 8-19 points - moderate severity of symptoms, and 20-35 - severe symptomatology.

Also in this algorithm are filling the diary of urination (frequency and volume), palpation (finger examination) of the prostate and various instrumental diagnostic methods.

The diagnosis is adenoma

When suspicions on the development of prostate adenoma already exist, then a checkup of the prostate and evaluation of its severity is necessary. Let's start with the symptom questionnaire for prostate disease.

An assessment of anxiety

1. Is there a feeling that after the release of urine the bladder has not been emptied during the last month and how often?
2. Is it necessary, in urination, 2 hours after its satisfaction during the last month and how often?
3. Have there been intermittent urination during the last month and how often?
4. How often was it difficult to temporarily refrain from emitting urine when you had the urge to urinate during the past month?
5. How often did it feel that the pressure of the urine stream was weak during the last month?
6. How often did I have to press myself once more to start emitting urine within the last month?
7. How many times at night did you have to go up to the toilet for a little need during the last month?

In the questionnaire, 6 options are offered for each item - from 0 to 5 points:

• 0 points - when no such symptom was noticed at all.
• 1 point - the presence of the symptom of the disease in one urination per day.
• 2 points - when somewhat less than half of the urine emissions per day were accompanied by similar signs.
• 3 points - a clear tracking of manifestations of prostate diseases in half of urination per day.
• 4 points - more than half of all visits to the toilet in the day were accompanied by the above manifestations of the disease.
• 5 points - when the symptoms are present all the time.

After the poll, the points are counted, it is clear that the more points are scored, it means that the treatment should be more serious and longer than in the moderate cases.

Quality of life and their relation to urination disorder

Here, in fact, one question stands: "What is your attitude to the fact that if you had to constantly live with urological problems until the end?". Variants of answers 7 - from 0 to 6 points. T. e. (0), good (1), satisfactory (2), vague (3), unsatisfactory (4), bad (5), very bad (6).

Weak manifestations will result from 0 to 7 points. Moderate signs - from 8 to 19 points and expressed - from 20 to 35 points.

When the symptoms of prostate disease at a moderate or severe level, it is necessary to be examined additionally. Let's talk about this further.

Palpation of the prostate

This is a digital rectal examination of the prostate. Palpation of the prostate allows you to determine the size, consistency, soreness of the prostate (in the presence of chronic prostatitis).

Evaluation of the urine stream

Normally, a man emits about 15 ml per second. urine. If the volume of urine per second is from 15 and below to 10 ml., It is worth talking about moderate symptoms. If less than 10 ml / s, then this can be a manifestation of a severe form of benign prostatic hyperplasia. Through the flow of urine, it is possible to determine and predict the progression of the disease. But we must also remember that with age, in norm, usually the urine stream weakens somewhat. After all, the muscles of the bladder can just relax.

Uroflowmetry

Just the method that is used to measure the different characteristics of the urine stream. This method should be performed at least 2 times in conditions of filling the bladder (150-350 milliliters) and when there is a natural urge to urinate. To evaluate the results, use uroflowmetry curve, which indicates the maximum flow rate of urine. Flow rate exceeding 15 milliliters/second, is considered normal. The total time of urination is also estimated. Normally, for a volume of urine of 100 milliliters - 10 seconds, for 400 milliliters - 23 seconds.

Studies have shown that there is a dependence of urination on age. Normally, it is considered that the flow rate decreases by 2 milliliters / second every 10 years. This decrease in speed is due to aging of the bladder wall.

Analysis of the residual volume of urine

In other words, this is how completely a man can empty a urinary. This can be done with a catheter, which is injected through the urethra into the bladder or ultrasound.

Ultrasound examination

The technique of ultrasonic measurement of the remainder of urine is less accurate, but more common. Therefore, the study is repeated several times for clarification. ThroughUltrasoundyou can also measure the volume of the prostate, the state of the kidneys using this technique.

TRUZITransrectal ultrasound. This study allows to study in detail the structure of the prostate, to obtain its exact dimensions, and also to reveal signs of chronic prostatitis or prostate cancer. TRUS allows you to determine the development of prostate adenoma at very early stages.

Quite often in patients with severe hyperplasia of the prostate calcification sites are determined. The presence of calcinates in the central zone of the prostate indicates the final (5) stage of the development of the disease.

Urodynamic examination

Here, using the inserted catheter through the urethra, the urinary bladder is examined for its function and pressure in it. Measurement of pressure in the bladder is carried out at the time of urine. Further, water is poured into the catheter through the catheter and it is observed how much the bladder is capable of contracting.

Cystoscopy

The cystoscope is a thin flexible tube with a lens and illumination at the end. It is injected through the urethra. The prostate and bladder are examined. You can detect an increase in the prostate, the way it puts pressure on the urethra, the internal structure of the bladder and the stones in it.

Pyelography intravenous, or contrasting

It is a picture of the x-ray of the urinary tract. You can identify pathology, obstruction of the pathways. A contrast agent is injected into the vein of the examined man and the X-ray of the area of ​​the kidneys, bladder, ureters is performed.

Cystomanometry

Method with the help of which the pressure inside the bladder is determined. This method allows you to measure intravesical pressure at different stages of filling the bladder, as well as during urination.

In a healthy person, the initial urge to urinate occurs when there are 100-150 milliliters of urine in the bladder, while the pressure is 7-10 centimeters of the water column. When the volume of the bladder is filled to 250-350 milliliters, the urge to urinate sharply increases. The normal intravesical pressure is 20-35 centimeters of water column. Such a reaction of the bladder is called normoreflectory.

Increased intravesical pressure (above 30 centimeters of water column) with a bubble volume of 100-150 milliliters indicates hyperreflexogenicity (increased detrusor reflex). And vice versa, the lowered pressure (by 10-15 centimeters of water column) when the bubble is filled up to 600-800 milliliters speaks of detrusor hyporeflexia. Reflexogenicity detrusora allows you to evaluate its reserve function, and the relationship between volume and pressure characterizes the elastic properties of the detrusor.

Cystomanometry performed during urination, allows to determine vesicoureteral patency and detrusor contractility. Normally, the maximum intravesical pressure during urination is 45-50 centimeters of water column. If the pressure is increased, this indicates that there is an obstacle in emptying the bladder.

Cystography

The method of studying the bladder with the use of contrast. There is a descending and ascending cystography. Downward cystography involves moving the contrast from top to bottom. This method allows you to determine the filling defect in the neck of the bladder. In the picture, this filling defect is seen as a bump. Ascending cystography allows to determine the deformation of the urethra in the prostate.

Computed tomography and magnetic resonance imaging

These studies provide more detailed information (the relationship with neighboring organs) about prostate adenoma.

What are the PSA standards for prostate adenoma?

Prostate-specific antigen (PSA)- protein-enzyme, which is produced by normal cells of the prostate gland. It enters the seminal fluid and dilutes it. In this case, a small amount of prostate-specific antigen enters the blood.

In benign prostatic hyperplasia, PSA is produced in increased amounts, with malignant tumors, its blood level rises even more.

PSA levels for men of different ages:

1. up to 50 years - <2.5 ng / ml;
2. 50-60 years - <3.5ng / ml;
3. 60-70 years - <4.5 ng / ml;
4. older than 70 years - 6.5 ng / ml.

Each gram of benign prostatic adenoma increases the PSA level by 0.3 ng / l, and each gram of the malignant tumor by 3.5 ng / ml. With prostate adenoma, the level of prostate-specific antigen almost never rises above 10 ng / ml. If this happens, then there is a suspicion of cancer.

In prostate adenoma, the PSA level in the blood rises by no more than 0.75 ng / ml per year. A faster increase is characteristic of malignant tumors.

The prostate-specific antigen can circulate in the blood in a free form (free PSA), or be associated with other proteins (bound PSA). Usually, the level of free and common prostate-specific antigen is determined in the laboratory. If the free is less than 15% of the total - there is a risk of a malignant tumor.

An indicator such as PSA density is also important. In order to obtain it, the level of prostate-specific antigen in the blood is divided by the volume of the prostate gland. If the PSA density is greater than 0.15 ng / ml / cm3, there is a risk of cancer.

In all cases, when a suspicion of prostate cancer arises after a blood test for PSA, the doctor prescribes a biopsy.

Questions and answers

Is there a malignant prostate adenoma?

Prostate adenoma is a benign neoplasm by definition. It does not germinate into neighboring tissues and does not give metastasis.

However, with time, prostate adenoma can become malignant. Prostate cancer is developing. Usually the "first bell", signaling the development of a malignant tumor, is an increase in the blood level of the prostate-specific antigen. Finally confirm the diagnosis helpsbiopsy.

Prostate cancer, unlike adenoma, is able to germinate into neighboring tissues and give metastases. The success of treatment depends heavily on how early it was started.

Is it possible to use physiotherapeutic methods to treat prostate adenoma?

The following physiotherapy methods can not be used:

1. Any kind of heating of the prostate gland.
2. Various vibratory procedures.
3. Ultrasound.
4. Electromagnetic waves.

All of the above methods of physiotherapy exacerbate the course of the disease.

With prostate adenoma, electrophoresis is most often used to deliver the drug directly to the prostate tissue.

Is it possible to use massage as a method of treatment?

Massage is effective only for chronic prostatitis (inflammation of the prostate). To treat prostate adenoma, massage is contraindicated.

What foods should be eaten?

Daily consumption of raw pumpkin seeds significantly increases the effect of treatment, especially in the early stages of the disease.

Are there any exercises that should be done with prostate adenoma?

You should perform exercises at least 5-10 times per session.

1. In the supine position on the back with the buttocks torn from the floor, you need to draw the anus.
2. In the position on all fours take turns pulling your legs back, then to the side. Simultaneously with the stretching of the legs, it is necessary to pull the opposite hands forward (that is, if pulling the left leg back means simultaneously pulling the right hand forward).
3. Lying on his back pull up the knees bent at the knees, and then lower them in turn to the right, then to the left of the trunk.

What is the difference between prostate adenoma and prostatitis?

Prostate adenoma is a disease in which its benign enlargement occurs. Prostatitis is an inflammatory process in the prostate gland.

Related Videos

How to remove symptoms of prostate adenoma in a few minutes

Chronic prostatitis, prostate adenoma. Get lots of safe recipes for free.

How to treat prostate adenoma, easy and fast!

Prostate adenoma and prostatitis treatment

Prostatitis and prostate adenoma symptoms and treatment. The prostate gland in men is photo.

Treatment of prostate adenoma

Jet diagnosis - prostate adenoma. Than to treat a prostatitis?

In the treatment, and even better, in the prevention of prostate adenoma colloidal phytoformulas are effective. Painless treatment of prostatitis with the help of Meil ​​Active Complex.

Mail Active Complex (Male Active Complex) - effective in the main diseases of the male sexual sphere: eliminates inflammation in the prostate and helps reduce adenoma.

1. Affects the emotional and psychological aspects of "male" diseases (increases the sense of confidence in men, increases libido).
2. Affects complex both in the male sexual sphere, and on the systems that ensure its normal work - cardiovascular and nervous.
3. Corrects the violation of urination against the background of diseases and in connection with age: normalizes the frequency of urination, a feeling of incomplete emptying of the bladder, sudden urges.
4. Improves spermatogenesis: increases the number of normal motile sperm that are capable of fertilization (used in complex programs to correct male infertility).

How to get rid of prostatic adenoma

A source

The recommendations in this article are based on official authoritative sources:

1. Video on the topic.
2. Medvedev B. A. The second heart of a man. Prostate treatment / Panacea series. - Rostov n / a: Phoenix, 2004. - 320 s.
3. Tkach I. FROM. Prostate adenoma, its treatment, questions and answers on the site:http://www.polismed.com/articles-adenoma-prostaty-01.html.
4. Hasgov G. N. Folk medicine. The best recipes of traditional medicine. - Moscow: Arnadia, 1998. - 352 sec. / Medicine for all.
5. Hasgov G. N. Official and traditional medicine. The most detailed encyclopedia. - Moscow: Publishing house Eksmo, 2012.