The prostate is a small, unpaired organ that is located in the pelvic cavity just below the bladder and in front of the rectum. The urethra runs through the thickness of the prostate.
Structure and function of the prostate
The prostate is made up of smooth muscle fibers and secreting cells. The main function of the gland is to secrete secretions that are involved in the liquefaction of the ejaculate, ensure the movement of the sperm and protect them from the aggressive environment of the vagina. The prostate is also a valve that prevents the flow of urine during ejaculation and the seminal fluid during urination.
The weight of the prostate in a healthy adult male is only about 20 g. The hormones of the pituitary and adrenal glands, androgens, estrogens have a great impact on their condition. Over the course of life, the size of the prostate can change: in boys it is small, during puberty the prostate increases dramatically. When hormone secretion subsides (usually by the age of 45-50), the reverse development of the gland usually begins.
However, the opposite process often occurs - benign prostatic hyperplasia (BPH) or prostate adenoma.
What is a prostate adenoma?
This disease has many synonyms: prostate adenoma, benign prostatic hyperplasia, benign nodular prostatic hypertrophy, and others.
The name reflects the essence of the pathological processes taking place in the gland: the glandular tissue grows and forms dense nodules. The size of the prostate increases, causing compression of the urethra and spasm of the smooth muscle cells. This leads to the appearance of symptoms of the disease.
The size of the prostate has no direct influence on the urinary dysfunction. Symptoms may be absent with a significant increase or appear in the early stages of the disease.
BPH grows benign, which means it doesn't metastasize. This fundamentally differentiates BPH from prostate cancer. The most important reference point for starting malignant transformation of the prostate is the level of prostate specific antigen (PSA).
The causes of BPH
According to statistics, men under the age of 30 tend to have no signs of BPH. The incidence of BPH increases with age and peaks in the ninth decade of life (90%).
The causes of prostate adenoma are not yet fully understood. The prostate adenoma is believed to be multifactorial in nature. The role of the male sex hormone testosterone has long been recognized in both normal prostate growth and the development of BPH. It is known that men between the ages of 40 and 50 go through a period of the most profound restructuring of hormonal regulation, during which the levels of testosterone circulating in the blood decrease. A decrease in the amount of testosterone and a relative increase in the level of estrogen (female sex hormones) in the male body leads to the growth of the prostate.
The change in the hormone ratios in the man's body was the starting point for the investigation of the causes and the mechanism of development of benign prostatic hyperplasia. In addition to hormonal disorders, the inflammatory process, accompanied by prostate edema, is important for the development of prostate adenomas, since it can play an important role in increasing the number of prostate cells, and organ edema, as a mechanical factor, contributes to the intensification of the symptoms of the disease.
Symptoms of a prostate adenoma
The enlargement of the prostate causes compression of the urethra and causes smooth muscle spasm. This process is accompanied by impaired urine output:
- the need to wake up at night to empty the bladder;
- a decrease in the tension of the urine stream;
- Feeling of incomplete emptying of the bladder after urination;
- the appearance of an unrestrained need to urinate
- increased urination during the day;
- low urination.
The symptoms mentioned above are often joined by difficulties starting to urinate, which are more pronounced in the morning and which make you urinating hard. These symptoms are the reason to see a doctor.
Treatment of prostate adenoma
The course of the disease significantly worsens the quality of life and the lack of adequate treatment can lead to surgery. Given the progressive nature of this disease, drug therapy for BPH should be carried out over a long period of time. Therapy can vary widely depending on the prevalence of symptoms. Pharmacotherapy eliminates urinary tract problems, reduces discomfort and restores quality of life. You should also be aware that prostate adenoma can be asymptomatic or cause unspecific urinary problems that do not correspond to the classic clinical picture. This misleads patients and wastes valuable time. But the earlier treatment is started, the more effective it will be.
Prevention of BPH
There are currently no specific methods of prevention. One of the preventive measures is the annual visit to the urologist after 40 years. At the appointment, the doctor can assess symptoms, conduct the necessary examination, and prescribe effective treatment.