The prostate is a gland sexual located below the bladder, at the crossroads of the urinary tract and genital. It is involved in reproduction by providing nutrients required sperm and producing a liquid that liquefied.
The prostate is also involved in the preservation of sperm by creating a protective envelope.
Apart from cancer and prostatitis, another disease can affect the body: the benign prostatic hyperplasia. This disease is due to hypertrophy which increases with age. The first signs are urinary disorders that must sound the alarm because without treatment, sometimes very severe complications may occur.
The prostate adenoma
Between birth and puberty, the prostate grows slowly and then undergoes a surge of growth hormone (as a result of a male hormone, dihydrotestosterone) to reach adult weight stable. For unknown reasons, prostate then swell again to a volume sometimes important is the adenoma or benign hypertrophy. Thus, most men advance in age, the greater the volume of the prostate increases.
This phenomenon is not cancer appears normal from quarantine, and that time does not adenoma urination, consultation is not necessary. However, its location is important. If the enlarged tissue extends to the periphery of the gland, it does not cause any symptoms, but if it extends near the urethra it could crush and hinder urination, and urinary disorders appear.
After sixty years, nearly two in three men are affected (50% of men 60 years and 90% of more than 80 years). In industrialized countries, the disease is the third leading cause of healthcare spending.
The imperative urination
When hypertrophy bladder discomfort and irritation, the desires become frequent urination (first night and day) and irresistible, even when the bladder is empty. Urination is difficult (low strength of the jet) and drags with the so-called ‘late drops, which are uncontrollable. Most disturbances occur mainly in the morning, the first jet is the most difficult. Taken in isolation its symptoms are not specific, but their association is characteristic of the prostate adenoma. In the beginning they are minimal, but worsen over time.
This treatment is essential because if complications are rare, they are serious: total inability to urinate (acute retention of urine), infection of the prostate, urinary tract, blood in the urine and kidney can dilate , Then who do their filtering function.
The review diagnosis
The examination to assess the importance of symptoms and their impact on the quality of life of the patient. The affected states rectal consistency, volume and the limits of the prostate. When it is smooth and elastic it is probably an adenoma. If it is harsh and irregular cancer may be suspected. In the latter case, only a biopsy to confirm the diagnosis of cancer. The rate of PSA, a specific antigen of the prostate, can be used as an indicator provided it is well correlated to the volume of the prostate, because it increases as the size of the organ. Other tests (ultrasound, X-rays, measure urine flow…) confirm the diagnosis and help the doctor to assess the stage of the disease and its impact.
What treatment?
If the discomfort is bearable, certain medications can alleviate symptoms in facilitating the opening of the bladder neck and thus voiding or decreasing the volume of adenoma. The annual consultation will be essential. In addition, some rules of hygiene are essential to drink enough during the day to avoid any risk of infection or calculations, avoid fatty foods or too spicy, alcohol, soft drinks, long trips and sitting practice consistent physical activity, ie rather than walking or riding bikes to avoid compression of the lower abdomen, aggravating factor disorders.
If significant discomfort and complications, surgery offers two types of intervention. If the adenoma was small (less than 60g) endoscopic resection can be performed. It is to remove hypertrophied part, shred by shred, using an electrical device (a résecteur) into the channel of the urethra. When the adenoma is larger, we must resort to traditional surgery by high.
Sometimes, treatment with hyperthermia (for heat) is used or when the patient does not permit the surgery, you can put a prosthesis in the prostatic urethra to give the patient the opportunity to urinate normally.
In all cases, the adenoma is unpredictable developments, the decision is always difficult.
What impact on sexuality?
This issue still worries. It should be known after the operation the only mechanism sexual likely to be disturbed is ejaculation. Indeed, it can cause retrograde ejaculation: can no longer be forward, it takes place in the bladder and thus leads to infertility. Hence the importance of consulting the early symptoms to facilitate the management of the disease. All other functions are preserved and libido disorders occur, they can only be psychological. The usual advice is to wait a month and a half before resuming sexual activity, and thereafter we must not hesitate to turn to a specialist if problems persist.
What is the difference between prostate adenoma and cancer?
The adenoma extends from the center of the gland when cancer develops from the periphery. In the latter case, growth remains silent because she does not touch the urethra and thus hamper urination. Urinary disorders are therefore already at an advanced stage. In addition, the symptoms are any other kind: impotence, urinary extra pain, and so on. But beware, an adenoma does not turn into cancer. It can only be associated.