A male gland that is not present in females and is located in the pelvic region behind the pubic bone and surrounds the upper part of the urethra. Benign prostatic hyperplasia, also known as benign prostatic hyperplasia, is a very common disease of the prostate gland, which is an important part of the male genitourinary system and responsible for secreting 70% of semen, where the number of cells increases and the size of the prostate gland enlarges. The most important characteristic of this enlargement is It is a benign, non-malignant (i.e., non-cancerous) type. It is worth noting that the incidence of this hyperplasia is very large, especially when males age, that is, after the age of forty, and the incidence of benign prostatic hyperplasia is almost certain after the age of ninety years.
With the symptoms of some other disorders and lies in the anatomical location of the prostate gland in the genitourinary system and the disorders that occur in the cells of the prostate gland and surrounding other organs and can be summarized as follows: Weak or slow urine flow. Feeling of fullness in the bladder despite urination. Difficulty and pain when urinating begins. frequent urination. Urgent need to urinate, especially at night. Returning to urinating again a minute after the end of urination for the first time.
On the clinical symptoms and signs we referred to previously, in addition to observing the anatomical changes that occur in the prostate gland, which can be detected using the following methods: Medical history (general indicator of prostate symptoms and accurate evaluation of symptoms) Clinical examination of the abdomen and pelvis, the aim of which is to detect any disturbances or changes that occur in the abdominal and pelvic area, which contain the prostate gland. Calculate urine flow rate. A urine test to see how much urine is left in the bladder after urination. Pressure flow studies to measure pressure in the bladder and urination. Urinalysis to make sure there is no blood or infection. Urine culture analysis. A blood test to detect prostate-specific antigen (PSA), which indicates a higher than normal level for prostate disorders, including prostate cancer. Cystoscopy. Digital rectal exam Ultrasound examination of the prostate. The treatment methods used depend on the severity of symptoms and the severity of inflation. The therapeutic measures are listed as follows: Self-monitoring while following the doctor's instructions regarding health, dietary, and sexual habits. The use of drugs that inhibit the division of prostatic cells and prevent them from enlarging. The drugs of first choice by doctors are alpha-1 receptor blockers. This group includes the following drugs: Tamsulosin Doxazosin Prazosin Alfuzosin Alpha-reductase inhibitors: Finasteride Dutasteride
Which includes removing the prostate gland, and this is in advanced disease symptoms and there are many surgical methods, and the latest methods are laser and vaporization.
Open surgical treatments are used in cases that do not respond to drug treatment, which makes surgery necessary to relieve symptoms and avoid complications. These include surgeries:
Laparoscopic removal of prostate tissue pressing on the urethra: The idea of surgery is to insert a small surgical instrument through the opening of the urethra, and reach the position of the prostate pressure on the urethra, and then begin to remove the enlarged prostate tissue through cutting and cauterization, this surgery is one of the most The most common types of prostate surgery.
Possible complications of this surgery: infections resulting from infection of the wound, and it is prevented by a course of strong antibiotics before and after surgery. Bleeding during the operation. Retrograde ejaculation of semen: It is painless and does not represent a medical concern except in terms of fertility and the ability to reproduce. Erection problems: The natural ability to have an erection may be affected for some time after the operation, but it gradually improves within a few months.
Transurethral incision of the prostate: The idea of surgery is instead of removing the enlarged prostate tissue, the surgeon makes a small incision in the prostate tissue in the area of the urethra blockage, which helps urine pass more easily and relieve symptoms. This surgery is used in cases of moderate inflation, or in cases where the general health situation does not allow to perform other types of surgeries, and the patient can go home on the same day with a urinary catheter placed for a few days, and the improvement of symptoms is relatively slower than the previous surgery. Possible complications of this surgery: Retrograde ejaculation: It occurs at a lower rate than the cases of surgery to remove prostate tissue. Erection problems: The natural ability to have an erection may be affected for some time, but it gradually improves over a few months.
Prostatectomy surgery: The idea of surgery is to open the abdomen and remove the inner part of the prostate tissue, and this surgery is used in advanced cases of prostate enlargement, which cannot be relied on other types of surgeries, as it is resorted to in the event of advanced complications on the prostate Bladder and urethra, recovery from this surgery requires several weeks. Possible complications of this surgery: bleeding and loss of large amounts of blood. Contamination and infections. incontinence. Retrograde ejaculation of semen. Erection problems.
Minimally invasive treatment of prostate enlargement: What is meant by minimally invasive surgery is the minimally invasive surgical intervention, in which many modern techniques are used in order to reduce the possibilities of complications and increase the speed of recovery of the patient, the most important of which are:
BPH laser treatment: The idea is to destroy and remove the enlarged tissue in the prostate with a high-energy laser beam. This type of treatment is used in some patients with enlarged prostate, whose general health does not allow them to undergo other surgeries. Laser treatment of prostate enlargement depends on two main mechanisms: Cauterization: The laser beam burns the enlarged prostate tissue. Emptying: where laser tools empty the enlarged prostate tissue in a similar way to a prostatectomy
Advantages of treating prostate enlargement with laser: – The chances of retrograde ejaculation of semen are lower. Less chances of erection problems.
Disadvantages of treating prostate enlargement with laser: Cauterization leads to irritation of the urinary tract, which may exacerbate symptoms. Ironing may need to repeat the process after some time. The patient experiences pain with urination a few weeks after the operation.
Treating enlarged prostate with microwave heat treatment: The idea is to rely on a surgical pole inside the urethra that generates high heat from microwaves. This heat directed to the enlarged prostate tissue destroys it, which results in a shrinking of the prostate. Especially. There are high chances of needing to repeat the operation again after a period of time, but the advantage of this operation is that it can be performed under local anesthesia in doctors’ offices. Advertisement Possible complications of this operation: Pain associated with urination for several weeks after the operation. Decreased amount of semen in ejaculation. Symptoms may not improve. Feeling an urgent urge to urinate for a few days after the operation.
Cauterization of the enlarged prostate tissue: The idea is to insert a specialized surgical needle through the urethra to reach the site of the enlarged prostate, and then begin to produce high-energy waves that lead to the cauterization of the enlarged prostate tissue. General health, especially those associated with rapid bleeding. Possible complications of this operation: Erectile dysfunction in this operation is very low, but there are some other complications: Symptoms may reappear in some patients. Pain associated with urination a few weeks after the operation. A feeling of urgency to urinate.
Prostate stents: The idea is to insert a small metal stent into the urethra at the site of pressure on the enlarged prostate tissue, so that this stent ensures that the urethra is not obstructed, and this secondary solution is resorted to in people who refuse to take medication, as well as those who refuse to undergo curative surgery, and this is considered The solution is one of the least acceptable solutions to doctors due to its low long-term therapeutic efficacy. Complications of prostate stents: Difficulty removing the stent. The stent may move out of place and worsen symptoms. Pain associated with urination. They need to be changed every 6 weeks, and the prices for stents are high. Treatment of benign prostatic hyperplasia with interventional radiology Interventional radiology aims to treat BPH