A prostate adenoma is the most common benign tumor in men and develops from the glands of the transition zone. Statistics show that 75-85% of men over the age of 40-50 develop a microscopic prostate adenoma.
There are well-tolerated adenomas, but there are also adenomas that, through their complications, can have a serious evolution. The evolution of the condition is not dependent on the volume of the tumor, and early follow-up and correctly conducted treatment are essential elements in preventing prostate adenoma complications.
What are the development stages of prostate adenoma?
About the prostate
The prostate is a glandular and fibromuscular organ, consisting of several lobes, which surrounds the prostatic urethra. On the periphery is the prostatic capsule, which is made of fibrous tissue. This organ has a chestnut appearance, with a diameter of 4/2/3 cm and a weight of 25 gr.
What are the development stages of prostate adenoma?
From a clinical point of view, prostate adenoma can evolve in 3 stages:
- Prostatism phase
- Incomplete retention phase without bladder distension
- Incomplete retention phase with bladder distention
1. Prostatism phase
Prostate adenoma can lead to bladder muscle hypertrophy, which can be manifested by:
- Nocturnal pollakiuria (frequent urination during the night)
- Decrease in the strength of the urinary stream
2. Incomplete retention phase without bladder distention
Due to the maintenance of the subvesical obstruction (prostate adenoma), the atrophy of the bladder muscles and the appearance of the bladder residue (storage capacity of the bladder) occur.
The patient may have the following symptoms:
- Diurnal pollakiuria (frequent urination during the day)
- Dysuria (difficulty urinating)
3. Incomplete retention phase with bladder distension
Due to the increase in the bladder residue (over 300 ml), bladder distention occurs, and the patient may have the following symptoms:
- Marked dysuria
- Intense nocturnal and diurnal pollakiuria
- Urinary incontinence due to overfilling – the capacity of urine produced exceeds the storage capacity of the bladder
Treatment of prostate adenoma
The prostate adenoma treatment plan consists of a series of stages:
- Surveillance through annual urological examination – watchful waiting.
- Drug treatment with alpha-blockers, 5 alpha-reductase inhibitors, antimuscarinics, phytotherapy
- Surgical treatment. Either open surgery – reserved today only for adenomas larger than 90 gr, or endoscopic surgery – for adenomas smaller than 90 gr
- Transurethral resection of the prostate (TURP) is still the gold standard in prostate adenoma surgery smaller than 90 gr, while for adenomas over 90 gr, different types of laser are used
Considering the complexity of the prostate adenoma, as well as the associated symptoms, it is essential to present patients to the urologist specialist as early as possible, from the first symptoms or changes in the investigations carried out for this purpose.
