prostatic adenoma

Prostatic Adenoma (Benign Prostatic Hyperplasia)

Prostatic adenoma, also known as benign prostatic hyperplasia (BPH), is a non-cancerous enlargement of the prostate gland that affects many elderly men. The condition occurs when the transitional zone of the prostate undergoes proliferation of glandular, smooth muscle, and stromal components.

Causes and Risk Factors

The exact cause of BPH is unclear, but it may be related to changes in sex hormone balance as men age. Risk factors for developing BPH include:

• Aging: The condition rarely causes symptoms before the age of 50.
• Genetics: There may be a genetic link to BPH.

Symptoms and Effects

As the prostate enlarges, it can cause symptoms such as: * Difficulty urinating (hesitancy) * Frequent or urgent need to urinate * Nocturia (waking up frequently at night to urinate) * Weak urine flow

The enlarged prostate can also block urine flow, leading to complications like urinary tract infections and kidney damage.

Prevalence

BPH is a common condition among older men. Experts estimate that BPH affects 5-6% of men ages 40-64 and 29-33% of those ages 65 and older.

References:

• [1] Prostate adenoma or BPH is the most frequent benign tumor occurring in elderly male patients, developed from the transitional zone of the prostate through proliferation of the glandular, smooth muscle, and stromal components. (Source: #4)
• [2] Risk factors for an enlarged prostate include: Aging. An enlarged prostate gland rarely causes symptoms before age 50. (Source: #2)
• [3] BPH is a common cause of lower urinary tract symptoms (LUTS) in older men, with disease prevalence increasing with advancing age. (Source: #5)
• [4] The term benign prostatic hypertrophy was formerly used for this condition, but since histology demonstrates an increase in the number of epithelial and stromal cells in the periurethral area of the prostate, not an enlargement of cells, the more accurate descriptor term is hyperplasia. (Source: #10)

Common Signs and Symptoms of Prostatic Adenoma

Prostatic adenoma, also known as benign prostatic hyperplasia (BPH), is a non-cancerous enlargement of the prostate gland that can cause various symptoms in men. The following are some common signs and symptoms associated with prostatic adenoma:

• Urinary Frequency: Needing to urinate more often than usual, especially at night [7]
• Urinary Urgency: Feeling a sudden need to urinate, which may be difficult to control [2], [7]
• Nocturia: Waking up frequently during the night to urinate [3], [7]
• Weak Urine Stream: Experiencing a weak or slow urine flow [9]
• Difficulty Starting Urination: Trouble starting to urinate, which may be accompanied by a feeling of hesitation [9]
• Incomplete Emptying of the Bladder: Feeling that the bladder is not fully emptied after urinating [9]

These symptoms can vary in severity and may worsen over time if left untreated. It's essential for men experiencing these symptoms to consult with their healthcare provider for proper diagnosis and treatment.

References:

[2] - Symptoms include difficulty peeing and a sudden need to pee. [3] - Polyuria, or increased frequency of urination. [7] - Signs and symptoms · Urinary frequency · Urinary urgency · Nocturia- Needing to get up frequently at night to urinate · Hesitancy - Difficulty starting urination [9] - Feb 13, 2023 — difficulty starting urination · a frequent need to urinate · difficulty fully emptying the bladder.

Diagnosing Prostatic Adenoma: A Comprehensive Overview

Prostatic adenoma, also known as benign prostatic hyperplasia (BPH), is a non-cancerous enlargement of the prostate gland. Diagnosing this condition involves a combination of medical history, physical examination, and various diagnostic tests.

• Medical History: Your healthcare provider will ask questions about your symptoms, such as difficulty urinating, weak urine flow, or frequent urination.
• Physical Examination: A digital rectal exam (DRE) is often performed to feel the prostate gland. This can help identify any abnormalities in the texture, shape, or size of the gland.

Diagnostic Tests

Several tests may be used to diagnose prostatic adenoma:

• Urinalysis: A urine test to measure the speed of your pee stream and detect any abnormalities.
• Prostate-Specific Antigen (PSA) Blood Test: Measures the level of PSA in the blood, which can indicate prostate problems.
• Transrectal Ultrasound with Prostate Biopsy: Uses sound waves to create images of the prostate gland and may involve taking a tissue sample for further examination.

Other Diagnostic Tests

Additional tests may be used to confirm diagnosis or assess the severity of symptoms:

• Intravesical Prostatic Protrusion (IPP) and Prostate Volume (PV): Measures the size of the prostate gland.
• Urodynamic Tests: Evaluates how well your bladder is storing and releasing urine.

Gleason Score

If cancer is suspected, a Gleason score may be assigned to determine the aggressiveness of the tumor. This score ranges from 2 to 10, with higher scores indicating more aggressive cancer.

According to [5], tests may include urinalysis NIH external link; prostate tests, such as a prostate-specific antigen (PSA) blood test or prostate biopsy · urodynamic tests.

References:

[1] Sep 24, 2024 — Diagnosis. Your health care provider likely will start by asking questions about your symptoms. [3] Measuring prostate specific antigen (PSA) levels in the blood to screen for prostate cancer is recommended, as well as performing the DRE. [5] Tests may include urinalysis NIH external link; prostate tests, such as a prostate-specific antigen (PSA) blood test or prostate biopsy · urodynamic tests. [9] Diagnosis · a physical exam · a digital rectal exam (DRE) · urine tests, including urinalysis · blood tests, including the prostate-specific antigen (PSA) test.

Treatment Options for Prostatic Adenoma

Prostatic adenoma, also known as benign prostatic hyperplasia (BPH), is a non-cancerous enlargement of the prostate gland that can cause urinary symptoms in men. While there are various treatment options available, drug therapy remains a common approach to manage BPH.

Alpha-Blockers: A Common Treatment Option

Alpha-blockers are a group of medications that work by relaxing the muscles in the prostate and bladder neck, making it easier to urinate [3]. These drugs block alpha receptors (chemical binding sites) in the prostate and bladder, reducing tension on the urethra. Examples of alpha-blockers include tamsulosin (Flomax), silodosin, and alfuzosin.

5-Alpha Reductase Inhibitors: For Enlarged Prostate Glands

For men with larger prostate glands, 5-alpha reductase inhibitors are used to shrink the prostate gland. These medications work by blocking the production of dihydrotestosterone (DHT), a hormone that contributes to prostate growth [4]. Finasteride and dutasteride are two commonly prescribed 5-alpha reductase inhibitors.

Other Treatment Options

While drug therapy is effective for many men, other treatment options may be considered depending on individual circumstances. These include:

• Surgery: In some cases, surgery may be necessary to relieve urinary symptoms or remove the enlarged prostate gland.
• Minimally invasive procedures: Less invasive procedures, such as laser therapy or water vapor ablation, can also be used to treat BPH.

References

[1] Jiwrajka M. (2018). Selective alpha blockers in the treatment of benign prostatic hypertrophy. [Context result 1]

[2] Mar 22, 2023. AUA guidelines for symptomatic treatment of BPH. [Context result 2]

[3] Alpha blockers are a group of BPH medications. They work by blocking alpha receptors (chemical binding sites) in the prostate and bladder. [Context result 3]

[4] 5-alpha reductase inhibitors are used to treat larger prostate glands. They shrink the prostate gland if it's enlarged. Finasteride and dutasteride are the two... [Context result 4]