Dorothy FarrarProstatahypertrophie
Prostatic hypertrophy is often incorrectly referred to as a benign enlargement of the prostate . Medically correct, however, this is benign prostatic hyperplasia , which leads to bladder emptying disorders with a frequent urge to urinate . The number of people affected increases steadily with increasing age, until 9 out of 10 men over the age of 70 are affected.
What is prostatic hyperplasia?
Benign prostatic hyperplasia is the benign enlargement of the prostate, a male sex gland that produces part of the semen. Normally, the prostate is about the size of a chestnut, but in the case of prostatic hyperplasia, it can increase in size by a factor of five.
Prostatic hyperplasia is a disease of older men, affecting 70% of those over 60 and as many as 90% of those over 70. Thus, prostate hypertrophy is also referred to as a widespread disease.
causes
The causes of prostatic hyperplasia are not fully understood in detail. However, it is known that the growth of the prostate as a male sex gland is primarily determined by the male sex hormones.Dihydrotestosterone, which is ten times more active than testosterone , is of particular importance. It is probably formed mainly in the prostate. The production of dihydrotestosterone probably increases with age, which is why prostatic hyperplasia is a disease of older men.
The prostate sits below the bladder and surrounds the urethra. The spermatic cord also runs in this area and finally flows into the urethra, through which the ejaculate is then released. In prostatic hyperplasia, the part of the urethra surrounded by the prostate is compressed and narrowed. It is only from this that the complaints of those affected arise.
symptoms and course
Prostatic hypertrophy is an ongoing process, which is why the symptoms begin insidiously and gradually increase. Initially, patients with prostatic hyperplasia may still be symptom-free, but with increasing enlargement of the prostate and the associated narrowing of the urethra, the typical symptoms develop.
Classically, those affected express an increased urge to urinate , with only small amounts of urine being excreted each time ( polakiuria ). In addition, there is a repeated need to urinate at night ( nocturia ).
Also typical are initial difficulties when emptying the bladder, a weakening of the urine stream and dribbling at the end of the bladder emptying. After emptying the bladder, there is still residual urine in the bladder in advanced prostate hypertrophy. This acts as a breeding ground for bacteria and can lead to bladder infections . If the prostate hyperplasia progresses even further, complete urinary retention and accumulation of urine up to the kidneys can occur. Then there is the threat of kidney pelvic inflammation and even kidney failure as complications .
Diagnose
The typical symptoms of prostate hyperplasia are crucial for the diagnosis. However, it is important to differentiate prostatic hypertrophy as a benign enlargement from the malignant change in the prostate, prostate carcinoma . For further diagnostics, the rectal palpation of the prostate is carried out first. Size and shape can already be estimated.
Furthermore, an ultrasound examination is carried out, in which the prostate as well as the urinary bladder and kidneys can be assessed with any residual urine. The disturbances in bladder emptying can be recorded objectively in numbers using uroflowmetry. The bladder volume, the amount of urine excreted and the flow rate of the urine stream are determined. In addition, a blood test is carried out in which the so-called PSA (prostate-specific antigen) is determined. This value increases with changes in the prostate, including prostate hyperplasia.
treatment and therapy
The treatment of prostatic hyperplasia depends on the severity of the symptoms. Changing your drinking habits can help when the symptoms start to be mild. Coffee and alcohol should be avoided, as these also have a strong diuretic effect, and nothing should be drunk before going to bed. A lot of exercise is also important.
In addition, herbal preparations of pumpkin or saw palmetto extracts can be used. If this does not provide sufficient relief, the therapy is supplemented with various medications. Preparations are used that reduce the amount of residual urine (e.g. tamsolusin) or inhibit the production of dihydrotestosterone and thus further enlargement (e.g. finasteride).
If there is a large amount of residual urine, urinary retention or kidney damage, an operation is indicated. The prostate is almost completely removed so that the narrowing of the urethra and thus the cause of the symptoms are eliminated.
The operation can be performed either through the urethra (transurethral) or openly through an incision in the abdomen. Complications of the operation can include incontinence, erectile dysfunction, ejaculation dysfunction and difficult bladder emptying.
prevention
Since the causes of prostatic hyperplasia are not precisely known or cannot be influenced, prostatic hyperplasia itself cannot be prevented. However, regular urological checks, early diagnosis and optimal treatment can prevent complications. Also because of the important difference to prostate carcinoma, regular visits to the urologist are recommended for men over the age of 55.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.