Benign Prostatic Hyperplasia
The treatment for benign prostatic hyperplasia may be medicinal or surgical.
What is it?
The prostate is a gland exactly below the bladder and embraces the first part of the urethra so that in reality urination occurs through the prostate. As age advanced, it increases in size and blocks the passage for urine, thus creating the symptoms which make life hard for the man suffering from benign prostatic hyperplasia. Often it is not the increase in the size of the prostate that cause the problem but the “spasm” caused in the prostate which in this way which puts pressure on the urethra and makes it narrow, causing urination problems.
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Causes
Although many studies have been carried out seeking the causes of benign prostatic hyperplasia, until now there are no remarkable results. It is proven that the disease is caused by many factors.
The most important causes we can note are:
- Testosterone & estrogen disorders: as age advances the prostate does not respond in the same way to the augmenting testosterone action, resulting in hormonal instability.
- Interaction of epithelium and the stroma
Prostatic Hyperplasia Symptoms
The symptoms presented by the prostate of men suffering from prostatic hyperplasia are many: frequent urination, night urination, intense urination, sometimes incontinence, discomfort in urination, a feeling of incomplete emptying of the bladder, reduced urination radius, reduced urination quantity etc.
Diagnosis
For the benign prostatic hyperplasia many diagnostic tests may be carried out, which provide the andrologist with a complete picture of the effects of the disease on the patient. So, the results can help determine the correct treatment plan.
The diagnosis always begins with the medical history, regarding the type of symptoms, their severity and when they appear.
An important test is the measurement of the urine flow, which is complemented by a kidney ultrasound.
One of the most detailed tests is the transrectal prostate ultrasound, and finally, in special cases, additional radiological check may be undertaken, even an upper and lower abdomen CT scan.
The doctors in the ANDROCLINIC can manage and address both Benign Prostatic Hyperplasia as a disease and any sexual problems a man with benign prostatic hyperplasia is facing.
Treatment of Prostatic Hyperplasia
The treatment for benign hyperplasia may be medicinal or surgical.
Medicinal tratment of Prostatic Hyperplasia
There are now many alternatives for the medicinal treatment of benign prostatic hyperplasia. There are drugs that reduce the prostate, drugs that relax its “spasm” or a combination of them.
One basic worry of men suffering from benign prostatic hyperplasia and are still sexually active is how their sex life will be affected by these drugs. The truth is that most of the drugs circulating until now for the benign prostatic hyperplasia have had a negative effect on the erection or ejaculation.
The medication aiming at reducing the prostate may indeed have negative effects and there are no medicines in this class not causing such side-effects. The medication aiming at “relaxing” the prostate so that it does not press on the urethra may affect ejaculation. But that is not true in the same degree about all drugs in this category and the best selection must be carried out based on the patient’s response to the treatment.
Today, however, there are new products not affecting erection. Now there is available medication based on plant products produced by reputable pharmaceutical industries and it can be a very good alternative for men indicated for it.
Finally, there is medication for benign prostatic hyperplasia which enhances erectile function. This medication is ideal for the man who, along with benign prostatic hyperplasia also faces erectile dysfunction in its initial stages.
Consequently, modern man has the possibility to manage his prostate problem conservatively, without sacrificing any part of his sexual activity.
Is medication effective?
Medication corresponds to the patient’s symptoms. Usually the strategy for medicinal administration is determined as follows:
Alpha-adrenergic receptor blockers: these drugs affect urination positively, but they have side-effects like dizziness and weakness.
5-α-reductase inhibitors: the more the prostate grows, the more difficult urination becomes. In order to reduce its size, these drugs are uses, when the prostate weighs more than 40 grams.
Anticholinergic drugs: when the bladder is overactive and its contractions happen even with small urine volumes, then hyperplasia is expected. The medication reduces the symptoms of night urination and urgent urination.
Surgical response to Prostatic Hyperplasia
However, a surgical response is necessary for those with a more serious problem. The modern surgical treatment of benign prostatic hyperplasia is done by greenlight laser and the TURIs method.
Greenlight laser takes its name from the laser radiation color, i.e. green. During prostate removal with the laser method, the special tool enters the urethra (transurethral) and reaches the spot where the prostate is. There the laser been is energized and guiding it to the prostatic tissue, it is absorbed by it and volatilizes it (i.e. “vaporizes”). So prostatic tissue is practically removed and this results in widening the urethral tube and restore urination. The patient usually remains in the hospital for one day and very soon returns to his normal activities.
The Turis Method
The TURis method is another modern technique of transurethral prostate resection. In the case of TURis we have evaporation but it can be combined at the same time with cutting, i.e. removal of small parts of the prostate and so the operation is faster. The special instrument enters the urethra and when it reaches the prostate it is energized and starts vaporizing the prostate through energy creation in the form of plasma or removing parts of the prostate, depending on the doctor’s choice. The final result is a widening of the urethra and the release of urine flow. In this method the patient also stays in hospital for one day and very soon returns to his activities.
Many men worry about their sex life after removing the prostate and above all how it will be affected by the operation. In general, the possible problem consists in ejaculation loss. The patient has the feeling of ejaculating and the pleasure accompanying it, but semen no longer exits the urethra or does so in smaller quantities. This is to be expected after a prostate operation and is not harmful or aggravating for the body. Erection disorders are unusual after a prostate operation for benign hyperplasia although it can sometimes be observed.
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Because our doctors have more than 18 years’ experience in the sector
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OUR TEAM
Vasilis Protogerou
Dimitrios Mporousas
Konstantinos Makarounis
