Prostate Adenoma Treatment in Kyiv – Comfortable and Effective

The development of adenoma is associated with age-related tissue changes and hormonal fluctuations. Additional factors include:

• hereditary predisposition;
• autoimmune and immune disorders;
• hormonal system imbalance;
• chronic diseases of the perineum;
• pelvic organ injuries;
• frequent hypothermia.

The risk increases with smoking, obesity, low physical activity, and alcohol abuse, as well as with past illnesses such as diabetes, stroke, chlamydia, ureaplasmosis, and circulatory disorders.

The symptoms of the disease are mainly associated with urination: it becomes difficult, incomplete, and frequent, sometimes accompanied by mucus, flakes, or traces of blood. The urinary stream becomes weak and intermittent.

To accurately diagnose the disease and distinguish it from prostatitis, the following are used:

• urological examination;
• prostatic fluid analysis;
• urinary tract X-ray;
• contrast-enhanced tomography;
• urethral tissue smear;
• laboratory cytological and bacteriological studies.

As the tissue enlarges, the volume of the prostate gland can increase from 28–30 mm³ to 70 mm³, leading to:

• pressure on the bladder;
• incomplete emptying;
• difficulty urinating;
• formation of benign nodules;
• urolithiasis;
• growth of pathogenic microflora.

This significantly raises the risk of secondary kidney diseases such as cystitis, hydronephrosis, pyelonephritis, and renal failure.

Conservative therapy is used in the early stages of the disease or when symptoms are mild. It includes several approaches:

1. Medication therapy:
   • Alpha-blockers to relieve spasms of the bladder smooth muscles and improve urine flow;
   • 5-alpha-reductase inhibitors to reduce prostate volume and slow disease progression;
   • Anti-inflammatory agents to manage inflammation if present.
2. Lifestyle correction:
   • A diet limiting salty and spicy foods while increasing daily fluid intake;
   • Physical activity and avoidance of prolonged sitting;
   • Quitting smoking and reducing alcohol consumption.
3. Monitoring and observation:
   • Regular urological check-ups and tests to assess treatment effectiveness;
   • If the disease progresses, a switch to minimally invasive or surgical methods may be required.

Conservative treatment helps alleviate symptoms, slow prostate growth, and delay the need for surgery.

Laser enucleation is a minimally invasive procedure for removing enlarged prostate tissue using laser technology. The process involves:

1. Preparation:
   • The patient undergoes a full examination, including ultrasound and laboratory tests;
   • Anesthesia is administered (usually spinal or general);
   • The procedure plan and potential risks are discussed.
2. Procedure:
   • An endoscope with a laser instrument is inserted through the urethra;
   • The doctor separates adenomatous nodules from healthy tissue and removes them;
   • Simultaneously, blood vessels are sealed to minimize bleeding.
3. Postoperative period:
   • A catheter is placed for 1–2 days to restore urine flow;
   • The patient is usually discharged within 1–2 days if stable;
   • Follow-up visits to the urologist are scheduled after 1–2 weeks and again after a month.
4. Advantages:
   • Minimal trauma;
   • Low risk of bleeding;
   • Rapid recovery;
   • Preservation of bladder and sexual function.

Recovery: light physical activity after a few days, follow-up visits at 1–2 weeks and after one month.
This procedure provides long-term results with minimal risk of complications, particularly for middle-aged and older patients.

Surgical intervention is indicated for large prostate sizes, pronounced symptoms, or complications (e.g., urolithiasis). Methods include:

1. Transurethral Resection (TURP):
   • A resectoscope is inserted through the urethra to remove prostate nodules layer by layer;
   • Simultaneous vessel cauterization minimizes bleeding;
   • A catheter is placed for 1–3 days to ensure normal urine flow.
2. Open Adenomectomy:
   • Indicated for large prostate volumes or complications;
   • An incision is made in the lower abdomen to remove adenomatous tissue;
   • A catheter is placed for several days, and hospitalization lasts 5–7 days.
3. Endoscopic Minimally Invasive Surgery:
   • Uses modern endoscopic instruments;
   • Less blood loss and trauma compared to open surgery;
   • Faster recovery period.
4. Postoperative care:
   • Follow-up with a urologist, lab tests, and ultrasound control;
   • Recommendations for bladder function recovery and lifestyle adjustments;
   • Regular check-ups to monitor surgical outcomes.

Advantages of surgical treatment: complete removal of adenomatous nodules, restoration of normal urination, prevention of complications, and suitability for advanced cases.