The prostate is a small, unpaired organ located in the pelvic cavity just below the bladder and in front of the rectum. The urethra passes through the thickness of the prostate gland.
The structure and function of the prostate gland
The prostate is composed of smooth muscle fibers and secreting cells. The main function of the gland is to secrete secretions, which are involved in liquefying the ejaculate, ensuring the movement of sperm and protecting them from the aggressive environment of the vagina. The prostate gland is also a valve that prevents the flow of urine during ejaculation and seminal fluid during urination.
The weight of the prostate of a healthy adult man is only about 20 g. The hormones of the pituitary gland and adrenal glands, androgens, and estrogens have a great influence on its condition. During life, the size of the prostate can change: in boys, it is small, during puberty, the prostate increases dramatically. When the secretion of hormones begins to fade (usually this occurs at the age of 45-50 years), the reverse development of the gland normally begins.
However, the opposite process often occurs - benign prostatic hyperplasia (BPH), or prostate adenoma.
What is prostate adenoma?
This disease has many synonyms: prostate adenoma, benign prostatic hyperplasia, benign prostatic nodular hypertrophy, and others.
The name reflects the essence of the pathological processes occurring in the gland: the glandular tissue grows, forming dense nodules. The size of the prostate increases, which causes constriction of the urethra and spasm of smooth muscle cells. This leads to the onset of symptoms of the disease.
The size of the prostate has no direct effect on urinary impairment. Symptoms may be absent with a significant increase or appear in the early stages of the disease.
BPH has benign growth, that is, it does not metastasize. This fundamentally distinguishes BPH from prostate cancer. The main reference point for the onset of malignant transformation of the prostate gland is the level of prostate specific antigen (PSA).
The causes of BPH
According to statistics, in men younger than 30 years, signs of BPH are usually absent. With age, the incidence of BPH increases, reaching a peak by the ninth decade of life (90%).
The causes of prostate adenoma are still not fully understood. It is believed that prostate adenoma has a multifactorial nature. The role of the male sex hormone testosterone has long been known both in the normal growth of the prostate gland and in the development of BPH. It is known that men aged 40 to 50 years have a period of the most profound restructuring of hormonal regulation, while there is a decrease in the level of testosterone circulating in the blood. A decrease in the amount of testosterone and a relative increase in the level of estrogens (female sex hormones) in the male body leads to the growth of the prostate gland.
The change in the hormonal ratios in the man's body was the starting point in the study of the causes and mechanism of development of benign prostatic hyperplasia. In addition to hormonal disorders, the inflammatory process, accompanied by edema of the prostate gland, is important in the development of prostate adenoma, since it can play an important role in increasing the number of prostatic cells, and the edema of the organ, as a mechanical factor, contributes to the intensification of the symptoms of the disease.
Symptoms of prostate adenoma
The enlargement of the prostate gland leads to compression of the urethra and causes smooth muscle spasm. This process is accompanied by impaired urination:
- 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 difficult to restrain the urge to urinate;
- increased urination during the daytime;
- low-volume urination.
Often, the above symptoms are joined by difficulty at the beginning of the act of urination, which is more pronounced in the morning and makes you strained to start urinating. These symptoms are the reason for seeking medical attention.
Treatment of prostate adenoma
The course of the disease significantly worsens the quality of life, and the lack of adequate treatment can cause surgery. Given the progressive nature of this disease, drug therapy for BPH should be carried out for a long time. Depending on the prevalence of symptoms, therapy can vary significantly. Pharmacotherapy eliminates urinary problems, reduces complaints and restores quality of life. You should also be aware that prostate adenoma can be asymptomatic or cause nonspecific urinary problems that do not resemble the classic picture of the disease. This misleads patients and makes them waste valuable time. But the earlier the treatment is started, the more effective it is.
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 will be able to assess the symptoms, conduct the necessary examination and prescribe an effective treatment.